Copyright © 1992 by the European Society of Cardiology.
© 1992 The European Society of Cardiology
Total sympathetic activity and atrial natriuretic factor levels in VVI and DDD pacing with different atrioventricular delays during daily activity and exercise
From the Cardiac Departments of Athens General, Hippocratio and Eginitio Hospitals, Athens University Greece
Received 6 November 1990; revised 23 October 1991; .
Correspondence: Dr George Theodorakis, Davaki 34, 174 55 Alimos, Athens, Greece
Abstract
The purpose of the study was to assess at rest and during exercise total sympathetic activity, as expressed by plasma cyclic AMP (cAMP) blood levels and sinus node activity (SNA), as well as atrial natriuretic factor (ANF) blood levels in VVI and DDD pacing with long and short atrioventricular delays in DDD paced patients suffering from complete heart block. Clinical parameters, such as exercise time, and arterial blood pressure (ABP) were also taken into consideration. Thirteen patients (six males, mean age 65 ±2 years), were examined randomly in VVI and DDD pacing with 100 and 150ms atrioventricular delays (A VD). Plasma cAMP and A NF were measured at rest, at peak exercise and 15 and 30 min after the test. The cAMP at rest remained unchanged whatever the pacing mode or the AVD, but 30 min after exercise, the cAMP levels were statistically lower in DDD pacing with short AVD (100 ms) than in DDD with long AVD (150 ms) or VVI pacing (cAM P DDD/100 ms: 16 ±0·8 pmol. Ml–1, cAMP DDD/150 ms: 20 ±2 pmol .ml–1 , P<0·01 .cAMP VVI: 29 pmol. Ml–1, P<0·00l). ANF plasma levels at rest were significantly higher in VVI pacing than in DDD modes, with either long or short AVD (ANF DDD/100 ms: 93 ± 10 pg . ml–1, ANF DDD/150 ms: 100±13pg .ml–1, ANF VVI: 150± 16 pg .ml–1, P< 0·007, P<0·03 respectively compared to VVI).
During exercise ANF release was statistically lower in DDD with 100 or 150 ms AVD, than in VVI pacing mode (ANF DDD/100ms: 124±15 pg .ml–1, ANF DDD/150 ms: 128±14 pg .ml–1, VVI: 182± 17 pg . ml–1, P<0·0002 and P<0·02 respectively compared with VVI pacing). Fifteen minutes after exercise the ANF levels in DDD pacing with 100 ms AVD were statistically lower than in DDD pacing with 150 ms AVD (DDD/100 ms: 94 ±10pg. ml–1 and DDD/ 150ms: 112± 11 pg . ml–1, P<0·04). Also, in VVI pacing the ANF levels remained statistically higher than in DDD pacing with either 100 ms or 150 ms AVD.
Exercise lime was longer in DDD pacing with short AVD, than in VVI pacing (DDD/100ms: 14·8± 1·5min, VVI: 12·6±1·7min, P<0·05); sinus mode activity at rest was higher in VVI pacing than in DDD (DDD/100ms: 76 ±3 b . min–1, VVI: 91 ±4 b . min–1, P <0·01; maximum ABP during peak exercise test was lower in VVI pacing, than in DDD pacing (DDD/100ms: 175±8mmHg, VVI: 152±9mmHg, P<0·01).
These results suggest the superiority of DDD pacing and also that the adaptation of AvD during DDD pacing may favour a more physiological pacing mode.
Key Words: Cyclic AMP • atrial natriuretic factor • cardiac pacing • AV synchrony • AV adaptation
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. A. Zullo Characteristics of the Acute Rise of Atrial Natriuretic Factor During Ventricular Pacing* Chest, June 1, 2002; 121(6): 1942 - 1946. [Abstract] [Full Text] [PDF]
|
|