Abstract WITH progressive sophistication of the operative treatment of heart disease and expansion of operability limits to include more precariously ill patients, the problems of postoperative myocardial depression with increased rhythm instability have assumed increased importance. Surgeons at the University of Oregon and University of Illinois hospitals have been investigating the use of atrial pacing as one means of meeting these problems. Cardiologists and physiologists have employed atrial electrodes as experimental tools for the study of cardiac function,1 and subsequently in the clinical setting for the evaluation of complex arrhythmias and intracardiac shunts2,3 and for treating occasional cases of ventricular irritability.4,5 However, it was not until recently that the value of atrial pacing as a surgical adjuvant for maintaining optimum postoperative cardiac output and synchronous rhythm stability was first reported.6,7 Other authors have since described similar results with this technique,8,9 but heretofore no reports have attempted References 1. Gilmore, J.P., et al: Synchronicity of Ventricular Contraction: Observations Comparing Hemodynamic Effects of Atrial and Ventricular Pacing , Brit Heart J 25:299-307 ( (May) ) 1963.Crossref 2. Vogel, J.H., et al: Simple Technique for Identifying P-Waves in Complex Arrhythmias , Amer Heart J 67:158-161 ( (Feb) ) 1964.Crossref 3. Vogel, J.H.: Grover, R.F.; Blount, S.G., Jr.: The Platinum Electrode , Amer Heart J 65:841-842 ( (June) ) 1963.Crossref 4. Heiman, D.F., and Helwig, J., Jr.: Suppression of Ventricular Arrhythmias by Transvenous Intracardiac Pacing , JAMA 195:1150-1153 ( (March 28) ) 1966.Crossref 5. Kastor, J.A., et al: Transvenous Atrial Pacing in the Treatment of Refractory Ventricular Irritability , Ann Intern Med 66:939-945 ( (May) ) 1967.Crossref 6. Woodson, R.D., et al: Use of Atrial Pacing in Cardiac Surgical Patients , Circulation 36( (suppl 2) ):275 (Oct) 1967.Crossref 7. Woodson, R.D.: Atrial Pacing in Cardiac Surgical Management: A Preliminary Report , Northwest Med 66:1109-1114 ( (Dec) ) 1967. 8. Beller, B.; Frater, R.W.M.; and Wulfson, N.: Cardiac Pacemaking in the Management of Postoperative Arrhythmias , Ann Thorac Surg 6:68-76 ( (July) ) 1968.Crossref 9. Litwak, R.S., et al: Support of Myocardial Performance After Open Cardiac Operations by Rate Augmentation, read before the 48th annual meeting of the American Association of Thoracic Surgeons, Pittsburgh, April 1968. 10. Woodson, R.D., et al: Postoperative Atrial Pacing: Selection of Patients, Dis Chest, to be published. 11. Kloster, F.E., et al: Serial Cardiac Output and Blood Volume Studies Following Cardiac Valve Replacement , Circulation 33:528-539 ( (April) ) 1966.Crossref 12. Samet, P., et al: Atrial Contribution to Cardiac Output in Complete Heart Block , Amer J Cardiol 16:1-10 ( (July) ) 1965.Crossref 13. Friesen, W.G.: Right Atrial Electrocardiography , Northwest Med 67:245-250 ( (March) ) 1968. 14. Mitchell, J.H.; Gilmore, J.P.; and Sarnoff, S.J.: The Transport Function of the Atrium: Factors Influencing the Relation Between Mean Left Atrial Pressure and Left Ventricular End-Diastolic Pressure , Amer J Cardiol 9:237-247 ( (Feb) ) 1962.Crossref 15. Martin, R.H., and Cobb, L.A.: Observations on the Effect of Atrial Systole in Man , J Lab Clin Med 687:224-232 ( (Aug) ) 1966. 16. Benchimol, A., et al: Contribution of Atrial Systole to the Cardiac Function at a Fixed and at a Variable Ventricular Rate , Amer J Cardiol 16:11-21 ( (July) ) 1965.Crossref 17. Samet, P., et al: Significance of the Atrial Contribution to Ventricular Filling , Amer J Cardiol 15:195-202 ( (Feb) ) 1965.Crossref 18. Reid, J.M., and Stevenson, J.C.: Cardiac Arrhythmias Following Successful Surgical Closure of Atrial Septal Defect , Brit Heart J 29:742-747 ( (Nov) ) 1967.Crossref 19. Woodson, R.D., et al: Surgical Management of Tetralogy of Fallot in Children Under Age 4, Ann Surg, to be published.
Archives of Surgery – American Medical Association
Published: Dec 1, 1968