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Abolition of ischemic response to atrial pacing following aortocoronary bypass surgery

B I Jugdutt, S J Lee, R F Taylor

    Circulation
    |August 1, 1976
    PubMed

    Insights

    Successful aortocoronary bypass surgery (ACBS) improved cardiac function by abolishing the ischemic response to right atrial pacing (RAP). This indicates enhanced myocardial perfusion during stress in angina patients post-surgery.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Cardiovascular Physiology

    Background:

    • Coronary artery disease often leads to left ventricular (LV) dysfunction and angina.
    • Aortocoronary bypass surgery (ACBS) aims to restore myocardial perfusion.
    • Assessing LV function and ischemic response is crucial for evaluating surgical outcomes.

    Purpose of the Study:

    • To evaluate the impact of successful ACBS on left ventricular (LV) function.
    • To investigate the changes in ischemic response to right atrial pacing (RAP) after ACBS.
    • To determine the utility of various hemodynamic parameters in assessing ACBS success.

    Main Methods:

    • Studied 22 angina patients before and after ACBS.
    • Assessed ischemic response to right atrial pacing (RAP) pre- and post-surgery.
    • Monitored left ventricular end-diastolic pressure (LVEDP) and other hemodynamic parameters.

    Main Results:

    • Successful ACBS abolished angina during RAP in all patients.
    • Post-pacing LVEDP significantly decreased in patients who experienced angina pre-surgery (Group 1).
    • Ejection fraction and cardiac output changes were not significant indicators of ACBS success.

    Conclusions:

    • Successful ACBS effectively eliminates the ischemic response to pacing-induced stress.
    • The abolition of the ischemic response suggests improved myocardial perfusion post-ACBS.
    • Right atrial pacing is a valuable tool for assessing the functional improvement after ACBS.

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