Document Detail

Selecting the best site for pacing leads after cardiac surgery by evaluating the asynchrony of myocardial deformation observed with different pacing sites.
MedLine Citation:
PMID:  20875356     Owner:  NLM     Status:  In-Process    
INTRODUCTION AND OBJECTIVES: After cardiac surgery, temporary pacing leads are routinely implanted in the right ventricle (RV). The objective was to investigate the effect of different ventricular pacing locations on cardiac synchrony (by evaluating myocardial deformation, or strain) and efficiency in patients undergoing cardiac surgery.
METHODS: Interventricular asynchrony (i.e. the difference in the time of onset of deformation between right and left ventricles; Tε-R/L) and intraventricular asynchrony (i.e. the standard deviation and maximum difference in the time of onset of deformation in six segments of the left ventricle [LV]; Tε-SD and Tε-MD, respectively) were assessed in 19 patients. Doppler echocardiography was used to evaluate these parameters and cardiac output after pacing in the RV and in three different LV segments.
RESULTS: Pacing in the RV resulted in the greatest increases in asynchrony parameters from baseline: Tε-R/L 59.8 ms (standard deviation [SD] 40.5 ms) vs. 28.23 ms (SD 56.9 ms), P=.002; Tε-SD 53.2 ms (SD 34.4 ms) vs. 36.6 ms (SD 34.9 ms), P=.007; and Tε-MD 135.3 ms (SD 82.9 ms) vs. 90.5 ms (SD 87.4 ms), P=.007. Pacing in the LV resulted in less asynchrony: for anterior LV pacing, Tε-R/L was 17.2 ms (SD 53.8 ms), Tε-SD was 35.8 ms (SD 17.9 ms), and Tε-MD was 91.3 ms (SD 45.2). The change from baseline was not significant. Cardiac output was lower after RV pacing than after anterior LV pacing: 4.36 (SD 1) vs. 4.70 (SD 1); P=.001.
CONCLUSIONS: Pacing in the LV produced less asynchrony than RV pacing. In addition, anterior LV pacing resulted in a higher cardiac output than RV pacing. These findings suggest that the location normally used for temporary leads after cardiac surgery should be changed.
José Luis Moya-Mur; Enrique Oliva-De Anquin; Tomasa Centella-Hernández; Soledad Ruiz-Leira; Alicia Megías-Sáez; Juan Pablo Tomás-Zarlenga; Antonio Hernández-Madrid; Eva García-Galloway; Concepción Moro
Related Documents :
2882626 - High-dose acetylsalicylic acid after cerebral infarction. a swedish cooperative study.
10318656 - Stroke in patients with acute coronary syndromes: incidence and outcomes in the platele...
1598096 - The risk of stroke in patients with acute myocardial infarction after thrombolytic and ...
17356186 - The merci retrieval system for acute stroke: the southeast regional stroke center exper...
12379966 - Infrequent causes of stroke.
11180966 - Pitx2 expression defines a left cardiac lineage of cells: evidence for atrial and ventr...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista española de cardiología     Volume:  63     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  Spain    
Other Details:
Languages:  eng; spa     Pagination:  1162-70     Citation Subset:  IM    
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid, España.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Submaximal exercise testing plus atropine in myocardial perfusion SPECT.
Next Document:  Soluble ST2 monitoring provides additional risk stratification for outpatients with decompensated he...