International Medical Journal, Vol. 23., Iss. 3, 2017, P. 11−15.
PULSE PRESSURE CLASSES AND PACING PARAMETERS IN PATIENTS AT THE ANNUAL STAGE AFTER IMPLANTATION
V. N. Karazin Kharkiv National University
V. T. Zaytsev Institute of General and Emergency Surgery (NAMS of Ukraine), Kharkiv, Ukraine
Permanent pacing is the standard treatment of patients with heart rhythm disorders such as bradyarrhythmia and chronic heart failure. One of its positive effects is to improve the pumping function of the heart, which affects the blood pressure increase. With the increase in systolic blood pressure (SBP) the pulse pressure (PP) increases, which adversely affects hemodynamic, elastic properties of the main vessels and the function of the left ventricle (LV) and, in turn, requires modification of drug therapy. Setting and checking ECG parameters is an important task in the correct programming of the device, which, however, can affect the SBP, PP and heart rate. In the above article pacing parameters in five PP classes (very low PP −− less than 20 mm Hg, low PP −− from 20 to 40 mm Hg, normal PP −− from 40 to 60 mm Hg, high PP −− from 60 to 80 mm Hg, very high PP −− more than 80 mm Hg) in 201 patients at the annual stage after implantation of the pacemaker were studied. In the early postoperative period (3ЃE days) after 6 months and a year after implantation in DDD (R), VVI (R) modes and drug therapy, pacing parameters were evaluated depending on PP class: basic pacing rate, stimulation percentage of the right ventricle (RV) and LV, the impedance and the amplitude of the LV and RV electrodes and the detected and stimulated AV−delay. Parameters data were measured with the help of programmers to the implanted devices Medtronic, Vitatron, Sorin, St. Jude Medical. Average base frequency of stimulation was 62 beats per min in all PP classes at all stages of follow−up after pacemaker implantation. Reduction in impedance and amplitude of the LV and RV electrodes in all PP classes in VVI(R) and DDD(R) pacing modes, increase of the detected and stimulated AV−delay −− in class V and tendency to reduction in PP class III after pacemaker implantation in DDD(R) pacing mode were observed. Additional optimization of the passing parameters in patients with II, IV and V PP classes during first year after implantation is required.
Key words: pulse pressure, permanent pacing, pacing parameters.