PHYSIOLOGICAL PACING IMPROVES SYMPTOMS AND INCREASES EXERCISE CAPACITY IN THE ELDERLY PATIENT

We evaluated the benefits of physiological pacing in the elderly by re cruiting 13 subjects > 75 years of age, already fitted with a physiolo gical pacing system. All had been paced for complete or Mobitz II hear t block. Double blind cross over study was performed comparing exercis e capacity, measuring distance walked on a 6-min walking test and time taken to climb two flights of stairs; and symptoms, evaluated by an a ctivity of daily living questionnaire, in atrioventricular synchronous and ventricular pacing. Mean distance walked was significantly higher in atrioventricular synchronous than in ventricular pacing (360 +/- 6 5 m vs. 327 +/- 69 m; P < 0.01). No significant difference was found i n the ability to climb stairs but there was a marked improvement in th e symptomatic questionnaire score, 19 +/- 5 in physiological pacing in creasing to 28 +/- 10 with ventricular. Physiological pacing in the el derly produces an increase in exercise tolerance and improves symptoms ; therefore, age alone should not be a contraindication to a physiolog ical system.