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European Heart Journal 1992 13(7):908-913;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Ventricular rate-adaptive pacing in the elderly

C.-P. LAU, C. K. WONG, Y. T. TAI, P. C. FONG, J. P.-S. LI and F. L. W. CHUNG

Division of Cardiology, University Department of Medicine, Queen Mary Hospital, University of Hong Kong

Received 21 August 1991; revised 11 November 1991; .

Correspondence- Dr C P. Lau, Senior Lecturer in Cardiology, Division of Cardiology, University Department of Medicine, Queen Mary Hospital, University of Hong Kong.

Abstract

The role of ventricular rate-adaptive pacing ( VVIR) in the elderly was investigated in 12 patients with a mean age of 85 ± 2 years (range 75–95 years) with implanted activity-initiated VVIR pacemakers. Although four patients had significant extracardiac diseases, all were capable of independent walking and self care. The pacing rate achieved during structured daily activities (walking, climbing stairs, washing, bed-making and scrubbing floors) were compared with those achieved by 10 age-matched healthy subjects. Apart from the more strenuous activities (ascending stairs and floor-scrubbing), the pacing rates achieved by the patients were comparable to those of the healthy subjects and occurred within an appropriate time. In a 4-weekly randomized, double-blind crossover protocol in the VVI and VVIR pacing modes, all patients underwent assessments in a 12-min walking distance test, a 24 h non-invasive ambulatory blood pressure recording and a symptomatic documentation. During VVIR pacing, the 12-min walking distance was significantly improved compared to VVI pacing (556 ± 52 vs. 545 ±55 m, P< 0.05). There was no difference between the recorded blood pressure and symptom scores between the two pacing modes, although most patients preferred VVIR pacing (P< 0.05). It is concluded that VVIR pacing in this elderly population can improve exercise capacity, and the patients' preference for the VVIR mode was documented despite the absence of a measurable difference in symptomatology.

Key Words: Geriatric • rate-responsive pacing


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