The A-R Interval as Exercise Indicator: A New Option for Rate Adaptation in Single and Dual Chamber Pacing

RUITER, J.H., ET AL.: The A‐R Interval as Exercise Indicator: A New Option for Rate Adaptation in Single and Dual Chamber Pacing. We investigated the possibility to use the interval from an atrial stimulus to the Ventricular R wave [A‐R interval) as an indicator of physical stress, in 16 patients wi...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 1990-12, Vol.13 (12), p.1656-1665
Main Authors: RUITER, JAAP H., BOER, HANS DE, BEGEMANN, MALCOLM J.S., MECHELEN, ROB VAN
Format: Article
Language:English
Subjects:
A-R interval
Adult
Aged
Aged, 80 and over
Arrhythmias, Cardiac - drug therapy
Arrhythmias, Cardiac - physiopathology
Arrhythmias, Cardiac - therapy
Atrioventricular Node - physiopathology
AV nodal Wenckebach block
Electrocardiography
exercise stress test
Exercise Test
Female
Heart Rate
Humans
Male
Middle Aged
Pacemaker, Artificial
rate adaptive pacing
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Summary:RUITER, J.H., ET AL.: The A‐R Interval as Exercise Indicator: A New Option for Rate Adaptation in Single and Dual Chamber Pacing. We investigated the possibility to use the interval from an atrial stimulus to the Ventricular R wave [A‐R interval) as an indicator of physical stress, in 16 patients with pacemakers implanted for severe atrial bradycardia but with intact AV conduction. The A‐R interval was studied during incremental atrial pacing at rest and during exercise with a constant workload. In addition, the atrial pacing rate was kept constant just above spontaneous sinus rate and the dynamics of the A‐R interval were studied during exercise with a low constant workload and during a maximal exercise test with increasing workload. Incremental atrial pacing prolonged the A‐R interval and this response was blunted during exercise [p < 0.003). Atrial pacing at a constant rate and during a constant workload resulted in an almost direct shortening of the A‐R interval. When the workload was increased but the atrial rate kept constant, a pronounced shortening of the A‐R interval was noted [p < 0.0001). It is concluded that changes of the A‐R interval during different kinds of exercise were prompt and predictable in patients with sinus node dysfunction but intact AV conduction. In these patients the shortening of the A‐R interval during exercise may be a suitable indicator for rate adaptive atrial pacing.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.1990.tb06868.x