OBJECTIVES: The aims of this study were to test the hypotheses that in the postoperative period after coronary artery bypass graft surgery (1) atrio-right ventricular (RA-RV) pacing induces a decrease in cardiac output compared with RA pacing alone and (2) atrio-biventricular (RA-BiV) pacing improves CO compared with RA-RV pacing. DESIGN: A prospective observational study. SETTING: A single-center university hospital. PARTICIPANTS: Patients referred for coronary artery bypass graft surgery. INTERVENTIONS: Patients were studied during atrial, RA-RV, and RA-BiV pacing. Cardiac output (echocardiography) and left ventricular dyssynchrony were assessed at each step. MEASUREMENTS AND MAIN RESULTS: RA-RV pacing induced a significant decrease in cardiac output (4.3 +/- 1.0 to 3.7 +/- 0.8 L/min, p < 0.01) and a significant increase in left ventricular dyssynchrony (13 +/- 12 to 80 +/- 25 milliseconds, p < 0.01). Biventricular pacing induced a significant increase in cardiac output (3.7 +/- 0.8 to 4.5 +/- 1.0 L/min, p < 0.01) and a significant decrease in left ventricular dyssynchrony compared with right ventricular pacing (80 +/- 25 to 21 +/- 16 milliseconds, p < 0.05). CONCLUSIONS: RA-BiV pacing improves cardiac output compared with RA-RV pacing in the postoperative period after coronary artery bypass graft surgery. This improvement is related to an improvement in left ventricular synchronicity.
OBJECTIVES: The aims of this study were to test the hypotheses that in the postoperative period after coronary artery bypass graft surgery (1) atrio-right ventricular (RA-RV) pacing induces a decrease in cardiac output compared with RA pacing alone and (2) atrio-biventricular (RA-BiV) pacing improves CO compared with RA-RV pacing. DESIGN: A prospective observational study. SETTING: A single-center university hospital. PARTICIPANTS: Patients referred for coronary artery bypass graft surgery. INTERVENTIONS:Patients were studied during atrial, RA-RV, and RA-BiV pacing. Cardiac output (echocardiography) and left ventricular dyssynchrony were assessed at each step. MEASUREMENTS AND MAIN RESULTS:RA-RV pacing induced a significant decrease in cardiac output (4.3 +/- 1.0 to 3.7 +/- 0.8 L/min, p < 0.01) and a significant increase in left ventricular dyssynchrony (13 +/- 12 to 80 +/- 25 milliseconds, p < 0.01). Biventricular pacing induced a significant increase in cardiac output (3.7 +/- 0.8 to 4.5 +/- 1.0 L/min, p < 0.01) and a significant decrease in left ventricular dyssynchrony compared with right ventricular pacing (80 +/- 25 to 21 +/- 16 milliseconds, p < 0.05). CONCLUSIONS:RA-BiV pacing improves cardiac output compared with RA-RV pacing in the postoperative period after coronary artery bypass graft surgery. This improvement is related to an improvement in left ventricular synchronicity.
Authors: Daniel Y Wang; Lauren A Kelly; Marc E Richmond; T Alexander Quinn; Bin Cheng; Michelle D Spotnitz; Santos E Cabreriza; Yoshifumi Naka; Allan S Stewart; Craig R Smith; Henry M Spotnitz Journal: Tex Heart Inst J Date: 2013
Authors: Jose B García-Bengochea; Angel L Fernández; Daniel Sánchez Calvelo; Julian Alvarez Escudero; Francisco Gude; José R González Juanatey Journal: J Cardiothorac Surg Date: 2012-10-22 Impact factor: 1.637