Universität zu Köln

Madershahian, Navid, Scherner, Maximilian, Weber, Carolyn, Kuhn, Elmar, Choi, Yeong-Hoon, Slottosch, Ingo and Wahlers, Thorsten (2015). Temporary biventricular pacing improves bypass graft flows in coronary artery bypass graft patients with permanent atrial fibrillation. Interact Cardiovasc. Thorac. Surg., 21 (4). S. 435 - 441. OXFORD: OXFORD UNIV PRESS. ISSN 1569-9285

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Abstract

OBJECTIVES: We have previously demonstrated the impact of univentricular pacing modalities on bypass graft flow (BGF) in the coronary artery bypass graft (CABG) patient with permanent atrial fibrillation (AF). The aim of the present study was to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing in patients with and without severe left ventricular dysfunction. METHODS: In 43 CABG patients [mean age 69.5 +/- 1.3 years; ejection fraction (EF) 49 +/- 2%] with AF, we analysed coronary vascular resistances (CVRs) and the contemporary changes in the BGF obtained during right ventricular outflow tract (RVOT), right-(RV), left-(LV) and right-left ventricular pacing (biventricular pacing, BiVP) using the ultrasonic transit-time methodology. RESULTS: BiVP resulted in the highest percentage decrease of CVR in the overall study group by 17.5 +/- 3.0% (P < 0.001), followed by RVOT pacing with 13.9 +/- 3.9%. Accordingly, the highest mean BGF was achieved during BiVP, resulting in a 21.6 +/- 2.6% increase when compared with no pacing and 16 +/- 3.7% when compared with RV pacing. Analysis of patients according to their preoperative LV function (EF >= 50%, n = 26; EF <50%, n = 17) showed significantly lower CVR (P < 0.037) and higher BGF during BiVP in patients with lower EF. CONCLUSIONS: Placement of an additional LV pacing wire offered a significant improvement in BGF by minimizing CVR in patients with AF and poor EF.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-391244
DOI:	10.1093/icvts/ivv169
Journal or Publication Title:	Interact Cardiovasc. Thorac. Surg.
Volume:	21
Number:	4
Page Range:	S. 435 - 441
Date:	2015
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1569-9285
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VENTRICULAR OUTFLOW TRACT; CARDIAC-OUTPUT; FOLLOW-UP; TIME; FAILURE; SITE; ABNORMALITIES; STIMULATION; DYSFUNCTION; MODES Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39124