Physiological Principles of a New Method for Rate Responsive Pacing Using the Pre-ejection Interval
The pre‐ejection interval (PEI) was measured in 30 patients during isotonic and isometric exercise, emotional stress, isoproterenol infusion, Valsalva maneuver, carotid massage, atropine injection and incremental pacing. In patients with complete AV block, the simultaneous atrial rate was used as a...
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| Veröffentlicht in: | Pacing and clinical electrophysiology 1988-11, Vol.11 (11), p.1545-1554 |
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| description | The pre‐ejection interval (PEI) was measured in 30 patients during isotonic and isometric exercise, emotional stress, isoproterenol infusion, Valsalva maneuver, carotid massage, atropine injection and incremental pacing. In patients with complete AV block, the simultaneous atrial rate was used as a standard of comparison to assess the changes observed in PEI. The sensitivity, specificity, proportionality and speed of response were evaluated to determine the applicability of PEI for rate responsive pacing. PEI shortened promptly and proportionately to atrial cycle length with isotonic and isometric exercise, emotional stress, and isoproterenol (R values from 0.88 to 0.98, p < 0.001). It was neither affected by preload changes (Valsalva) nor by parasympathetic system (carotid massage and atropine). Incremental pacing had no effect in most of the patients but some showed a slight prolongation, similarly to what is observed with atrial cycle length. It is concluded that PEI is suitable for rate control in physiologically adaptive pacemakers. |
| doi_str_mv | 10.1111/j.1540-8159.1988.tb06272.x |
| format | Article |
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In patients with complete AV block, the simultaneous atrial rate was used as a standard of comparison to assess the changes observed in PEI. The sensitivity, specificity, proportionality and speed of response were evaluated to determine the applicability of PEI for rate responsive pacing. PEI shortened promptly and proportionately to atrial cycle length with isotonic and isometric exercise, emotional stress, and isoproterenol (R values from 0.88 to 0.98, p < 0.001). It was neither affected by preload changes (Valsalva) nor by parasympathetic system (carotid massage and atropine). Incremental pacing had no effect in most of the patients but some showed a slight prolongation, similarly to what is observed with atrial cycle length. 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In patients with complete AV block, the simultaneous atrial rate was used as a standard of comparison to assess the changes observed in PEI. The sensitivity, specificity, proportionality and speed of response were evaluated to determine the applicability of PEI for rate responsive pacing. PEI shortened promptly and proportionately to atrial cycle length with isotonic and isometric exercise, emotional stress, and isoproterenol (R values from 0.88 to 0.98, p < 0.001). It was neither affected by preload changes (Valsalva) nor by parasympathetic system (carotid massage and atropine). Incremental pacing had no effect in most of the patients but some showed a slight prolongation, similarly to what is observed with atrial cycle length. It is concluded that PEI is suitable for rate control in physiologically adaptive pacemakers.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atropine</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Carotid Sinus - physiology</subject><subject>Electrocardiography</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Heart - physiology</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Isoproterenol</subject><subject>isotonic and isometric exercise</subject><subject>Male</subject><subject>Middle Aged</subject><subject>pre-ejection interval</subject><subject>rate responsive pacing</subject><subject>Stress, Psychological - physiopathology</subject><subject>Stroke Volume</subject><subject>Time Factors</subject><subject>Valsalva Maneuver</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkE1v2zAMhoViQ5d1_QkDhB12s6cP68M7rQu6rkObBUGLHgVZphtljpVJTpv8-9lIkPt4IAG-5EviQegTJTkd4ssqp6IgmaaizGmpdd5XRDLF8t0ZmpykN2hCaKEyzXX5Dr1PaUUIkaQQ5-icFZIxrifIzZf75EMbnr2zLZ5H3zm_aSHh0GCLZ_CK76Ffhho3IeKF7QEvIG1Cl_wL4Ll1vnvGj2nM_XJoRMhgBa73ocO3XQ_xxbYf0NvGtgkuj_UCPf64fpj-zO5-39xOr-4yV5BSZI7IQukGeKWJlNJprXldq8bKAqTVSgioKStpVTtnOWMN1ZpYXQlgXFkt-AX6fPDdxPB3C6k3a58ctK3tIGyTUVpoNpAZBr8eBl0MKUVozCb6tY17Q4kZCZuVGTGaEaMZCZsjYbMblj8er2yrNdSn1SPSQf920F99C_v_cDbzq-n1II7_ZQcLn3rYnSxs_GOk4kqYp9mNuaeL4vts8cuU_B_ayJsy</recordid><startdate>198811</startdate><enddate>198811</enddate><creator>CHIRIFE, RAUL</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198811</creationdate><title>Physiological Principles of a New Method for Rate Responsive Pacing Using the Pre-ejection Interval</title><author>CHIRIFE, RAUL</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4095-c06478fe3b80666c8883dd7fa64e6a8755ed1291bdcca322f1880a8b5e237a853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1988</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atropine</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Carotid Sinus - physiology</topic><topic>Electrocardiography</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Heart - physiology</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Isoproterenol</topic><topic>isotonic and isometric exercise</topic><topic>Male</topic><topic>Middle Aged</topic><topic>pre-ejection interval</topic><topic>rate responsive pacing</topic><topic>Stress, Psychological - physiopathology</topic><topic>Stroke Volume</topic><topic>Time Factors</topic><topic>Valsalva Maneuver</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CHIRIFE, RAUL</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pacing and clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CHIRIFE, RAUL</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Physiological Principles of a New Method for Rate Responsive Pacing Using the Pre-ejection Interval</atitle><jtitle>Pacing and clinical electrophysiology</jtitle><addtitle>Pacing Clin Electrophysiol</addtitle><date>1988-11</date><risdate>1988</risdate><volume>11</volume><issue>11</issue><spage>1545</spage><epage>1554</epage><pages>1545-1554</pages><issn>0147-8389</issn><eissn>1540-8159</eissn><abstract>The pre‐ejection interval (PEI) was measured in 30 patients during isotonic and isometric exercise, emotional stress, isoproterenol infusion, Valsalva maneuver, carotid massage, atropine injection and incremental pacing. In patients with complete AV block, the simultaneous atrial rate was used as a standard of comparison to assess the changes observed in PEI. The sensitivity, specificity, proportionality and speed of response were evaluated to determine the applicability of PEI for rate responsive pacing. PEI shortened promptly and proportionately to atrial cycle length with isotonic and isometric exercise, emotional stress, and isoproterenol (R values from 0.88 to 0.98, p < 0.001). It was neither affected by preload changes (Valsalva) nor by parasympathetic system (carotid massage and atropine). Incremental pacing had no effect in most of the patients but some showed a slight prolongation, similarly to what is observed with atrial cycle length. It is concluded that PEI is suitable for rate control in physiologically adaptive pacemakers.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>2462238</pmid><doi>10.1111/j.1540-8159.1988.tb06272.x</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0147-8389 |
| ispartof | Pacing and clinical electrophysiology, 1988-11, Vol.11 (11), p.1545-1554 |
| issn | 0147-8389 1540-8159 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent Adult Aged Aged, 80 and over Atropine Cardiac Pacing, Artificial - methods Carotid Sinus - physiology Electrocardiography Exercise Test Female Heart - physiology Heart Rate Humans Isoproterenol isotonic and isometric exercise Male Middle Aged pre-ejection interval rate responsive pacing Stress, Psychological - physiopathology Stroke Volume Time Factors Valsalva Maneuver |
| title | Physiological Principles of a New Method for Rate Responsive Pacing Using the Pre-ejection Interval |
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