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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Importance of AV synchronous pacing during low intensity exercise evaluated by oxygen kinetics.
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Importance of AV synchronous pacing during low intensity exercise evaluated by oxygen kinetics.

机译：通过氧气动力学评估低强度运动时AV同步起搏的重要性。

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It has been shown that dual chamber pacing with preservation of AV synchrony (DDD) is superior to fixed rate ventricular (VVI) or rate responsive ventricular (VVIR) pacing modes, as evaluated by ventilatory response to exercise. Previous studies have focused on the benefits of maintained AV synchrony at maximal exercise. However, there are limited data comparing O2 kinetics in different pacing modes during low intensity exercise, representing the majority of daily activities. This study aimed to provide an evaluation of different pacing modes using O2 kinetics during low intensity exercise. Nineteen patients (age 61 +/- 18 years) with complete AV block underwent low intensity treadmill exercise (35 W) with simultaneous evaluation of symptoms and O2 kinetics in three pacing modes. The first test was performed in DDD mode followed by a second test in VVIR mode with a programmed heart rate corresponding to the sinus rate during the first test. After 6 minutes of each test, the mode was switched from DDD to VVIR and vice versa. The third test was performed in VVI mode at 70 beats/min. O2 kinetics were defined as O2 deficit (time [rest to steady state] x delta VO2-sigma VO2 [rest to steady state]) and mean response time (MRT) of oxygen consumption (O2 deficit/delta VO2). The O2 deficit was 551 +/- 134 mL in DDD pacing, 634 +/- 139 mL in VVIR pacing, and 648 +/- 179 mL in VVI pacing (P = 0.001). MRT was 49 +/- 7.8 seconds in DDD pacing, 54.7 +/- 9.5 seconds in VVIR pacing, and 57.4 +/- 11.0 seconds in VVI pacing (P = 0.002). Ten (53%) patients developed symptoms during switch from DDD to VVIR mode whereas the switch from VVIR to DDD mode was not perceived by any patient (P < 0.001). In conclusion, our study shows an impact of AV synchronous pacing and heart rate adaptation on O2 kinetics during low intensity exercise that correspond to casual daily life activities. Our observations may have clinical implications for the management of patients with complete AV block.
机译：通过运动对呼吸机的反应评估，具有房室同步性（DDD）的双室起搏优于固定速率的心室（VVI）或速率反应性心室（VVIR）起搏模式。先前的研究集中在最大运动量时保持房室同步的好处。但是，在低强度运动期间，比较不同起搏模式下的O2动力学的数据有限，代表了大多数日常活动。这项研究旨在通过低强度运动期间使用氧气动力学评估不同的起搏模式。 19例完全性房室传导阻滞患者（61 +/- 18岁）接受了低强度跑步机运动（35 W），同时以三种起搏模式同时评估了症状和O2动力学。第一次测试是在DDD模式下执行的，然后是第二次在VVIR模式下进行的测试，其编程的心率对应于第一次测试期间的窦率。每次测试6分钟后，将模式从DDD切换到VVIR，反之亦然。第三次测试是在VVI模式下以70次/分钟的速度进行的。 O2动力学定义为O2不足（时间[静止状态] x VO2-sigma VO2δ[静止]）和耗氧量的平均响应时间（MRT）/ O2缺乏/ delta VO2。在DDD起搏器中O2缺乏量为551 +/- 134 mL，在VVIR起搏器中为634 +/- 139 mL，在VVI起搏器中为648 +/- 179 mL（P = 0.001）。在DDD起搏中，MRT为49 +/- 7.8秒，在VVIR起搏中为54.7 +/- 9.5秒，在VVI起搏中为57.4 +/- 11.0秒（P = 0.002）。十名（53％）患者在从DDD切换到VVIR模式期间出现症状，而任何患者均未察觉从VVIR切换到DDD模式（P <0.001）。总之，我们的研究表明，在低强度运动中，AV同步起搏和心率适应对O2动力学的影响与日常休闲活动相对应。我们的观察结果可能对完全性房室传导阻滞患者的治疗具有临床意义。

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