Journal article
Usefulness of Cardiac Resynchronization Therapy in Patients With Continuous Flow Left Ventricular Assist Devices
The American journal of cardiology, Vol.123(1), pp.93-99
01/01/2019
DOI: 10.1016/j.amjcard.2018.09.022
PMID: 30539750
Abstract
The benefit of cardiac resynchronization therapy in patients supported by a left ventricular assist device (LVAD) is unknown. There are currently no guidelines regarding the continuation, discontinuation or pacemaker (PM) settings post-LVAD implant. The aim of the study was to assess the hemodynamic benefit of biventricular (BiV) pacing in LVAD patients. We studied 22 patients supported by LVADs (age 62 +/- 9, 21 males) who had received a BiV PM before LVAD implant. A total of 123 complete sets of hemodynamics were obtained during BiV pacing (n = 54), right ventricular (RV) pacing (n = 54), and intrinsic rhythm (n = 15).
There were no significant differences in right atrial (RA) pressure, mean pulmonary artery pressure (mPA), PCWP, cardiac output, PA saturation (PASat) and right ventricular stroke work index between BiV and RV pacing. Hemodynamics obtained during intrinsic rhythm in 15 non-PM-dependent patients were not significantly different compared with those obtained during BiV or RV pacing. Furthermore, hemodynamics were similar at different heart rates ranging 50 to 110 beats/min. Right ventricular stroke work index was significantly lower at the highest heart rate compared with baseline and lowest heart rates suggesting decreased RV performance at higher heart rate. In conclusion, BiV pacing does not have any acute hemodynamic benefit compared with RV pacing or intrinsic rhythm in LVAD patients. A lower heart rate may confer better RV performance. (C) 2018 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Usefulness of Cardiac Resynchronization Therapy in Patients With Continuous Flow Left Ventricular Assist Devices
- Creators
- Vlad Cotarlan - University of CincinnatiFrances Johnson - Iowa Orthopaedic CenterJennifer Goerbig-Campbell - Iowa Orthopaedic CenterKellyAnn Light-McGroary - University of IowaChakradhari Inampudi - University of IowaJennifer Franzwa - University of IowaKyle Jenn - University of IowaCarol Johnson - University of IowaRudhir Tandon - University of IowaRizwan Tahir - Geisinger Medical CenterYassar Nabeel - MetroHealthUzodinma Emerenini - Tulane UniversityMichael Giudici - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.123(1), pp.93-99
- DOI
- 10.1016/j.amjcard.2018.09.022
- PMID
- 30539750
- NLM abbreviation
- Am J Cardiol
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Publisher
- Elsevier
- Number of pages
- 7
- Language
- English
- Date published
- 01/01/2019
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9985035877702771
Metrics
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