Related Experiment Video

Updated: Sep 30, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Impact of atrio-biventricular pacing to poor left-ventricular function after CABG

U Weisse1, F Isgro, Ch Werling

  • 1Clinic for Cardiac Surgery, Heart Centre Ludwigshafen, Germany. weisseu@klilu.de

The Thoracic and Cardiovascular Surgeon
|June 22, 2002
PubMed

Insights

Optimizing epicardial pacing after coronary artery bypass grafting (CABG) is crucial for patients with poor left-ventricular function. Atrio-biventricular pacing improved cardiac index and reduced wedge pressure, enhancing hemodynamic stability.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Patients with poor left-ventricular function after coronary artery bypass grafting (CABG) face significant hemodynamic challenges postoperatively.
  • Synchronous ventricular activation and contraction are vital during the early vulnerable period following cardiac surgery.

Purpose of the Study:

  • To compare the effects of different epicardial pacing modes on postoperative hemodynamic status in patients with impaired left-ventricular function after CABG.
  • To evaluate the efficacy of atrio-biventricular, atrio-monoventricular, and atrial pacing.

Main Methods:

  • A study involving 22 patients with poor left-ventricular function (ejection fraction < 30%) undergoing elective CABG.
  • Postoperative hemodynamic parameters were assessed 3-24 hours after surgery under different pacing modes (atrio-biventricular, atrio-monoventricular, atrial).
  • Temporary epicardial pacing electrodes were placed on the right atrium and both ventricles; pacing mode was confirmed by ECG.

Main Results:

  • In patients with left bundle branch block, atrio-left-ventricular and atrio-biventricular pacing increased cardiac index and decreased wedge pressure.
  • Atrial and atrio-right-ventricular pacing led to decreased cardiac index in patients with left bundle branch block.
  • In patients with right bundle branch block, atrio-right-ventricular and atrio-biventricular pacing increased cardiac index.

Conclusions:

  • Atrio-biventricular pacing demonstrated superior hemodynamic benefits, increasing cardiac index and decreasing wedge pressure compared to atrial pacing (AAI).
  • Site-specific pacing strategies are essential for optimizing postoperative hemodynamics in patients with wall-motion abnormalities and impaired cardiac conduction.
  • Tailored pacing can potentially reduce the need for inotropic support in this vulnerable patient population.
Abstract

More Related Videos

Implantation of the Syncardia Total Artificial Heart16:11

Implantation of the Syncardia Total Artificial Heart

Published on: July 18, 2014

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...