Original articleCardiovascularOptimized Biventricular Pacing in Atrioventricular Block After Cardiac Surgery
Section snippets
Patient Selection
This study was approved by the Western Institutional Review Board. With the consent of the attending surgeon, patients undergoing open-heart surgery with a high probability of postoperative AVB were approached to enroll in this study. All patients gave informed consent. Candidates included patients undergoing valve replacement surgery and patients with known first, second, or third degree block. Patients were excluded if the surgeon did not plan to dissect the aorta or pulmonary artery in case
Study Population
A total of 15 patients were enrolled in this study. Eight patients were excluded because they did not develop heart block. Upon separation from CPB, the protocol was initiated in 7 patients. Six patients developed complete heart block and one patient remained in first-degree heart block. Table 2 lists baseline clinical characteristics for these patients including primary pathologic lesions.
Preoperatively, 4 patients were in normal sinus rhythm and 3 patients were in first-degree heart block.
Comment
This study indicates that BiVP at optimum AVD significantly enhances CO in patients with AVB during open-heart surgery. Although optimum AVD setting was patient specific, in each case BiVP was associated with significant improvement in CO compared with RV or LV pacing. The present study systematically studies acute effects of pacing protocol modification at constant heart rate in patients who require pacing for AVB after CPB during open-heart surgery. In this study, we focused primarily on the
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