Tasneem Z. Naqvi JIMG 2010;3:1168-1180 Effect of Atrial Pacing Rate and AVD LV Filling and Ejection Effect of AVD optimization on diastolic function and.

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Tasneem Z. Naqvi JIMG 2010;3:1168-1180 Effect of Atrial Pacing Rate and AVD LV Filling and Ejection Effect of AVD optimization on diastolic function and LV ejection. To suppress ventricular ectopy, the atrial pacing rate was increased to 80 beats/min at onset. Marked restrictive mitral inflow with tall E-wave, short deceleration time, and a small A-wave is shown at baseline at an AVD of 110 ms (A). LV outflow pulsed wave (PW) Doppler shows decreased peak velocity of 0.5 m/s and pulsus alternans pattern (alternating increase and decrease in peak velocity) indicating advanced LV dysfunction (B). At an optimal AVD of 170 ms, mitral inflow (C) became less restrictive. Pulsus alternans pattern continued; however, LV ejection velocities increased to 0.6 m/s (D). Increased atrial pacing to 90 beats/min further improved mitral inflow (E) and abolished pulsus alternans pattern on LV outflow Doppler (F). Abbreviations as in Figure 1. Tasneem Z. Naqvi JIMG 2010;3:1168-1180 American College of Cardiology Foundation