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Temporary physiologic pacing in inferior wall acute myocardial infarction with right ventricular damage
Authors:M F Matangi
Affiliation:From the University of Saskatchewan and Plains Health Centre, 4500 Wascana Parkway, Regina, Saskatchewan, Canada, S4S 5W9
Abstract:Atrioventricular (AV) sequential pacing for chronic complete heart block is clearly superior in both the laboratory animal and in humans.1–3 The importance of AV synchrony in patients with acute myocardial infarction (AMI) is not well appreciated. Some investigators suggest that AV synchrony is extremely important in patients with inferior AMI, right ventricular (RV) dysfunction and nonsinus bradyarrhythmias.4–6 The predominantly used pacing mode in such patients is ventricular demand pacing with aggressive fluid loading.7 A canine model of right coronary artery occlusion, septal damage and complete heart block conclusively showed that addition of AV synchrony improves mean arterial pressure 29% and cardiac output 34% .8 This study compares the hemodynamics of ventricular demand and atrial or AV sequential pacing in 5 patients with inferior AMI, RV dysfunction and non-sinus bradyarrhythmias.
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