Key result
Permanent biventricular pacing upgraded during a second re-do CABG in a 59-year-old male improved ejection fraction from 15% to 45% and NYHA class from III-IV to I at follow-up.
Why the study?
Does permanent biventricular pacing via epicardial leads improve LVEF and symptoms in a patient with severe ischemic cardiomyopathy undergoing re-do CABG?
Case Report (n=1)
No
Does permanent biventricular pacing via epicardial leads improve LVEF and symptoms in a patient with severe ischemic cardiomyopathy undergoing re-do CABG?
Absolute Event Rate: 45% vs 15%
Intraoperative epicardial biventricular pacing upgrade during re-do CABG in a patient with severe ischemic cardiomyopathy and wide QRS led to significant improvement in LVEF and symptoms.
Intraoperative biventricular pacing upgrade may improve LVEF and symptoms in re-do CABG for ischemic cardiomyopathy; single case leaves open need for prospective trials.
Biventricular pacing has been suggested in end-stage heart failure. We present a 59-year-old patient undergoing second re-do CABG (coronary artery bypass graft) and carotid artery endarterectomy. Ejection fraction was 15%, QRS-width 175 ms. Following the carotid and CABG procedure, an implanted single-chamber ICD (implantable cardioverter defibrillator) was upgraded to permanent biventricular DDD pacing by implantation of one epicardial left ventricular and one epicardial atrial electrode. At follow-up two months postoperatively ejection fraction had significantly improved to 45%, the patient underwent stress test with adequate load and reported a good quality of life.
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Dzemali et al. (2009) conducted a case report in Heart failure and ischemic cardiomyopathy (n=1). Permanent biventricular DDD pacing via epicardial electrodes vs. Baseline was evaluated on Ejection fraction. Permanent biventricular pacing upgraded during a second re-do CABG in a 59-year-old male improved ejection fraction from 15% to 45% and NYHA class from III-IV to I at follow-up.
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