Characteristics of chronically paced cardiac functions in the congenital complete atrioventricular block.

Characteristics of morphology, cardiac function, and cardiac reserve at late state were evaluated at rest, by changing the pacing rates, and after exercise in patients with ventricular pacemakers for isolated congenital complete atrioventricular block. Heart size was reduced statistically after pacemaker implantation, and concentric myocardial hypertrophy was observed. Cardiac pump functions at rest seemed fairly well compensated by increased ejection fraction, but the cardiac index was still lower than that of the normal heart. Responses of cardiac function towards the changing rates were considered satisfactory, and those variables had statistic correlations with the pacing rates. After exercise, significant increase of cardiac pump function and also statistic acceleration of myocardial function were observed. This fact proved that cardiac reserve was good, although the increased cardiac output after exercise was still insufficient without an increase in heart rate. More physiological pacing modes would be required as currently recommended.