June 1, 1999Pacing and Clinical Electrophysiology
Acute Hemodynamic Effects of Alternate and Combined Site Pacing in Patients after Cardiac Surgery
Why the study?
Does alternate and combined site pacing improve cardiac output in patients after cardiac surgery?
Population
37 patients undergoing coronary revascularization or aortic valve replacement.
Comparison
Alternate and combined site epicardial pacing. vs Right atrial pacing and single-site ventricular…
Design
Other, various combinations of sites in random order
Follow-up
Acute
Authors
Discussion
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Member takes
Implication
Multisite pacing should not yet guide post-surgical management; leaves open whether QRS shortening yields clinical benefit.
Structured PICO
Does alternate and combined site pacing improve cardiac output in patients after cardiac surgery?
P
Population
37 patients undergoing coronary revascularization (bypass surgery) or aortic valve replacement (10 patients with EF > 50% and 27 patients with EF <= 50%).
I
Intervention
Alternate and combined site epicardial pacing (DVI pacing at RV paraseptal area, RV outflow tract, LV apex, and various combinations).
C
Comparator
Right atrial pacing (AAI) and single-site ventricular pacing.
O
Outcome
Cardiac output (CO)surrogate
Acute multisite ventricular pacing after cardiac surgery reduces QRS duration but fails to improve cardiac output regardless of baseline ejection fraction.
Cite This Study
Buckingham et al. (1999) studied this question.