Liebold, Andreas and Roedig, Gabriele and Merk, Johannes and Birnbaum, Dietrich E. (1998) Short atrioventricular delay dual-chamber pacing early after coronary artery bypass grafting in patients with poor left ventricular function. JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 12 (3). pp. 284-287. ISSN 1053-0770,
Full text not available from this repository.Abstract
Objective: To investigate the effect of short atrioventricular (AV) delay dual-chamber pacing on mean arterial pressure (MAP) and stroke volume index (SVI) in patients with poor left ventricular (LV) function after cardiac surgery. Design: A prospective study. Setting: A university hospital, single-center study. Participants: The study group consisted of 20 patients aged 63 +/- 9 years with a left ventricular ejection fraction (LVEF) less than 30%. The control group consisted of 20 patients aged 61 +/- 10 years, with an LVEF greater than 50%. Interventions: Immediately after routine coronary artery bypass grafting (CABG) the AV delay was shortened from 160 to 40 milliseconds in atrial-paced (DDD) mode and from 100 to 40 milliseconds in atrial-sensed ventricular stimulation (VDD) mode. MAP was on-line monitored and SVI was calculated by thermodilution. In one patient with an LVEF of 18% (case study), transmitral flow velocity and LV isovolumetric relaxation time were assessed using Doppler echocardiography during VDD pacing at 40-, 80-, and 120-millisecond AV delay. Results: Short-AV delay DDD pacing decreased MAP in the control group (84.3 +/- 9 v 75.7 +/- 9 mmHg; p < 0.05) and SVI in both groups (study group, 35.9 +/- 7 v 31.7 +/- 7 mL/m(2); control group, 35.3 +/- 6 v 31.0 +/- 6 mL/m(2); p < 0.05). Shortening the AV delay had no influence on MAP and SVI during VDD pacing. During the echocardiographic case study, AV delay shortening distinctly modified ventricular filling patterns. Optimal LV filling and transmitral flow were achieved with an intermediate AV delay of 80 milliseconds. Conclusion: Dual-chamber pacing with nonphysiologic short AV delay failed to improve acute hemodynamics in patients with poor LV function after CABG. Short AV delay VDD pacing was superior to DDD pacing in both normal and impaired LV function. The use of Doppler echocardiography enabled optimization of the AV delay on the basis of LV filling patterns. Copyright (C) 1998 by W.B. Saunders Company.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | IDIOPATHIC DILATED CARDIOMYOPATHY; DIASTOLIC FUNCTION; CARDIAC-OUTPUT; HEART-FAILURE; DISEASE; IMPROVEMENT; DOPPLER; temporary cardiac pacing; short atrioventricular delay; poor left ventricular function; coronary artery bypass grafting |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 May 2023 09:47 |
| Last Modified: | 09 May 2023 09:47 |
| URI: | https://pred.uni-regensburg.de/id/eprint/49766 |
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