Вестник хирургии имени И.И. Грекова (Oct 2015)
ASSESSMENT OF EFFICACY OF TEMPORARY EPICARDIAL BIVENTRICULAR RESYNCHRONIZATION PACING AFTER CARDIAC SURGERY
Abstract
The temporary pacing is provided as a key principle of maintenance and correction of hemodynamics after weaning the patient from cardiopulmonary bypass. There are conventional algorithms of temporary pacing, but the substantiation of electrode fixation areas is variable. The authors experimentally investigated the efficacy of temporary epicardial pacing in DDD and DDDBV using 18 laboratory animals after cardiac surgery with application of cardiopulmonary bypass. The hemodynamic parameters were compared in given groups. It was noted that in case of temporary epicardial pacing in DDDBV conditions was the best hemodynamic effect. The authors recommended more optimal areas for electrode fixation in temporary pacing: bachmans bunble (closest to the artrial septum), proximal part of the crista terminalis for the right atrium electrodes; the front-side free wall of the right ventricle at the distance of 3-4 cm from the apex of the heart, diaphragmatic surface of the right ventricle proximal to artioventricular groove for the right ventricle electrodes; obtuse margin (side wall of the left ventricle), diaphragmatic surface of the left ventricle proximal to artioventricular groove for the left ventricle electrodes.
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