The Effects of Traditional Dual Chamber Cardiac Permanent Pacemaker on Arterial Distensibility Using Carotid-Femoral (Aortic) Pulse Wave Velocity in Patients with Angiographically Normal Coronary Arteries

Introduction: The traditional dual chamber cardiac permanent pacemakers are widely used for symptomatic bradycardia. Pulse wave velocity (PWV) is an index of arterial stiffness and a marker of cardiovascular events. This study aims to investigate arterial distensibility using carotid-femoral (aortic) PWV measurements in patients with traditional dual chamber cardiac permanent pacemakers and angiographically normal coronary arteries. Patients and Methods: We recruited 17 paced patients and 17 age and sex matched controls. Aortic PWV was determined using an automatic device, the Complior Colson (France), which allowed on-line pulse wave recording and automatic calculation of PWV. PWV is calculated from measurements of pulse transit time and the distance travelled by the pulse between two recording sites, according to the following formula: PWV (m/s) = Distance (m) / Transit time (s)Results: The carotid-femoral PWV (10.20 ± 2.00, 9.06 ± 0.94 m/s, p= 0.04) was increased in patients with dual chamber pacing as compared with age and sex-matched control group. Multiple regression analysis between PWV and clinical parameters (age, sex, weight, height, systolic blood pressure, diastolic blood pressure, pulse pressure, mean blood pressure, heart rate) showed that PWV correlated positively with age (r2= 0.31; p= 0.007). Similar results were obtained in the paced patients (age, r2= 0.36; p= 0.03) and control (age, r2= 0.33; p= 0.04) subgroups when analyzed separately.Conclusion: Arterial distensibility is increased in patients with traditional dual chamber cardiac permanent pacemakers and angiographically normal coronary arteries, as compared with age and sex matched controls.