Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation

Figure 3

Change of pulse pressure variation (PPV) during sinus and pacemaker rhythm. ECG, arterial pressure, and noncalibrated pneumobelt signals were recorded during the dynamic preload test. While the initial segment of the arterial pressure panel during sinus rhythm indicates minimal changes in pulse pressure (PP) resulting in borderline PPV, the switch to ventricular pacemaker rhythm is accompanied by enormous pressure fluctuations and a severalfold increase in PPV. The straight lines indicate the 3 breathing cycles detected by the pneumobelt during the first and second part of recording. Based on the pneumobelt signal, the arterial pressure swings occurring during the pacemaker rhythm seem to be unrelated to the ventilation.