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ARTICLE |

Atrial Pacing Following Open-Heart Surgery FREE

Richard J. Cleveland, MD; Ronald J. Nelson, MD; Donald W. Zeilenga, MD; Maurice Lippmann, MD
[+] Author Affiliations

Accepted for publication Feb 18, 1972.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara, Calif, Jan 15,1972.

Reprint requests to Department of Surgery, Harbor General Hospital, 1000 W Carson St, Torrance, Calif 90509 (Dr. Cleveland).


Arch Surg. 1972;105(1):26-29. doi:10.1001/archsurg.1972.04180070024004
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In 50 patients with acquired valvular heart disease, an epicardial atrial pacing electrode was placed in juxtaposition to the sino-atrial node for epicardial-atrial pacing in the early postoperative period. In ten patients countershock failed to convert atrial fibrillation and precluded atrial pacing, and 12 patients did not require this procedure. Epicardial atrial pacing was used in 28 patients. Satisfactory atrial pacing was established in 12 of 21 patients undergoing mitral valve surgery, ten of 20 patients receiving an aortic valve prosthesis, and six of nine patients undergoing multiple valve surgery. Control of atrial or ventricular ectopy was the indication for pacing in 22 patients, while sinus bradycardia with hypotension necessitated pacing in six. Atrial electrograms were diagnostically important in seven patients. All electrodes were removed prior to discharge from the hospital. There were no complications secondary to the use of the electrode. Temporary atrial pacing is a safe and useful adjunct in the early postoperative period in patients undergoing surgery for valvular heart disease.

REFERENCES

Hodam RP, Starr A:  Temporary postoperative epicardial pacing electrodes . Ann Thorac Surg 8:506-510, 1969;.
Woodson RD, Starr A:  Atrial pacing after mitral valve surgery . Arch Surg 97:984-990, 1968;.
Friesen WG, Woodson RD, Ames AW, et al:  A hemodynamic comparison of atrial and ventricular pacing in postoperative cardiac surgical patients . J Thorac Cardiovasc Surg 55:271-279, 1968;.
Vogel JH, Kambuzia T, Averill KH, et al:  A simple technique for identifying P-waves in complex arrhythmias . Amer Heart J 67:158-161, 1964;.
Bailey GWH, Braniff BA, Hancock EW, et al:  Relation of left atrial pathology to atrial fibrillation in mitral valvular disease . Ann Intern Med 69:13-20, 1968;.
Bush HL, Gelband H, Hoffman BF, et al:  Electrophysiological basis for supraventricular arrhythmias: Following surgical procedures for aortic stenosis . Arch Surg 103:620-624, 1971;.
Langendorf R, Pick A, Wintermitz M:  Mechanisms of intermittent ventricular bigeminy: I. Appearance of ectopic beats dependent upon length of the ventricular cycle, the "rule of bigeminy." Circulation 2:422-430, 1955;.
DeSanctis RW:  Diagnostic and therapeutic uses of atrial pacing . Circulation 43:748-761, 1971;.

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Hodam RP, Starr A:  Temporary postoperative epicardial pacing electrodes . Ann Thorac Surg 8:506-510, 1969;.
Woodson RD, Starr A:  Atrial pacing after mitral valve surgery . Arch Surg 97:984-990, 1968;.
Friesen WG, Woodson RD, Ames AW, et al:  A hemodynamic comparison of atrial and ventricular pacing in postoperative cardiac surgical patients . J Thorac Cardiovasc Surg 55:271-279, 1968;.
Vogel JH, Kambuzia T, Averill KH, et al:  A simple technique for identifying P-waves in complex arrhythmias . Amer Heart J 67:158-161, 1964;.
Bailey GWH, Braniff BA, Hancock EW, et al:  Relation of left atrial pathology to atrial fibrillation in mitral valvular disease . Ann Intern Med 69:13-20, 1968;.
Bush HL, Gelband H, Hoffman BF, et al:  Electrophysiological basis for supraventricular arrhythmias: Following surgical procedures for aortic stenosis . Arch Surg 103:620-624, 1971;.
Langendorf R, Pick A, Wintermitz M:  Mechanisms of intermittent ventricular bigeminy: I. Appearance of ectopic beats dependent upon length of the ventricular cycle, the "rule of bigeminy." Circulation 2:422-430, 1955;.
DeSanctis RW:  Diagnostic and therapeutic uses of atrial pacing . Circulation 43:748-761, 1971;.

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