Echocardiography for determining the optimal atrioventricular interval in patients with dual chamber pacemakers.
BACKGROUND
We investigated the clinical value of Doppler echocardiography for determining the optimal setting of atrioventricular interval in patients with dual chamber pacemakers (DDD). In 38 patients with complete atrioventricular block and DDD pacemakers, the atrioventricular interval was prolonged in a stepwise fashion by 20 ms, from 90 to 250 ms, and cardiac stroke volume and transmitral flow were measured by pulsed Doppler echocardiography.


METHODS
The optimal atrioventricular interval at which the cardiac stroke volume was maximal was 168.9 +/- 15.6 ms. The atrioventricular interval was 178.4 +/- 23.4 ms when the end of the A wave coincided with complete closure of the mitral valve.


RESULTS
There was a significant linear relationship between the optimal atrioventricular interval and the predicted optimal atrioventricular interval (Y = 86.2 +/- 0.5X, r = 0.70, standard error of the estimate [SEE] = 11.5, P < 0.01).


CONCLUSIONS
The optimal atrioventricular interval setting for DDD pacing can be successfully determined using Doppler echocardiography, which is a noninvasive, repeatable, and simple approach.
Sun
Pin
P
Department of Cardiac Ultrasound, Affiliated Hospital of Medical College, Qingdao University, Qingdao City, China. sunnysunpin@163.com
Zhao
Qing
Q
Wang
Zhi-Bin
ZB
Li
Jian-Sheng
JS
Wo
Jin-Shan
JS
Cai
Shang-Lang
SL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D016275:Atrial Function; D054537:Atrioventricular Block / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects; D018619:Echocardiography, Doppler, Pulsed; D004867:Equipment Design; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D009200:Myocardial Contraction; D010138:Pacemaker, Artificial; D011237:Predictive Value of Tests; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016276:Ventricular Function
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