Avtor/Urednik		Lipar, Luka; Žižek, David
Naslov		Vpliv fizioloških dražljajev in nevro-humoralni odzivi pri preddvorno-prekatni in sinhroni prekatni elektrostimulaciji srca
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2004
Obseg		str. 42
Jezik		slo
Abstrakt		BACKGROUND. VDD pacing system is an alternative to DDD pacing system in patients with atrioventricular (AV) block and normal sinus node function. Critical point in VDD pacing system is atrial sensing which is not as reliable as with DDD pacing system due to a floating sensing electrode. Pacing mode, pacing frequency and atrioventricular (AV) synchrony have a distinctive influence on peripheral levels of atrial and brain natriuretic peptides (ANP and BNP, respectively). AIM. The amplitude of the detected atrial signal varies greatly and can be influenced by respiration, posture, stress and exercise. In case of inappropriate atrial sensing the stimulation is no longer physiologic and asynchrony occurs. Haemodynamic changes affect peripheral levels of ANP and BNP. HYPOTHESIS. We compared atrial sensing in patients supine, sitting upright and after exercise, AV synchrony, and peripheral levels of ANP and BNP in patients with VDD and DDD pacing systems. We assume that there are differences concerning atrial sensing, haemodynamic support and peripheral (evels of ANP and BNP between VDD and DDD pacing systems. Levels of ANP and BNP correlate with haemodynamic support. NiETHODS. Seventy-five patients with implanted VDD or DDD pacing system in year 2000 were enrolled prospectively into our study. Using the programmer we directly measured sensing threshold in atrium in patients supine, sitting upright and after standardized exercise. Among measured data we evaluated AV synchrony. Blood was collected from an antecubital vein and plasma proANP(1-98) and NT-proBNP Ievels were measured. Data of sensing thresholds in patients supine, sitting upright and after exercise were analyzed using repeated measure analysis of variance with Greenhouse-Geisser adjustment, when appropriate. Data of AV synchrony and plasma ANP and BNP levels were analyzed using Mann-Whitney test. The significances of correlations were obtained using Spearman's rho. (Abstract truncated at 2000 characters).
Deskriptorji		HEART BLOCK CARDIAC PACING, ARTIFICIAL ATRIAL NATRIURETIC FACTOR NATRIURETIC HORMONE SENSORY THRESHOLDS HEART ATRIUM