[Ventricular stimulation triggered by esophageal atriogram: a new technique of temporary physiologic stimulation in the course of acute myocardial infarct complicated by atrioventricular block and low cardiac output].
Advanced atrio-ventricular (AV) block during acute myocardial infarction (AMI) is considered a complicating dysrhythmia as the well as mechanism responsible for occurrence of life-threatening hemodynamic changes. Often, simple VVI pacing can result insufficient in improving the decreased cardiac output. VDD pacing, which preserves atrial contribution, should represent the most effective electrical approach; therefore, it requires intracavitary placement of 2 catheters. In 10 pts (6M, 4F, mean age of 63.8 +/- 6.6 years) with advanced AV block due to AMI (4 inferior, 6 anterior) and without sinus node dysfunction, we performed stable VDD stimulation (mean 16.6 +/- 20.6 hours) using only one catheter positioned in the right ventricle while the atrial impulse, filtered (50-70 Hz) and amplified through a special device, was derived from the esophagus. Such technique is rapid and reliable, avoiding problems associated with atrial sensing and catheterization.
Manfredini
R
R
Divisione di Cardiologia, Ospedale Maggiore, IRCCS, Milano.
Arlotti
M
M
Greco
E M
EM
Ambrosini
F
F
Sernesi
L
L
Lotto
A
A
D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods; D002303:Cardiac Output, Low / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006327:Heart Block / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*
Stimolazione ventricolare triggerata dall'atriogramma esofageo: nuova tecnica di stimolazione temporanea fisiologica in corso di ima complicato da bav avanzato e bassa portata cardiaca.