Document Detail

Clinical evaluation of combination therapy for biventricular pacing after cardiac surgery in patients with intractable heart failure.
MedLine Citation:
PMID:  16401992     Owner:  NLM     Status:  MEDLINE    
We examined the effectiveness of combination therapy for biventricular pacing after cardiac surgery. We performed biventricular pacing in seven patients until April 2003. The diagnosis of the patients was ischemic cardiomyopathy (ICM) in four patients and dilated cardiomyopathy (DCM) in three patients. The implantation method of biventricular pacing was performed with a myocardial electrode through a median sternotomy. DDD-R and SSI-R were used to perform biventricular pacing. A Y-adapter was connected to a generator so that the 2 leads could be implanted in both the right ventricles (RV) and left ventricles (LV). The clinical symptoms were New York Heart Association (NYHA) classification of 3.7+/-0.3 preoperatively and 1.8+/-0.6 postoperatively, showing a significant improvement (p<0.001). The cardiac index (CI) was 1.9+/-0.2 L/min/m2 preoperatively and 3.0+/-0.6 L/min/m2 postoperatively (p<0.05). The pulmonary capillary wedge pressure (PCWP) was 19.5+/-2.6 mmHg preoperatively and 13.6+/-2.0 mmHg postoperatively, showing a significant improvement (p<0.05). The intracardiac potential and threshold values were: left atrium 1.9+/-1.0 mV, threshold value (PW: 0.45 msec) 2.1+/-0.6 V, LV 4.9+/-4.23 mV, threshold value (PW: 0.45 msec) 2.2+/-1.51 V, and RV 3.6+/-0.9 V, threshold value (PW: 0.45 msec) 2.0+/-0.7 V. The LV and RV threshold values were high. The QRS interval improved from 158.4+/-18.0 msec preoperatively to 110+/-13.4 msec postoperatively, showing a significant reduction. This combination therapy when compared to the use of the biventricular pacing method used at the current time, does have the risks of cardiac surgery, but the clinical symptoms and hemodynamic performance improvement are great.
Shigeru Sakamoto; Junichi Matsubara; Yasuhiro Nagayoshi; Hisateru Nishizawa; Katsunori Takeuchi; Toshimichi Nonaka
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia     Volume:  11     ISSN:  1341-1098     ISO Abbreviation:  Ann Thorac Cardiovasc Surg     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-10     Completed Date:  2006-05-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9703158     Medline TA:  Ann Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  408-12     Citation Subset:  IM    
Department of Cardiovascular Surgery, Kanazawa Medical University, Ishikawa, Japan.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Cardiomyopathies / surgery,  therapy*
Cardiomyopathy, Dilated / surgery,  therapy*
Electrodes, Implanted
Heart Failure / surgery,  therapy*
Middle Aged
Myocardial Ischemia / surgery,  therapy*

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