title: A simple method of triggering balloon counterpulsation accurately during off-pump coronary artery bypass surgery.
abstract: With increasing experience, off-pump coronary artery bypass grafting for high-risk patients can be performed safely. However, in patients who need intraaortic balloon counterpulsation support, mistriggering of intraaortic balloon counterpulsation during mobilization of the heart can induce unstable hemodynamic conditions. My colleagues and I have developed a simple method of detecting the trigger signal accurately: an epicardial pacemaker wire is placed close to the apex of the left ventricle, and 1 precordial V lead is disconnected and then linked to the epicardial pacemaker wire. This method provides an excellent detection of R-wave potentials in any position of the heart throughout an entire off-pump coronary artery bypass grafting procedure.
authors.affiliation: Department of Cardiovascular Surgery, Heart Centre, Nagoya Tokushukai General Hospital, Aichi, Japan. takohno@hotmail.com
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ono
authors.forename: Teiji
authors.initials: T
authors.lastname: Asakura
authors.forename: Takeki
authors.initials: T
authors.lastname: Ohashi
authors.forename: Nagara
authors.initials: N
authors.lastname: Ono
mesh_terms: D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D015908:Counterpulsation / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D010138:Pacemaker, Artificial