Effect of atrioventricular delay on left ventricular diastolic function in patients with DDD-pacing for complete atrioventricular block

Dual Chamber (DDD) pacing with a short atrioventricular delay may improve cardiac function in patients with heart failure and compromised systolic left ventricular (LV) function, as suggested by preliminary observations. Our patients had a DDD pacemaker implanted for complete A-V block and underwent Doppler assessment of transmitral flow during pacing at incremental A-V delay values (100, 150 and 200ms) in a randomized fashion. Doppler indices of diastolic LV-function improved significantly at the shortest A-V delay value investigated (optimal measurements at 100ms). Paired comparisons between the various A-V delay values investigated showed significant differences in all variables studied except for the LV-isovolumic relaxation time.