Tasneem Z. Naqvi JIMG 2010;3:1168-1180 Increased Atrial Pacing Rate Requires Progressive Shortening of AVD Mitral inflow PW Doppler tracing at optimal.

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Tasneem Z. Naqvi JIMG 2010;3:1168-1180 Increased Atrial Pacing Rate Requires Progressive Shortening of AVD Mitral inflow PW Doppler tracing at optimal AVD of 190 ms and LV offset of 0 ms (A). Atrial pacing rate was then increased to 70 beats/min, and AVD was kept fixed at 190 ms. Marked E and A fusion developed (B). AVD was then progressively shortened to 120 ms until E and A separation occurred (C). Paced atrial rate was then increased to 80 beats/min at the AVD of 120 ms. Marked E and A fusion developed again (D). Progressive shortening of AVD to 90 ms (E), and then 80 ms (F) caused mitral inflow E and A separation. Further shortening of AVD to 70 ms led to shortening of mitral inflow A-wave and premature closure of mitral valve. Hence, optimal AVD at a paced atrial rate of 70 beats/min was 120 ms, and at 80 beats/min was 80 ms. Abbreviations as in Figures 1 and 2. Tasneem Z. Naqvi JIMG 2010;3:1168-1180 American College of Cardiology Foundation