title: The hemodynamic effect of right ventricle (RV), RT3DE targeted left ventricle (LV) and biventricular (BIV) pacing in the early postoperative period after cardiac surgery.
abstract: BACKGROUND
  Congestive heart failure negatively impacts the prognosis in patients after cardiac surgery. The aim of our study was to assess the value of targeted cardiac resynchronization therapy (CRT) within 72 hours after cardiac surgery in patients with mechanical dyssynchrony, who had an ejection fraction ≤ 35%, QRS ≥150 ms or between 120 and 150 ms.
  
  
  METHODS
  A prospective randomized trial based on three-dimensional echocardiography (RT3DE) and optimized sequential dual-chamber (DDD ) pacing in patients after cardiac surgery. DDD epicardial pacing (Medtronic coaxial epicardial leads 6495) was provided by a modified Medtronic INSYNC III Pacemaker (Medtronic Inc., Minneapolis, MN, USA).
  
  
  RESULTS
  The study included 21 patients with ischemic heart disease (HD) or valvular HD (16 men, 5 women, average age 69 years) with left ventricle (LV) dysfunction after cardiac surgery . Patients with biventricular (BIV) (CO 6.7 ± 1.7 L/min, CI 3.5 ± 0.8 L/min/m(2) ) and LV (CO 6.2 ± 1.5 L/min, CI 3.2 ± 0.7 L/min/m(2) ) pacing had statistically significantly higher CO and CI than patients with right ventricular (RV) (CO 5.4 ± 1.4 L/min, CI 2.8 ± 0.6 L/min/m(2) ) pacing (BIV vs RV P ≤ 0.001; LV vs RV P ≤ 0.05; BIV vs LV P ≤ 0.05).
  
  
  CONCLUSIONS
  RT3DE targeted and optimized CRT in the early postperative period after cardiac surgery provided better hemodynamic results than RV pacing.
authors.affiliation: Department of Cardiovascular Surgery Department of Anaesthesiology and Intensive Care Medicine Department of Cardiology Medical Statistics Unit, Institute for Clinical and Experimental Medicine, Videnska, Prague, Czech Republic Medtronic Czechia s.r.o., Revnicka, Prague, Czech Republic. frst@ikem.cz
authors.forename: Frantisek
authors.initials: F
authors.lastname: Straka
authors.forename: Jan
authors.initials: J
authors.lastname: Pirk
authors.forename: Marian
authors.initials: M
authors.lastname: Pindak
authors.forename: Ivo
authors.initials: I
authors.lastname: Skalsky
authors.forename: Vlastimil
authors.initials: V
authors.lastname: Vancura
authors.forename: Robert
authors.initials: R
authors.lastname: Cihak
authors.forename: Tomas
authors.initials: T
authors.lastname: Marek
authors.forename: Petr
authors.initials: P
authors.lastname: Lupinek
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Masin
authors.forename: David
authors.initials: D
authors.lastname: Schornik
authors.forename: Michal
authors.initials: M
authors.lastname: Zeman
authors.forename: Janka
authors.initials: J
authors.lastname: Skrobakova
authors.forename: Zora
authors.initials: Z
authors.lastname: Dorazilova
authors.forename: Jelena
authors.initials: J
authors.lastname: Skibova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058406:Cardiac Resynchronization Therapy; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006349:Heart Valve Diseases / Q000601:surgery / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery / Q000628:therapy*; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery / Q000628:therapy