Acute biventricular pacing after cardiopulmonary bypass decreases myocardial dyssynchrony and increases cardiac index.

摘要

RIGHT VENTRICULAR (RV) apical pacing frequently worsens ventricular dyssynchrony. Data suggest that RV apical pacing is associated with an increase in hospitalizations for heart failure (HF) and atrial fibrillation (AF). Cardiac resynchronization therapy (CRT) improves hemodynamic, functional, and quality of life indices in patients with chronic HF. After cardiopulmonary bypass (CPB), a number of patients may exhibit symptoms of heart failure with interventric-ular and intraventricular dyssynchrony. Patients may require atrioventricular (AV) pacing in the immediate post-CPB period. RV pacing may result in worsened septal dyssynchrony and hemodynamic profiles. The authors report a case in which early implementation of biventricular pacing (BiVP) in the post-CPB period resulted in the resolution of septal dyskinesia and an immediate improvement in hemodynamic function.