title: [New method for accurate ECG trigger of intraaortic balloon counterpulsation during off-pump coronary artery bypass surgery].
abstract: BACKGROUND
  Retractions of the heart required for exposure and construction of distal anastomoses often decrease R-wave amplitude of ECG and interfere with intraaortic balloon pump (IABP) trigger during off-pump coronary artery bypass (OPCAB). Missing R wave trigger results in asynchronous work of IABP and probably produces hemodynamic instability. We report our early experience with a new interface BPI 202 (Osypka Medical, Inc., USA) for sensing accurate ECG trigger for IABP during OPCAB procedure.
  
  
  METHODS
  Six high-risk patients undergoing multivessel OPCAB using BPI 202 are described.
  
  
  RESULTS
  With the new interface BPI 202, simulated R wave signal could be processed from an external dual chamber pacemaker sensing surface R wave. The simulated R wave was successfully used for controlling IABP and secured a synchronous work between the heart and IABP during heart retraction maneuver. BPI 202, an interface for IABP appeared to facilitate the intraoperative management of our series of patients.
  
  
  CONCLUSIONS
  We believe BPI 202 can produce a synchronous work of IABP during OPCAB procedures to high-risk patients and avoid dangerous hemodynamic instability.
authors.affiliation: Department of Anesthesia, Clinical Engineering, National Hospital Organization, Tokyo Medical Center, Tokyo 152-8902.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Mori
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kaneko
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Aoyama
authors.forename: Seiko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Wataru
authors.initials: W
authors.lastname: Takayama
authors.forename: Keiko
authors.initials: K
authors.lastname: Miyashita
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kobayasii
authors.forename: Masashi
authors.initials: M
authors.lastname: Nagumo
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kamikado
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000601:surgery*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D015908:Counterpulsation / Q000379:methods*; D004562:Electrocardiography; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods*; D008297:Male