Both a rapid and irregular ventricular response to atrial fibrillation may produce adverse hemodynamic effects and symptoms. Stabilization of ventricular response in patients with atrial fibrillation may be achieved by ventricular pacing. The aim of the study was to assess hemodynamic effect of right ventricular pacing in patients ( pts ) with VVI Biotronik Actros S pacemaker and chronic atrial fibrillation (chAF). Methods: 32 pts ( 15 males.I 7 females; mean age 70,2 +/9 years with VVI pacemaker and chAF were studied. Patients were studied at the each of tv.'o modes: VVI 40 beats/rain without pacing during ECHO examination (control AF pts) and 80 beats/min -with 100% pacing during Doppler studying ( VRS pts ). Continuous ECHO Doppler ,,,'ave of aortic outflow with mean velocity time integral ( VT1 ) , mean stroke volume ( SV ), mean cardiac output ( CO ) and mean cardiac index ( Cl ) from the five RR cycles were measured at each of the two modes in eve~ one patient. Five minutes intervals after a pacing mode reprogramming were allowed for the heart stabilization. Results: There were no significantly differences in VTI (cm): control AF pts=22,2 +/5,7 ; VRS pts = 22,1 +/5,8 (NS) and SV ( ml ): control AF pts =77,2 +/32,5 ; VRS pts = 74.1 +/26.2 (NS). Patients due to heart rate stabilization ( VRS pts ) 100% pacing during ECHO performing with mean heart rate 80/rain. achieved significantly higher rate dependent hemodynamic parameters: CO (I/mira): VRS pts = 5,75 +/1,2 ; control AF pts = 4,25 +/0,9 ( p.<O.05) and Cl (I/rain/m2): VRS pts = 3,62 +/1,2 ; control AF pts = 2,94 +/0,8 (p.<0,05). Conclusions: I.Right veutricular pacing 80/min due to heart rate stabilization in resting patients with chronic AF in resting state significantly increases rate dependant hemodynamic parameters..2.Selection of the most heraodynamic appropriate pacing rate during daily activities should be tested in future studies. NIGHT HEART RATE PROGRAMMING COULD IT CHANGE VENTRICULAR ARRHITHIMIA DENSITY IN PATIENTS WITH W I SYSTEM? AS Menezes Jr.; APM Nascente; BW Calac, a; GM Silveira; HPP Gama. Research Center of Santa Helena Hospital, Goi~nia, GO, Brazil.
Read full abstract