• J. Cardiothorac. Vasc. Anesth. · Jun 2009

    Comparative Study

    The impact of atrio-biventricular pacing on hemodynamics and left ventricular dyssynchrony compared with atrio-right ventricular pacing alone in the postoperative period after cardiac surgery.

    • Maxime Cannesson, Fadi Farhat, Maria Scarlata, Emmanuel Cassar, and Jean-Jacques Lehot.
    • Department of Anesthesiology and Intensive Care, Hospices Civils de Lyon, Louis Pradel Hospital, Claude Bernard Lyon 1 University, Lyon, France. maxime_cannesson@hotmail.com
    • J. Cardiothorac. Vasc. Anesth. 2009 Jun 1;23(3):306-11.

    ObjectivesThe aims of this study were to test the hypotheses that in the postoperative period after coronary artery bypass graft surgery (1) atrio-right ventricular (RA-RV) pacing induces a decrease in cardiac output compared with RA pacing alone and (2) atrio-biventricular (RA-BiV) pacing improves CO compared with RA-RV pacing.DesignA prospective observational study.SettingA single-center university hospital.ParticipantsPatients referred for coronary artery bypass graft surgery.InterventionsPatients were studied during atrial, RA-RV, and RA-BiV pacing. Cardiac output (echocardiography) and left ventricular dyssynchrony were assessed at each step.Measurements And Main ResultsRA-RV pacing induced a significant decrease in cardiac output (4.3 +/- 1.0 to 3.7 +/- 0.8 L/min, p < 0.01) and a significant increase in left ventricular dyssynchrony (13 +/- 12 to 80 +/- 25 milliseconds, p < 0.01). Biventricular pacing induced a significant increase in cardiac output (3.7 +/- 0.8 to 4.5 +/- 1.0 L/min, p < 0.01) and a significant decrease in left ventricular dyssynchrony compared with right ventricular pacing (80 +/- 25 to 21 +/- 16 milliseconds, p < 0.05).ConclusionsRA-BiV pacing improves cardiac output compared with RA-RV pacing in the postoperative period after coronary artery bypass graft surgery. This improvement is related to an improvement in left ventricular synchronicity.

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