Document Detail

Relation of QRS shortening to cardiac output during temporary resynchronization therapy after cardiac surgery.
MedLine Citation:
PMID:  20592584     Owner:  NLM     Status:  MEDLINE    
Cardiac resynchronization therapy (CRT) can improve cardiac function in heart failure without increasing myocardial oxygen consumption. However, CRT optimization based on hemodynamics or echocardiography is difficult. QRS duration (QRSd) is a possible alternative optimization parameter. Accordingly, we assessed QRSd optimization of CRT during cardiac surgery. We hypothesized that QRSd shortening during changes in interventricular pacing delay (VVD) would increase cardiac output (CO). Seven patients undergoing coronary artery bypass, aortic or mitral valve surgery with left ventricular (LV) ejection fraction < or =40%, and QRSd > or =100 msec were studied. CRT was implemented at epicardial pacing sites in the left and right ventricle and right atrium during VVD variation after cardiopulmonary bypass. QRSd was correlated with CO from an electromagnetic aortic flow probe. Both positive and negative correlations were observed. Correlation coefficients ranged from 0.70 to -0.74 during VVD testing. Clear minima in QRSd were observed in four patients and were within 40 msec of maximum CO in two. We conclude that QRSd is not useful for routine optimization of VVD after cardiac surgery but may be useful in selected patients. Decreasing QRSd is associated with decreasing CO in some patients, suggesting that CRT can affect determinants of QRSd and ventricular function independently.
Matthew E Spotnitz; Marc E Richmond; Thomas Alexander Quinn; Santos E Cabreriza; Daniel Y Wang; Catherine M Albright; Alan D Weinberg; José M Dizon; Henry M Spotnitz
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  ASAIO journal (American Society for Artificial Internal Organs : 1992)     Volume:  56     ISSN:  1538-943X     ISO Abbreviation:  ASAIO J.     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-09-02     Completed Date:  2011-01-04     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  9204109     Medline TA:  ASAIO J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  434-40     Citation Subset:  IM    
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MeSH Terms
Cardiac Output / physiology*
Cardiac Resynchronization Therapy / methods*
Cardiopulmonary Bypass*
Grant Support
R01 HL080152/HL/NHLBI NIH HHS; R01 HL080152-01A2/HL/NHLBI NIH HHS; R01 HL080152-02/HL/NHLBI NIH HHS; R01 HL080152-03/HL/NHLBI NIH HHS; R01 HL080152-04/HL/NHLBI NIH HHS; R01-HL080152/HL/NHLBI NIH HHS; T35 HL007616/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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