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Left ventricular systolic time intervals and cardiac hemodynamics during atrial pacing in normal subjects and patients with coronary artery disease



Left ventricular systolic time intervals and cardiac hemodynamics during atrial pacing in normal subjects and patients with coronary artery disease



Acta Cardiologica 34(4): 233-258



The effects of right atrial pacing, at progressively increasing rates, on left ventricular systolic time intervals and cardiac hemodynamics in subjects without manifest cardiac disease and with coronary artery disease are reported. The general response pattern of both groups was very similar and no definite differences were found except for the Q-U interval, which was longer at some pacing frequencies in coronary artery disease. In both groups mean and diastolic arterial pressure, and mean pulmonary artery pressure rose at increasing pacing rates. A progressive fall in arterial pulse pressure, stroke index, stroke work index, mean ejection rate index, left ventricular ejection time and the Q-A2 interval occurred with increasing cardiac frequencies. Cardiac index and left ventricular minute work index increased slightly at intermediate but fell at the highest pacing rates. Q-U interval revealed only minor changes. Tension time index generally increased with higher heart rates but fell at peak frequencies in some patients with coronary artery disease. Tension time index was not the only factor determining the appearance or persistence of angina pectoris. Heart rate and left ventricular performance at rest might influence the heart rate at which angina appears during atrial pacing in patients with coronary heart disease. Sublingual nitroglycerin administration during angina, elicited by uninterrupted atrial pacing, was followed by a definite fall in mean pulmonary artery pressure, systemic arterial pressure, cardiac index and related variables but no significant changes in left ventricular systolic time intervals were observed.

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Accession: 005801691

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PMID: 116462


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