title: [Analysis of fusion waves created with temporal pacing].
abstract: Fifty-five beats of fusion waves were recorded continuously with an audio digital tape and the tape was re-played for analysis. A 45-year-old male (56 kg, 175 cm) with cervical spondylosis was scheduled to undergo laminoplasty of the cervical vertebral (C2-C6). A temporal ventricular (VVI mode) pacing lead was inserted from the right cubital vein to the right ventricular apex for preventing bradycardia while manipulating the medulla. The height of the R wave decreased gradually and the depth of S wave increased in the earlier period of fusion beats and it was reversed later. The narrow QRS width indicated that the electrode was placed near the cardiac conducting system. The gradually increasing intervals between P waves activated the pacing, and the P wave intervals recovered inhibiting the pacing. During the recovery phase, some beats were still activated by pacing instead of depressing the rate below the original rate. These beats suggest the importance of considering the atrial-ventricular conducting time. Arterial pressure fluctuated only slightly during the 'fusion beats, suggesting that despite the abnormality in the cardiac conduction system due to pacing, contraction of the ventricular muscles was only slightly affected in this case.
authors.affiliation: Department of Anethesiology, Kyoto Prefectural University of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Ueda
authors.forename: K
authors.initials: K
authors.lastname: Shigemi
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: K
authors.initials: K
authors.lastname: Kakihara
authors.forename: Y
authors.initials: Y
authors.lastname: Nakajima
authors.forename: H
authors.initials: H
authors.lastname: Fukushima
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000768:Anesthesia, General; D001794:Blood Pressure / Q000502:physiology; D001919:Bradycardia / Q000517:prevention & control; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D006329:Heart Conduction System / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D013128:Spinal Osteophytosis / Q000601:surgery; D016278:Ventricular Function, Right / Q000502:physiology