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dc.contributor.authorHealy, David G
dc.contributor.authorHargrove, Martin
dc.contributor.authorDoddakulla, Kishore
dc.contributor.authorHinchion, John
dc.contributor.authorO'Donnell, Aongus
dc.contributor.authorAherne, Thomas
dc.date.accessioned2012-02-03T15:09:29Z
dc.date.available2012-02-03T15:09:29Z
dc.date.issued2012-02-03T15:09:29Z
dc.identifier.citationInteract Cardiovasc Thorac Surg. 2008 Oct;7(5):805-8. Epub 2008 Jun 9.en_GB
dc.identifier.issn1569-9285 (Electronic)en_GB
dc.identifier.issn1569-9285 (Linking)en_GB
dc.identifier.pmid18541607en_GB
dc.identifier.doi10.1510/icvts.2008.180497en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208996
dc.description.abstractWe have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml/min (24), DDD-biventricular 52 ml/min (25), VVI-univentricular 47 ml/min (23), VVI-biventricular 50 ml/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshBlood Flow Velocityen_GB
dc.subject.mesh*Cardiac Outputen_GB
dc.subject.meshCardiac Pacing, Artificial/*methodsen_GB
dc.subject.mesh*Coronary Artery Bypassen_GB
dc.subject.mesh*Coronary Circulationen_GB
dc.subject.meshCoronary Vessels/physiopathology/*surgery/ultrasonographyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshStroke Volumeen_GB
dc.subject.meshVascular Patencyen_GB
dc.titleImpact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.en_GB
dc.contributor.departmentDepartment of Cardiothoracic Surgery, Cork University Hospital, Wilton, Cork,, Ireland. cardiothoracic@gmail.comen_GB
dc.identifier.journalInteractive cardiovascular and thoracic surgeryen_GB
dc.description.provinceMunster
html.description.abstractWe have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml/min (24), DDD-biventricular 52 ml/min (25), VVI-univentricular 47 ml/min (23), VVI-biventricular 50 ml/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.


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