Temporary biventricular pacing after cardiac surgery: a method of supporting cerebral perfusion

One of the main aims in postoperative period after cardiac surgery is the improving good systemic hemodynamics. In this connection after the cardiac operation it is necessary to use temporary pacing. In literature we can find a lot of methods of application temporary pacing, but what is better we don’t know. Routinely, in cardiac surgical procedures, epicardial pacing leads are placed on the right atrium and right ventricle in case of significant bradycardia or the development of atrioventricular block. It has been reported previously that right atrium - right ventricle pacing may induce left ventricle dyssynchrony and hemodynamic compromise compared with atrial pacing alone. On the other hand, it has recently been suggested that right atrio-biventricular pacing may improve hemodynamics in postcardiac surgery patients. However, this conclusion is not clear in the clinical setting. And may be we will be able to reduce the doses of inotropes, if we will be use method of right atrio-biventricular pacing [16, 20]. Temporary atrio-biventricular pacing improves cardiac output after open-heart surgery and whether ventricular pacing optimization increases cardiac output in this setting. We will examine which forms of cardiac dysfunction benefit from temporary pacing using direct and indirect measures of perfusion and cardiac function. We will also analyze hemodynamics effect after cardiac operation with different setting of pacemaker. The results of our study demonstrate the high efficiency of temporary biventricular pacing, achieved the best hemodynamic effect compared with other methods of temporary pacemaker.

epicardial biventricular pacing, pacing after cardiac surgery, cerebral perfusion, cerebral protection