The effect of biventricular pacing after coronary artery bypass grafting: A prospective randomized trial of different pacing modes in patients with reduced.

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Presentation transcript:

The effect of biventricular pacing after coronary artery bypass grafting: A prospective randomized trial of different pacing modes in patients with reduced left ventricular function Frank Eberhardt, MD, Matthias Heringlake, MD, Maximilian S. Massalme, MD, Anika Dyllus, MD, Martin Misfeld, MD, PhD, Hans-H. Sievers, MD, Uwe K.H. Wiegand, MD, Thorsten Hanke, MD The Journal of Thoracic and Cardiovascular Surgery Volume 137, Issue 6, Pages 1461-1467 (June 2009) DOI: 10.1016/j.jtcvs.2008.11.025 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Postoperative hemodynamics in relation to postoperative pacing mode. Significant differences between atrial inhibited pacing and atrioventricular synchronous biventricular pacing (P < .05) are marked with asterisks. CVP, Central venous pressure; PAP, pulmonary arterial pressure; MAP, mean arterial pressure; AAI, atrial inhibited pacing; DDD-RVOT, atrioventricular synchronous pacing at right ventricular outflow tract; DDD-BIV, atrioventricular synchronous biventricular pacing. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1461-1467DOI: (10.1016/j.jtcvs.2008.11.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Time courses of aminoterminal pro–brain natriuretic peptide (NT-pro-BNP, left panel), troponin T (middle panel), and creatine kinase isoenzyme MB (CK-MB, right panel) in relation to pacing mode. There were no significant differences among pacing groups. AAI, Atrial inhibited pacing; DDD-RVOT, atrioventricular synchronous pacing at right ventricular outflow tract; DDD-BIV, atrioventricular synchronous biventricular pacing; pre-OP, preoperative; post-OP, postoperative. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1461-1467DOI: (10.1016/j.jtcvs.2008.11.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Cumulative doses during first 24 postoperative hours for norepinephrine (noradrenaline, left panel), dobutamine (middle panel), and milrinone (right panel) in relation to pacing mode. There were no significant differences among pacing groups. AAI, Atrial inhibited pacing; DDD-RVOT, atrioventricular synchronous pacing at right ventricular outflow tract; DDD-BIV, atrioventricular synchronous biventricular pacing. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1461-1467DOI: (10.1016/j.jtcvs.2008.11.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Cumulative incidences of atrial fibrillation (left panel) and ventricular arrhythmias (sustained ventricular tachycardia and ventricular fibrillation, middle panel) and amiodarone dose (right panel) during 96-hour stimulation period in relation to pacing mode. There were no significant differences among pacing groups. AAI, Atrial inhibited pacing; DDD-RVOT, atrioventricular synchronous pacing at right ventricular outflow tract; DDD-BIV, atrioventricular synchronous biventricular pacing. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1461-1467DOI: (10.1016/j.jtcvs.2008.11.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Creatinine clearance (by Modification of Diet in Renal Disease method, left panel) and RIFLE score (left panel) in relation to pacing mode. Significant difference (P < .05) between atrioventricular synchronous pacing at right ventricular outflow tract and atrioventricular synchronous biventricular pacing is marked with asterisk. AAI, Atrial inhibited pacing; DDD-RVOT, atrioventricular synchronous pacing at right ventricular outflow tract; DDD-BIV, atrioventricular synchronous biventricular pacing; pre-OP, preoperative; post-OP, postoperative. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1461-1467DOI: (10.1016/j.jtcvs.2008.11.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions