Abstract | OBJECTIVES: The purpose of this research was to assess the hemodynamic response to atrial, ventricular, and dual-chamber pacing in patients with Fontan physiology. BACKGROUND: METHODS: A cross-over trial was conducted with 21 patients (age 2 to 18 years, median 4 years; male patients = 13) in the intensive care unit after a Fontan operation. Hemodynamic parameters, including mean left atrial pressure (LAP, in mm Hg), mean pulmonary artery pressure (PAP, in mm Hg), mean arterial blood pressure (MAP, in mm Hg), and indexed cardiac output via Fick (Qs, in l/min/m2) were measured with atrial, ventricular, and dual-chamber pacing. Measurements were made after pacing for 10 min in each mode, and a 10-min rest was given between each pacing maneuver. RESULTS: Asynchronous ventricular (VOO) pacing resulted in significantly worse hemodynamics when compared to dual-chamber (DOO) and atrial (AOO) pacing with a higher LAP (9.4 VOO; 6.8 DOO; 5.4 AOO) and PAP (15.2 VOO; 13.5 DOO; 12.7 AOO) and lower Qs (3.0 VOO; 3.5 DOO; 3.9 AOO) and MAP (60.1 VOO; 66.5 DOO; 67.2 AOO). CONCLUSIONS: Asynchronous ventricular pacing, after the Fontan procedure, has acute, adverse hemodynamic consequences (elevated LAP and PAP and decreased Qs and MAP).
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Authors | Brent J Barber, Anjan S Batra, Grant H Burch, Irving Shen, Ross M Ungerleider, John W Brown, Mark W Turrentine, Motomi Mori, Yi-Ching Hsieh, Seshadri Balaji |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 46
Issue 10
Pg. 1937-42
(Nov 15 2005)
ISSN: 1558-3597 [Electronic] United States |
PMID | 16286183
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Blood Pressure
- Cardiac Pacing, Artificial
- Child
- Child, Preschool
- Cross-Over Studies
- Female
- Fontan Procedure
- Heart
(physiology)
- Hemodynamics
- Humans
- Male
- Prospective Studies
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