Load dependence of cardiac output in biventricular pacing: right ventricular volume overload in pigs

The Journal of Thoracic and Cardiovascular Surgery
David G RabkinH M Spotnitz

Abstract

Previous work from our laboratory has demonstrated that optimization of biventricular pacing is load dependent. During acute pulmonary stenosis and right ventricular pressure overload in swine, cardiac output was maximized by pacing the right ventricle 40 ms before the left ventricle. To extend those studies, this experiment examined biventricular pacing optimization during right ventricular volume overload. After median sternotomy in 6 anesthetized domestic pigs, complete heart block was induced by ethanol ablation. A conduit was grafted from the right ventricle to the right atrium to simulate tricuspid insufficiency. During epicardial, atrial tracking DDD biventricular pacing, atrioventricular delay was varied between 60 and 180 ms in 30-ms increments. Right ventricular-left ventricular delay was varied at each atrioventricular delay from +80 ms (right ventricle first) to -80 ms (left ventricle first) in 20-ms increments. Aortic flow, right ventricular pressure, and electrocardiogram were measured at each pacemaker setting with the graft clamped and unclamped. Atrioventricular and right ventricular-left ventricular delays had no significant effect on cardiac output with the graft clamped. With the graft unclamped, however, th...Continue Reading

References

Sep 1, 2001·The American Journal of Medicine·S S Barold
Jun 26, 2003·The Annals of Thoracic Surgery·Frank J ZimmermanEmile A Bacha
Jun 3, 2004·The Journal of Thoracic and Cardiovascular Surgery·David G RabkinHenry M Spotnitz
Aug 13, 2004·Pacing and Clinical Electrophysiology : PACE·David G RabkinHenry M Spotnitz

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Citations

May 29, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Andrew MaslowPaul M Heerdt
Jul 20, 2010·Journal of Cardiothoracic and Vascular Anesthesia·Mathew E SpotnitzHenry M Spotnitz
Feb 14, 2007·Journal of Vascular and Interventional Radiology : JVIR·Hanno HoppeJosef Rösch
Aug 13, 2004·Pacing and Clinical Electrophysiology : PACE·David G RabkinHenry M Spotnitz
Jan 6, 2005·The Journal of Thoracic and Cardiovascular Surgery·Henry M Spotnitz
Mar 7, 2006·The Journal of Thoracic and Cardiovascular Surgery·George BerberianHenry M Spotnitz
Jun 6, 2006·American Journal of Physiology. Heart and Circulatory Physiology·T Alexander QuinnHenry M Spotnitz

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