Abstract
Pulse to pulse blood pressure(BP) was monitored with a non-invasive monitoring system (FINAPRES) in 36 patients with cardiac pacemakers for complete atrio-ventricular block. In contrast to stable BP in DOD pacing, periodical fluctuation of BP was observed in VVI pacing in relation to changing sequence of P-waves and QRS. The mean range of the fluctuation of systolic BP, diastolic BP and pulse pressure in a supine position was 30.3±13. 8mmHg (15-65mmHg), 10.2±5.9mmHg(5-25mmHg) and 21.0±9.3mmHg(10-45mmHg), respectively at 70 ppm. The fluctuation range was similar at 100ppm and was relatively small at 50ppm . In a sitting position, the fluctuation was smaller at 50ppm, greater at 100ppm and various at 70ppm, comparing to that in a supine position. As the wide fluctuation of BP may cause pacemaker syndrome and means a significant role of atrial kick, maintenance of atrio-ventricular sequence is essential to prevent pacemaker syndrome and to maintain good cardiac function. ODD pacemaker should be indicated for all patients with atrio-ventricular block. Noninvasive continuous BP monitoring provides a handy and useful method for physiological evaluation of cardiac pacing.
