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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >The optimal pacing rate: an unpredictable parameter.
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The optimal pacing rate: an unpredictable parameter.

机译：最佳起搏速度：不可预测的参数。

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摘要

A three phase relation has been demonstrated between increasing heart rate and cardiac output at rest. Phase I with cardiac output increasing with increasing heart rate, phase II a plateau, and phase III decreasing cardiac output with any further increase in heart rate. The "optimal rate" can be defined as the heart rate at the onset of phase II. Twenty patients were studied, 13 male, mean age 60 years (range 31-71 years). All had chronic complete heart block and established DDD pacing. A maximal exercise test was performed to determine peak sinus rate. Exercise hemodynamics were measured using an ambulatory monitor (Capintec Vest), which permits measurement of relative cardiac output and relative ejection fraction. The patients were programmed to VVI pacing at a rate of 60 beats/min and performed three exercise tests at different workloads. The order of workloads was randomized and selected from a range (0, 25, 50, or 75 W) depending on fitness. After 3-minute stabilization, the VVI pacing rate was increased at 1-minute intervals until higher than peak sinus rate giving a total exercise time of 12 minutes. The "optimal rate band" was determined at each workload. The mean of this "optimal rate band" for each workload varied in a nonlinear manner. There was no correlation between mean optimal rate formula. Current definitions of chronotropic incompetence are inaccurate. Are some of these people at their "optimal rate" already? The arbitrary selection of rate response curves on age related criteria may lead to an impaired hemodynamic response.
机译：已证明心率增加与静息心输出量之间存在三相关系。随着心率增加，I期心输出量增加，II期达到平稳，III期心输出量减少，心率进一步增加。可以将“最佳速率”定义为II期开始时的心率。研究了20位患者，其中13位男性，平均年龄60岁（范围31-71岁）。所有患者均患有慢性完全性心脏传导阻滞并建立起DDD起搏。进行最大运动测试以确定峰值窦率。使用动态监测仪（Capintec Vest）测量运动血流动力学，该监测仪可测量相对心输出量和相对射血分数。患者被编程为以60次/分钟的速度进行VVI起搏，并在不同的工作量下进行了三个运动测试。工作负载的顺序是随机的，并根据适合程度从一个范围（0、25、50或75 W）中选择。稳定3分钟后，以1分钟为间隔增加VVI起搏速度，直到高于峰值窦窦速度，总运动时间为12分钟。在每个工作负载下确定“最佳速率带”。每个工作负载的“最佳速率带”的平均值以非线性方式变化。平均最佳利率公式之间没有相关性。当前对变时性无能的定义是不准确的。这些人中有些人已经达到了“最优速度”吗？在与年龄有关的标准上随意选择速率反应曲线可能会导致血液动力学反应受损。

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