SIMULTANEOUS USING OF ECG AND BLOOD-PRESSURE HOLTER REGISTRATION IN PATIENTS WITH PACEMAKER SYNDROME

The aim of the study was evaluation of usefulness of simultaneous 24 h ours ECG (HECG) and 24 hours blood pressure registration (HRR) in diag nosis of pacemaker syndrome (PS). The population study comprised 18 pa tients (15 female and 3 male aged 64+/-12)who underwent change of paci ng mode from VVI to DDD because of clinical signs of PS in years 1993- 1995. In each case simulataneous Holter ECG/Marquette Laser SXP/ and H olter BP /Space Labs 90270/ registration was made twice at least two m onth after the change of pacing mode: first-after 48 hour of DDD stimu lation and second after 48 hour of VVI stimulation. BP was measured in mmHg from 12 a.m. till 9 a.m. next day /3 measurments per hour/.The m ean /X/ and standard deviation /SD/ was calculated for values of systo lic /Rrs/, diastolic /RRd/ and mean calculated /RRm/ blood pressure. T he percentage of paced rhythm /%Paced/ was calculated for the same tim e one-hour compartments both for VVI and DDD stimulation. The t-studen t test and coefficient ''r'' of linear correlation was used for statis tical analysis. The level of significance p < 0,05 was assumed. Mean v alues of RRs for VVI and DDD mode of stimulation were 107,9 and 117,1 mmHg p < 0,001, for RRd accordingly 67,1 and 70,1 mmHg p < 0,001 and f or RRm 80,1 and 85,9 mmHg p < 0,001 respectively. The 24 hour analysis of ECG presented high statistical significantly difference between pe rcentage of both pacing modes respectively in DDD 95,6% and in VVI 71, 2% p < 0,001. The statistical significance /p < 0,001/ negative linear correlation between %Paced and RRs in patients during VVI stimulation was ascertained. The results confirmed that VVI pacing is unphysiolog ical mode of stimulation which provokes an evident decrease of systoli c, diastolic and mean calculated BP. Synchronic Holter ECG and Holter BP registration is usefulness method in diagnostics of pacemaker syndr ome.