Key result
Atrial pacing resulted in dramatic increases in cardiac output compared to ventricular pacing in four patients with right ventricular myocardial infarction and low-output syndrome.
Why the study?
Does atrial pacing improve cardiac output compared to ventricular pacing in patients with right ventricular myocardial infarction complicated by low-output syndrome and bradyarrhythmias?
Case Report (n=4)
Does atrial pacing improve cardiac output compared to ventricular pacing in patients with right ventricular myocardial infarction complicated by low-output syndrome and bradyarrhythmias?
Atrial or atrioventricular sequential pacing provides significant hemodynamic benefit over ventricular pacing in patients with right ventricular myocardial infarction and low-output syndrome.
Answers are grounded in this paper and cite their sources.
May suggest atrial pacing in RV MI low-output syndrome; hypothesis-generating and should not yet change practice.
Right ventricular and inferior-posterior myocardial infarctions in four patients were complicated by low-output syndrome unresponsive to increasing intravascular volume. Ventricular pacing was started because of bradyarrhythmias, but failed to increase cardiac output; atrial pacing at identical rates resulted in dramatic increases in cardiac output. The importance of atrial contribution to ventricular function, as well as the role of the pericardium in this clinical setting, are discussed. In treating right ventricular myocardial infarction, atrial or atrioventricular sequential cardiac pacing may be preferable to ventricular pacing.
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Eric J. Topol (1982) conducted a case report in Right ventricular and inferior-posterior myocardial infarctions complicated by low-output syndrome (n=4). Atrial pacing vs. Ventricular pacing was evaluated on Cardiac output. Atrial pacing resulted in dramatic increases in cardiac output compared to ventricular pacing in four patients with right ventricular myocardial infarction and low-output syndrome.
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