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Europace 2005 7(4):385-387; doi:10.1016/j.eupc.2005.02.119
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

CASE REPORT

Optimized perioperative biventricular pacing in setting of right heart failure*

George Berberiana,*, Joshua P. Kanterb, T. Alexander Quinnc and Henry M. Spotnitza 1

aDepartment of Surgery, Columbia University, College of Physicians and Surgeons 622 West 168th Street, PH 14-103, New York, NY 10032, USA; bDepartment of Pediatrics, Columbia University, College of Physicians and Surgeons 622 West 168th Street, PH 14-103, New York, NY 10032, USA; cBiomedical Engineering, Columbia University, College of Physicians and Surgeons 622 West 168th Street, PH 14-103, New York, NY 10032, USA

AIMS: A 78-year-old female with prior atrioventricular junctional ablation for paroxysmal atrial fibrillation and implantation of DDDR pacemaker underwent repair of severe tricuspid insufficiency. Effects of biventricular pacing were tested with temporary wires at the conclusion of cardiopulmonary bypass.

METHODS: An ultrasonic flow probe was placed on the ascending aorta for real time cardiac output measurements. Atrioventricular delay optimization was performed and biventricular pacing was initiated while right–left ventricular delays were varied.

RESULTS: There was no advantage of biventricular pacing (optimum right–left ventricular delay of +80 ms) compared with existing DDD.

CONCLUSIONS: This study confirms the physiological effects of right–left ventricular delay on cardiac output after cardiopulmonary bypass.

Key Words: biventricular pacing, cardiac output, heart failure

*Corresponding author. Tel.: +1 917 755 3285; fax: +1 212 342 5156. E-mail address: gb2128{at}columbia.edu (G.Berberian), hms2{at}columbia.edu (H.M. Spotnitz).


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