C-AMP and ANP Levels in VVI and DDD Pacing with Different AV Delays During Daily Activity and Exercise

THEODORAKIS, G., ET AL.: C-AMP and ANP Levels in VVI and DDD Pacing with Different AV Delays During Daily Activity and Exercise. Nine patients (three males) mean age 68 ± 8 years, having complete heart block, and paced in the DDD mode were examined in VVI and DDD pacing with 100 and 150 ms atrioventricular delays (AVD) during rest and exercise. Plasma atrial natriuretic peptide (ANP) and cyclic AMP (c-AMP) were measured at rest and at peak exercise test. ANP plasma levels at rest were significantly higher in VVI pacing compared to 150 AVD (p < 0.03). On exercise, ANP release was statistically increased only in DDD with 150 ms AVD, while in WI it remained in high levels at exercise but no significant change was found (p:ns). c-AMP during rest was unchanged in any pacing mode or AVD, but on exercise DDD pacing with short AVD (100 ms) released lower c-AMP plasma levels, than at rest (p:ns). DDD pacing with long AVD (150 ms) during exercise produced statistically higher c-AMP plasma levels (p < 0.05) than at rest. Also in VVI pacing the c-AMP plasma levels were statistically higher than at rest (p < 0.02). Adrenergic activity seems to be lower during exercise in DDD pacing with shorter AVD (100 ms) than in DDD with 150 ms AVD or VVI pacing. No difference was found in c-AMP plasma levels at rest. ANP release was also found to be lower at exercise in DDD pacing with short AVD (100 ms) than in DDD with 150 ms AVD. ANP plasma levels at rest were statistically higher in VVI pacing. (PACE, Vol. 13, December, Part II 1990)