Skip to main content

Doppler echocardiography and cardiac pacing

  • Chapter
  • 60 Accesses

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 96))

Abstract

The ability of Doppler echocardiography to evaluate changes in flow non-invasively on a beat to beat basis has made it quite valuable as a means of evaluating pacemaker physiology. Combined Doppler echocardiographic studies of the left atrium and mitral inflow have been used to evaluate left atrial size and function [1, 2] while Doppler echocardiographic studies of aortic flow velocity have been used to evaluate the effect of different pacing modes or different AV intervals on resting stroke volume [1, 3–10]. These studies are useful in evaluating patients for ventricular versus dual chamber pacemakers, and for optimizing the AV interval in patients who have received dual chamber pacemakers. Doppler echocardiographic studies can also be used to document atrial capture [11] to exclude pacemaker induced valvular regurgitation [3] and to investigate the hemodynamic alterations in patients with the pacemaker syndrome. This chapter will review the role that combined Doppler echocardiographic studies have played in improving our understanding of pacemaker physiology, and the clinical applications of these techniques.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Labovitz AJ, Williams GA, Redd RM, Kennedy HL: Noninvasive assessment of pacemaker hemodynamics by Doppler echocardiography: importance of left atrial size. J Am Coll Cardiol, 6:196–200, 1985.

    Article  PubMed  CAS  Google Scholar 

  2. Iwase M, Sotobata I, Yokota M, et al: Evaluation by pulsed Doppler echocardiography of the atrial contribution to left ventricular filling in patients with DDD pacemakers. Am J Cardiol, 58:104–9, 1986.

    Article  PubMed  CAS  Google Scholar 

  3. Zugibe F, Nanda NC, Barold SS, Akiyama T: Usefulness of Doppler echocardiography in cardiac pacing: assessment of mitral regurgitation, peak aortic flow velocity and atrial capture. PACE, 6:1350–7, 1983.

    PubMed  Google Scholar 

  4. Nanda NC, Bhandari A, Barold SS, Falkoff M: Doppler echocardiographic studies in sequential atrioventricular pacing. PACE, 6: 811–4, 1983.

    PubMed  CAS  Google Scholar 

  5. Stewart WJ, Dicola VC, Harthorne JW, et al: Doppler ultrasound measurement of cardiac output in patients with physiologic pacemakers. Am J Cardiol, 54: 308–12, 1984.

    Article  PubMed  CAS  Google Scholar 

  6. Forfang K, Otterstad JE, Ihlen H: Optimal atrioventricular delay in physiologic pacing determined by Doppler echocardiography. PACE, 9:17–20, 1985.

    Google Scholar 

  7. Faerestrand S, Ohm OJ: A time-related study of the hemodynamic benefit of atrioventricular synchronous pacing evaluated by Doppler echocardiography. PACE, 8: 838–48, 1985.

    PubMed  CAS  Google Scholar 

  8. Halperin JL, Teichholz LE, Steinmetz MY, et al: Selection of patients for dual-chamber pacing by noninvasive means: the VVI-variance index. Circulation, 70: II–409, 1984. (Abstract).

    Google Scholar 

  9. Halperin JL, Rothlauf EB, Stern EH, et al: Pulsed-Doppler echocardiographic assessment of hemodynamic function during dual-chamber cardiac pacing. Circulation, 68: III–379, 1983. (Abstract).

    Article  Google Scholar 

  10. Kafka W, Holdebrandt U, Delius W: Hemodynamic advantage of AV-sequential pacing with respect to the AV-delay. PACE, 8: A-38, 1985. (Abstract).

    Google Scholar 

  11. Switzer DF, Nanda NC: Doppler-echocardiographic assessment of cardiac pacemakers. Cardiol Clin, 3: 631–53, 1985.

    PubMed  CAS  Google Scholar 

  12. Tscheliessnigg KH, Stenzl W, Dacar D: Hemodynamic importance of a constant AV delay. PACE, 8: A-38, 1985. (Abstract).

    Google Scholar 

  13. Ausubel K, Furman S: The pacemaker syndrome. Annals Int Med, 103:420–9, 1985.

    CAS  Google Scholar 

  14. Maurer G, Torres MAR, Corday E, et al: Two-dimensional echocardiographic contrast assessment of pacing-induced mitral regurgitation: relation to altered regional left ventricular function. J Am Coll Cardiol, 3: 986–91, 1984.

    Article  PubMed  CAS  Google Scholar 

  15. Judy WV, Hall JH: Non-invasive analysis of pacemaker induced cardiodynamics. Circulation, 70:II–408, 1984. (Abstract).

    Google Scholar 

  16. Miyatake K, Okamoto M, Kinoshita N, et al: Augmentation of atrial contribution to left ventricular inflow with aging as assessed by intracardiac Doppler flowmeter. Am J Cardiol, 53:586–89, 1984.

    Article  PubMed  CAS  Google Scholar 

  17. Gardin JM, Tobis JM, Dabestani A, et al: Superiority of two-dimensional measurement of aortic vessel diameter in Doppler echocardiographic estimates of left ventricular stroke volume. J Am Coll Cardiol, 6:66–74, 1985.

