Outpatient Clinic, Budapest, Hungary
Reduction of cardiac output due to hypodynam rhythm abnormalities with hypertension is a possible factor of cardiogen stroke. We examined the effect of restore heart rate to the blood pressure, end diastolic and end end systolic diameters of the left ventricle changes in summary and by type of pacemakers. Treatment of hypertension was unchanged.
233 patients (77 ± 8 year; 111 women, 122 men) with hypertension and sinus node dysfunction, AV- block, or carotid sinus hypersensitivity were examined before and three months later of pacemaker implantation. For monitorization of pressure and volume overload we used the home blood pressure systolic and diastolic levels, end diastolic and end systolic diameters of the left ventricle. Statistically method: paired Student test.
Before pacemaker implantation: blood pressure: 134 ± 21.7/75.0 ± 10.5 mmHg, left ventricular end diastolic / end systolic diameter: 52.7 ± 6/34.7 ± 6 mm.
3 months after pacemaker implantation: blood pressure: 126.7 ± 17.1/72.8 ± 9.5 mmHg (p:<0.001/0.05), left ventricular end diastolic/end systolic diameter: 50.9 ± 6/33.1 ± 6 mm (p:<0.002/0.0003).
DDD pacemaker group (n:142):blood pressure reduction was expressed. From 136.6 ± 20.1/ 73.9 ± 10.1 mmHg to 123.9 ± 15.1/72.0 ± 8.9 mmHg (p:<0.001/0.05).
VVI pacemaker group (n: 77): blood pressure reduction: 131.6 ± 23.1/73.0 ± 10.5 mmHg to 126.0 ± 18.3/70.5 ± 11.0 mmHg (p:<0.05/n.s.). Reduction of the left ventricular end diastolic / end systolic diameter only in the VVI group was significantly:
from 53.9 ± 6.5/35.1 ± 5.8 mm to 49.7 ± 5.7/32.5 ± 5.2 mmHg (p:<0.001/0.003).
AAI type pacemaker group (n: 14): no significant changes.
Pacemaker implantion led to blood pressure reduction and decreased of the left ventricle end diastolic diameter significantly in elderly patients with hypodynam rhythm abnormalities and hypertension. Pacemaker implantation of these patients is an assistant non pharmacological treatment method of the blood pressure normalization without of the danger of the end organ damages. Results were depend on of the type of pacemaker.