Hermodynamic effects of biventricular stimulation in patients at post-operative period of coronary arterybypass surgery / Efeito hemodinamico da sincronização eletrica biventricular prolongada no pos-operatorio de revascularização do miocardio

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

The present study aims to evaluate the influence of lengthened biventricular stimulation on the post-surgical period of myocardical revascularization in patients that carry left ventricular dysfunction, FE ? 40%, associated to QRS endurance equal to or less than 130 ms. From a selection of 21 patients, 16 of which were randomized in 2 groups named: Biventricular Stimulation Group (EBV Group) and Control Group. Both groups have been submitted to a 12-hour continuous monitoring period, with the following parameters being collected: systemic hemodynamic parameters (mean arterial pressure, systemic vascular resistance index and temperature), cardiac hemodynamic parameters (cardiac output, cardiac index, left ventricle stroke volume index and heart rate) and pulmonary hemodynamic parameters (pulmonary artery wedge pressure, central venous pressure and pulmonary vascular resistance index). For the analysis of the results we have applied the Student´s t test, Wilcoxon rank-sum test, Fisher´s exact test, Wilks´ test and MANOVA. The synchronization obtained through biventricular stimulation under atrial sense increased the cardiac index, as a consequence of the increased systolic volume. A significant reduction of systemic vascular resistance has also been observed, in comparison to that of the non-stimulated patients. These effects have endured for the 6-hour period that succeeded the interruption of the stimulation in the EBV Group. There was no statistically significant difference in the average blood pressure between the groups. The stimulated group presented a lower pulmonary artery wedge pressure than that of the control group over the stimulation period. We can concluded the biventricular stimulation has produce an improvement on the systolic performance as the left ventricular do the restoration of the ventricular contractibility as a consequence of a synchronization that the not depend the frequency and the QRS lasting

ASSUNTO(S)

insuficiencia cardiaca marca-passo artificial (coração) heart failure artificial pacemaker (heart) coronariopatias coronary disease

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