The Impact of Differential Atrioventricular Delays on Arterial Distensibility Measured by Pulse Wave Velocity in Patients with Dual-chamber Pacing

Abstract

Objective:Atrioventricular (AV) delay optimization improves hemodynamics and clinical parameters of patients treated with dual-chamber (DDD) pacemakers. Pulse wave velocity (PWV) is an index of arterial stiffness and a marker of cardiovascular events. Increased levels of PWV is an indicator of diffuse atherosclerosis and rigid arteries. We aimed to investigate the impact of differential AV delay intervals (100, 150 and 200 ms respectively) on arterial distensibility measured by carotid-femoral PWV in patients with DDD pacing.Method:A total of 40 patients with DDD pacing were enrolled in our prospective study. PWV was measured for each AV delay (100 ms, 150 ms and 200 ms respectively) with 10 minute resting intervals. Pacing was programmed at least 10 beats/minute above the resting heart rate. PWV was automatically calculated by using the device, Complior Colson (France), which allows online pulse wave recording according to this formula: PWV(m/s) = distance (meter)/transit time (second).Results:There was a statistically obvious positive correlation between carotid-femoral PWV and prolongation of AV delay interval (p<0.001). According to gender analysis; weight, height and waist-hip ratio values were significantly higher in male group. Additionally, there was not a statistically significant difference between groups in terms of age, body mass index, mean, systolic and diastolic blood pressure, pulse pressure and PWV measured at differential AV delay intervals.Conclusion:Prolongation of AV delay interval increased carotid-femoral PWV values thereby decreased arterial distensibility in patients with DDD pacing. Therefore, optimum AV delay adjustment may provide better hemodynamics in these patients.

Keywords

• atrioventricular delay interval
• dual-chamber pacemaker
• pulse wave velocity