Biventricular pacing in conjunction with epicardial atrial pacing adversely affects timing of intra-aortic balloon pump.
A case of accidental triggering of an intra-aortic balloon pump during systole is presented. The patient had a cardiac resynchronization therapy device in place preoperatively for heart failure. A temporary epicardial atrial pacing wire was used during separation from cardiopulmonary bypass for rate control. An intra-aortic balloon pump was necessary for separation from bypass. Although the pacemaker functioned properly, the intra-aortic balloon triggered from the atrial pacing spike and was inflated during systole. Pacemaker and intra-aortic balloon electronics and timing settings that caused this are discussed in detail. Suggestions for prevention are presented.
Cross
David A
DA
Department of Anesthesiology, Scott and White Memorial Hospital, Texas A&M Health Sciences Center, Temple, Texas, USA. dacross@swmail.sw.org
Johnston
William E
WE
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D004868:Equipment Failure; D006352:Heart Ventricles; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D008297:Male; D010496:Pericardium; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000517:prevention & control*