Atrial and ventricular pacing after open heart surgery

Wisheart, J. D.; Wright, J E; Rosenfeldt, Franklin; Ross, John

doi:10.1136/thx.28.1.9

Cited by 19 publications

(2 citation statements)

References 32 publications

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“…Without normal timing the mean atrial pressure as well as the pressure in the pulmonary vascular system must be high if the same end-diastolic ventricular pressure is to be maintained. This is in agreement with earlier reports (17, 19,23). This booster effect of a properly timed atrial contraction elevates the end-diastolic ventricular pressure, increases the myocardial fibre length and thereby possibly increases the force of ventricular contraction, according to Starling's law.…”

Section: Atp Versus Frp At Restsupporting

confidence: 93%

Haemodynamic Effect of Atrial Triggered Versus Fixed Rate Pacing at Rest and During Exercise in Complete Heart Block

Kariöf

1975

Journal of Internal Medicine

227

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The central haemodynamics at rest and during exercise have been studied in 25 patients with complete AV block who were treated with fixed rate (FRP) and atrial triggered pacemakers (ATP). The aim of the investigation has been to study the effect of a synchronized atrial contraction for the filling of the ventricles and for the cardiac output (Q̇). Pressures and Q̇ have been determined during heart catheterization. The P wave for triggering the atrial synchronized pacemaker has been obtained with an electrode in close contact with the atria, introduced by means of mediastinoscopy. The study consists of two series. In the first series (12 patients) the central haemodynamics were recorded with each patient connected first the FRP (about 70 impulses/min) and later to the ATP. Most patients were studied both at rest and during exercise, the work loads being identical with both types of pacemakers. Q̇ at rest is 10% higher with ATP (p < 0.02) than with FRP and during exercise 20 % higher with ATP (p < 0.01). Stroke volume (SV) at rest is equal with both types of pacemakers, but significantly larger with FRP during work (p < 0.001). The left ventricular (LV) filling pressure is significantly lower (p < 0.01) with ATP at rest, but not during exercise (p < 0.8). In the second series 13 patients were studied at rest and during exercise. The recordings of pressures and Q̇ were first performed with the patient on ATP. After 30 min rest an identical study was performed with the patient connected to FRP, the rate of which was matched (FRPm) to that previously recorded with ATP. Q̇ at rest is 18% higher (p < 0.01) with ATP than with FRPm and during work 8 % higher (p < 0.05) with ATP. SV at rest is significantly larger (p < 0.01) with ATP than with FRPm, whereas during exercise no significant difference is observed between the two types of pacemakers. LV filling pressure at rest is significantly lower on the 5 % level with ATP; during exercise no significant difference is observed. The investigation shows that in many patients, especially younger ones, treatment with ATP makes it possible to obtain a larger Q̇ during exercise, and thus to increase the oxygen transporting capacity of the circulation. This benefical effect may be more pronounced in patients with low compliance of the ventricular myocardium.

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Section: Atp Versus Frp At Restsupporting

confidence: 93%

Haemodynamic Effect of Atrial Triggered Versus Fixed Rate Pacing at Rest and During Exercise in Complete Heart Block

Kariöf

1975

Journal of Internal Medicine

227

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“…10 where SVI = stroke volume index MAP = mean aortic pressure PCWP = pulmonary capillary wedge pressure 13.6 = specific gravity of mercury 1.055 = specific gravity of blood MSER (mljs) = mean systolic ejection rate =SV/ET. 6 where the SV = stroke volume [i.e., cardiac output/heart rate) ET = left ventricular systolic ejection time. The ET is measured from the beginning of upstroke of the aortic pressure tracing to the dicrotic notch.…”

Section: Methodsmentioning

confidence: 99%

Hemodynamic Findings During Sinus Rhythm, Atrial and AV Sequential Pacing Compared to Ventricular Pacing In a Dog Model

Zhou¹,

Yu²

1987

Pacing Clinical Electrophis

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The hemodynamic responses of atrial (AP), atrioventricular sequential (AVP) and ventricular pacing (VP) were compared to sinus rhythm (SR) in seventeen anesthetized dogs with intact AV conduction. The atrium and/or ventricle were paced at fixed rates above the control sinus rate. An AV interval shorter than normal conduction was selected to capture the ventricle. The changes of pulmonary capillary wedge pressure (PCWP, mmHg), mean aortic pressure (MAP, mmHg), cardiac output (CO, L/min), systemic vascular resistance (SVR, dynes/s/cm-5), left ventricular stroke work index (SWI) and mean systolic ejection rate (MSER, ml/s) during sinus rhythm, atrial pacing and atrioventricular sequential pacing (expressed in percentages of the individual values during ventricular pacing) were: (Chart: See text) The importance of atrial systole for cardiac performance was clearly demonstrated in dogs with normally compliant hearts. In both atrial and atrioventricular sequential pacing compared to ventricular pacing there was a reduction of pulmonary capillary wedge pressure (PCWP) (p less than 0.01) and systemic vascular resistance (SVR) (p less than 0.01) despite an increase in cardiac output (CO). The lesser mean systolic ejection rate (MSER) found during atrioventricular sequential pacing compared to sinus rhythm and atrial pacing may be explained by the abnormal ventricular depolarization in this pacing mode; nevertheless, the mean systolic ejection rate was still greater than that found during ventricular pacing (p less than 0.05).

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Hämodynamische Auswirkungen kardialer Arrhythmien

Thormann¹,

Schlepper²

1983

Herzrhythmusstörungen

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Atrial and ventricular pacing after open heart surgery

Cited by 19 publications

References 32 publications

Haemodynamic Effect of Atrial Triggered Versus Fixed Rate Pacing at Rest and During Exercise in Complete Heart Block

Haemodynamic Effect of Atrial Triggered Versus Fixed Rate Pacing at Rest and During Exercise in Complete Heart Block

Hemodynamic Findings During Sinus Rhythm, Atrial and AV Sequential Pacing Compared to Ventricular Pacing In a Dog Model

Hämodynamische Auswirkungen kardialer Arrhythmien

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