Non‐Invasive Beat‐to‐Beat Analysis of Stroke Volume and Digital Pulse Volume in Patients with Complete Heart Block and Artificial Pacing

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Abstract
A beat-to-beat analysis of digital arterial pulse volume (DAPA), left ventricular end-diastolic diameter (LVEDD), and stroke volume (SV) and their correlation to PQ interval in 10 patients with complete heart block and artificial cardiac pacing was studied. DAPA was measured by strain-gauge plethysmography and LVEDD/SV by echocardiography. A close relationship was found between SV and DAPA (correlation coefficient, r = 0.83-0.97) in 7 patients, who benefited from atrial contraction as regards SV and DAPA (increase with 35-94%). The optimal PQ interval was calculated to approximately 240 ms for DAPA and 180 ms for LVEDD and SV. Apparently there is a close relationship between beat-to-beat variations of SV measured by echocardiography and plethysmographically recorded digital arterial pulse volume. The variables may be useful in clinical practice for assessing the hemodynamic effect of atrial contribution in patients with various forms of cardiac conduction disturbances. The 2 methods may be useful to screen for patients who may benefit from AV synchronous rather than ventricular pacing.