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. 2013 Apr;145(4):1141-1143.
doi: 10.1016/j.jtcvs.2012.12.068. Epub 2013 Jan 12.

Cardiac pacing: a novel approach to right ventricle failure during pulmonary thromboendarterectomy

Vinod Havalad  1 , Matthew Bacchetta  2 , Daniel Y Wang  3 , Santos E Cabreriza  2 , Linda Aponte-Patel  1 , Bin Cheng  4 , Henry M Spotnitz  5
Affiliations

Cardiac pacing: a novel approach to right ventricle failure during pulmonary thromboendarterectomy

Vinod Havalad et al. J Thorac Cardiovasc Surg. 2013 Apr.

Abstract

Pulmonary thromboendarterectomy (PTE) reverses chronic thromboembolic pulmonary hypertension, decreasing pulmonary vascular resistance and pressure overload failure of the right ventricle (RV). Suboptimal cardiac function early after PTE on cardiopulmonary bypass (CPB) may require inotropic or mechanical support. Our laboratory demonstrated increased cardiac output (CO) with temporary biventricular pacing (BiVP) in an RV pressure overload pig model. In patients with left ventricular (LV) dysfunction, optimized temporary BiVP increases CO after CPB, reduces the vasoactiveinotrope score, and increases urine output. Our study tests the feasibility of BiVP reversal of RV failure after PTE.

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Figures

FIGURE 1.
FIGURE 1.
A, Representative effect of atrioventricular delay (AVD) optimization on cardiac output (CO). B, Representative effect of interventricular delay (VVD) optimization on CO.
FIGURE 2.
FIGURE 2.
Comparison of cardiac output (CO) in sinus rhythm (NSR) versus atrial pacing (AAI) or optimized biventricular pacing (BiVP) in 4 patients. Bars indicate standard error of the mean and P values are based on paired t test.
See this image and copyright information in PMC

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