The Impact of Limited Biventricular Stimulation on Cardiac Hemodynamics in Patients with Reduced Left Ventricular Function

Authors

  • Valon Asani
  • Omer Dzemaili

Abstract

Background: Patients with severely impaired left ventricular (LV) function often demonstrate prolonged inter- and intraventricular conduction. This prospective study investigates hemodynamic effects and outcomes of perioperative temporary biventricular pacing in patients with heart failure undergoing heart surgery. Methods: 100 consecutive cardiac surgery patients with a LV ejection fraction below 35% received biventricular stimulation via temporary myocardial electrodes. Group 1 consisted of 50 patients with LV dilatation (mean-LVEDD 65±5 mm), group 2 of 50 patients with normal or slightly dilated LV (mean-LVEDD 52±4 mm). Results: Hemodynamic parameters were measured immediately, 6 and 24 hours after operation. An increase of cardiac index (CI) and arterial blood pressure with biventricular pacing was observed in 27 patients (group 1/67.5%) versus 22 patients (group 2/55%) from 2.4±0.7 l/min/m2 to 3.5±0.5 l/min/m2 (p<0.01). This benefit persisted 6 and 24 hours postoperatively. The remaining patients already showed higher cardiac index prior to pacing (3.7±0.9 l/min/m2). In-group 1, responding patients required shorter times for ventilation support and intensive care. QRS duration before surgery was not predictive for the response to biventricular pacing. Conclusions: In the majority of patients with reduced LV function, temporary biventricular pacing improves CO and arterial blood pressure after surgery, especially when LV-dilatation is present.

Keywords: Biventricular Pacing, Cardiopulmonary Bypass, and Heart failure.

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Published

2015-12-26

How to Cite

Asani, V., & Dzemaili, O. (2015). The Impact of Limited Biventricular Stimulation on Cardiac Hemodynamics in Patients with Reduced Left Ventricular Function. ANGLISTICUM. Journal of the Association-Institute for English Language and American Studies, 3(8), 127–139. Retrieved from https://anglisticum.org.mk/index.php/IJLLIS/article/view/309

Issue

Section

Volume 3, No.8, August, 2014