Effect of pacemaker implantation on clinical course of ischemic heart disease and choice of optimal pacing parameters
Iskenderov, B.G.; Vakina, T.N.
Kardiologiia 45(2): 7-10
2005
ISSN/ISBN: 0022-9040 PMID: 15798697 Document Number: 587127
Effect of cardiac pacing on clinical course of ischemic heart disease was assessed in 154 patients with class II-IV angina pectoris with implanted pacemakers. Improvement of symptoms (decrease of number of anginal attacks, increase of exercise tolerance, reduction of number and doses of antianginal drugs) occurred in 72 patients (46.8%). In 30 patients (19.5%) increase of frequency of angina was accompanied with changed character, localization and duration of attacks as well as response to nitroglycerin. This was believed to be caused by augmented myocardial oxygen consumption due to 1.5-2 fold heart rate elevation during pacing and psychocardial syndrome. In 52 patients (33.8%) pacing was not associated with any changes of character of angina. It was shown that reprogramming of pacing parameters aimed at optimization of coronary reserve should be performed with consideration of angina class and presence of chronic heart failure. Optimal pacing rate was supposed to be 55-65 and 75-85 per min in patients with low coronary reserve and heart failure, respectively.