| Clinical Evaluation of Atrioventricular
Myocardial Pacing on Left or Biventricular Sites |
(Department of Thoracic and Cardiovascular Surgery,
Kanazawa Medical University, Ishikawa, Japan)
| Shigeru Sakamoto |
Junichi Matsubara |
Toshiaki Matsubara |
| Yasuhiro Nagayoshi |
Hisateru Nishizawa |
Shinji Shono |
| Masaaki Kanno |
Katsunori Takeuchi |
Toshimichi Nonaka |
| Yasuhisa Noguchi |
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Multisite pacing has recently been
available as a new treatment for patients with congestive heart
failure. This study was intended to evaluate the effects of atrioventricular
myocardial pacing on left or biventricular sites. Eleven patients
(4 men, 7 women) who had undergone atrioventricular myocardial
pacing between January 2000 and April 2002 were selected for
this study. They ranged in age from 24 to 74 years (mean age
58.5 years). The diagnosis was dilated cardiomyopathy in 3 patients,
ischemic cardiomyopathy in 4, complete atrioventricular heart
block in 2, sick sinus syndrome in 1，and atrial fibrillation
with bradycardia in 1. The method of pacemaker implantation was
atrioventricular myocardial pacing on left or biventricular sites
by means of mini-thoracotomy under general anesthesia. A DDD-R
pacemaker was used. When biventricular pacing was employed, the
ventricular pacing lead was cut, connected with a Y adapter,
and implantation was made biventricularly. We analyzed pre- and
postoperative hemodynamic states by means of a Swan-Ganz catheter,
and clinical course (NYHA class). There was a significant difference
between pre- and postoperative clinical course and hemodynamic
state. The atrioventricular myocardial pacing on left or biventricular
sites was a useful method of improving the clinical course and
hemodynamic state. It is concluded that this method is available
as a new therapeutic option in patients with congestive heart
failure.
Jpn. J. Cardiovasc. Surg. 32：234 -239 (2003) |
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