| Pacemaker Implantation for Atrial
Fibrillation with Bradycardia in Patients with Mitral Valve Disease |
(Department of Cardiovascular Surgery, Jikei University
School of Medicine, Tokyo, Japan and Department of Cardiovascular
Surgery, Kashiwa Hospital, Tokyo Jikei University School of Medicine*,
Kashiwa, Japan)
| Yoshihiro Ko |
Shigeki Horikoshi* |
Asatoshi Mizuno* |
| Isao Aoki* |
Shingo Taguchi* |
|
|
Some cases of atrial fibrillation
and bradycardia show improvement in slow ventricular response
after valvular surgery. However, there is still no established
view regarding the indications of pacemaker implantation for
the bradyarrhythmia with valvular disease. In 24 cases (permanent
pacing group: 15, non-pacing group: 9) of those with bradyarrhythmia
who were fitted with a myocardial pacing lead at the time of
valvular surgery, we examined predictions of pacemaker implantation
and the role of valvular surgery for the bradyarrhythmia. The
permanent pacing group showed much larger values than the non-pacing
group in regard to preoperative NYHA, right and left atrial pressure,
and duration of atrial fibrillation. After valvular surgery,
many cases that had significantly decreased left atrial pressure
after operation improved with regard to bradycardia. We should
judge the indication of pacemaker implantation after valvular
surgery from the evaluation of preoperative hemodynamics and
early postoperative cardiac function. Because atrial fibrillation
tends to accompany bradycardia due to chronic atrial load, we
must make an effort to promote the rapid recovery of cardiac
function by doing valvular surgery as early as possible.
Jpn. J. Cardiovasc. Surg. 31：382-384 (2002) |
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