Chronotropic competence in patients with the sick sinus syndrome wearing AAI or DDD pacemakers

The prevalence of chronotropic incompetence in patients with sinus node disease (SND) is not well defined. To assess this, we evaluated 18 patients (7 men, 11 women; mean age: 64 +/- 11) with SND and permanent pacemakers (AAI/DDD) with Holter monitoring and treadmill stress test. Only 2 patients rec...

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Bibliographic Details
Published inRevista española de cardiologia Vol. 46; no. 6; p. 335
Main Authors Goicolea de Oro, A, Márquez, L, López Gil, M, Kallmeyer, C, Chicote, R, García-Cosío, F
Format Journal Article
LanguageSpanish
Published Spain 01.06.1993
Subjects
Aged
Electrocardiography, Ambulatory - statistics & numerical data
Equipment Design
Exercise Test - statistics & numerical data
Female
Heart Rate
Humans
Male
Middle Aged
Pacemaker, Artificial - statistics & numerical data
Physical Exertion
Sick Sinus Syndrome - physiopathology
Sick Sinus Syndrome - therapy
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Summary:The prevalence of chronotropic incompetence in patients with sinus node disease (SND) is not well defined. To assess this, we evaluated 18 patients (7 men, 11 women; mean age: 64 +/- 11) with SND and permanent pacemakers (AAI/DDD) with Holter monitoring and treadmill stress test. Only 2 patients received active cardiac drugs (1, L-dopa an 1 propafenone). The treadmill tests results were compared with a control group of 15 men and 18 women (mean age: 66 +/- 5, p = NS) without organic heart disease. During ambulatory activity all pacemaker patients increased their own cardiac rate to a value higher than the programmed basic pacemaker rate. In 8 patients the maximal rate attained was over 100/min (mean 95 +/- 19/min). The maximal rate during treadmill test in pacemaker patients was 131 +/- 25 (control group 138 +/- 14, p = NS). Exercise tolerance in METs was similar in pacemaker patients (5.2 +/- 2.6) and in controls (5.8 +/- 1.2) (p = NS). Two pacemaker patients (12%) didn't reach 100/min during stress test. Most patients with SND and permanent pacemakers (AAI/DDD) are able to increase cardiac rate during exercise. Rate responsive pacing (AAIR/DDDR) should be limited to a minority of patients with true chronotropic incompetence.
ISSN:0300-8932