    Article  PubMed  CAS  Google Scholar 

  18. Huntsman LL, Stewart DK, Barnes SR, et al: Noninvasive Doppler determination of cardiac output in man. Circulation, 67: 593–601, 1983.

    Article  PubMed  CAS  Google Scholar 

  19. Schuster AH, Nanda NC: Doppler echocardiography: Part I: Doppler cardiac output measurements: Perspective and comparison with other methods of cardiac output determination. Echocardiography: A Review of Cardiovascular Ultrasound, 1: 45–54, 1984.

    Google Scholar 

  20. Lewis JF, Kuo LL, Nelson JG, et al: Pulsed Doppler echocardiographic determination of stroke volume and cardiac output: Clinical validation of two new methods using the apical window. Circulation, 70:425–431, 1984.

    Article  PubMed  CAS  Google Scholar 

  21. Gardin JM, Dabestini A, Natin K, et al: Reproducibility of Doppler aortic blood flow velocity measurements: studies on intra-observer, inter-observer and day-to-day variability in normal subjects. Am J Cardiol, 54: 1092–8, 1984.

    Article  PubMed  CAS  Google Scholar 

  22. Schuster AH, Nanda NC: Doppler echocardiographic measurement of cardiac output: comparison with a non-golden standard, (ed) Am J Cardiol, 53: 257–9, 1984.

    Google Scholar 

  23. Elkayam U, Gardin JM, Berkley R, et al: The use of Doppler flow velocity measurement to assess the hemodynamic response to vasodilators in patients with heart failure. Circulation, 67: 377, 1983.

    Article  PubMed  CAS  Google Scholar 

  24. Reiter MJ, Hindman MC: Hemodynamic effects of acute atrioventricular sequential pacing in patients with left ventricular dysfunction. Am J Cardiol, 49:687–92, 1982.

    Article  PubMed  CAS  Google Scholar 

  25. Eisenhauer AC, McElroy PA, Weber KT: Chronotropic dysfunction and exercise. Physiologic Principles and Clinical Applications. Weber KT &Janicki JS (eds). Philadelphia: WB Saunders, 1986.

    Google Scholar 

  26. Ionescu VL: An ‘on demand pacemaker’ responsive to respiratory rate. PACE 3: 375, 1980 (Abstract).

    Google Scholar 

  27. Rickards AF, Norman J: Relation between QT interval and heart rate. New design of physiologically adaptive cardiac pacemaker. Br Heart J 45: 56–61, 1981.

    Article  PubMed  CAS  Google Scholar 

  28. Anderson K, Humen D, Klein GJ, Brumwell D, Huntley S: A rate variable pacemaker which automatically adjusts for physical activity. PACE 6: A12, 1983 (Abstract).

    Google Scholar 

  29. Wish M, Fletcher RD, Gottdiener JS, et al: Optimal left atrioventricular sequence in dual chamber pacing-limitations of programmed A-V interval. J Am Coll Cardiol, 3: 507A, 1984 (Abstract).

    Google Scholar 

  30. Von Bibra H, Busch U, Wirtzfeld A: The beneficial effect of short AV-intervals in VDD patients. J Am Coll Cardiol 5: 394, 1985.

    Google Scholar 

  31. Haas J, Strait G: Pacemaker-induced cardiovascular failure: hemodynamic and angiographic observations. Am J Cardiol 33: 295–299, 1974.

    Article  PubMed  CAS  Google Scholar 

  32. Miyatake K, Izumi S, Okamoto M, et al: Semiquantitative grading of severity of mitral regurgitation by real-time two-dimensional Doppler flow imaging technique. J Am Coll Cardiol, 7: 82–8, 1986.

    Article  PubMed  CAS  Google Scholar 

  33. Perry GJ and Nanda NC: Diagnosis and quantitation of valvular regurgitation by color Doppler flow mapping. Echocardiography: A Review of Cardiovascular Ultrasound 3: 493–503, 1986.

    Google Scholar 

  34. Helmcke F, Nanda NC, Hsiung MC, Soto B, Adey C, Goyal RG, Gatewood R: Color Doppler assessment of mitral regurgitation using orthogonal planes. Circulation 75: 175–183, 1987.

    Article  PubMed  CAS  Google Scholar 

  35. Ambrose JA, Meller J, Herman MV, et al: The ventricular A wave and a new echocardiographic index of late diastolic filling of the left ventricle. Am Heart J, 96:615, 1978.

    Article  PubMed  CAS  Google Scholar 

  36. Naito M, Dreifus LS, Mardelli TJ, et al: Echocardiographic features of atrioventricular and ventricule-atrial conduction. Am J Cardiol, 46:625, 1980.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Kluwer Academic Publishers

About this chapter

Cite this chapter

Perry, G.J., Nanda, N.C. (1989). Doppler echocardiography and cardiac pacing. In: Cikes, I. (eds) Echocardiography in Cardiac Interventions. Developments in Cardiovascular Medicine, vol 96. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0907-6_35

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-0907-6_35

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6897-0

  • Online ISBN: 978-94-009-0907-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics