Transesophageal Pacing for Temporary Heart Rate Acceleration and Management of Hemodynamics

Use of temporary atrial pacing in management of patients after cardiac surgery.

Takeda M, Furuse A, Kotsuka Y. University of Tokyo, Japan. Cardiovasc Surg 4(5):623-7, 1996. The authors' clinical experience with temporary atrial pacing to evaluate its use in the management of patients after cardiac surgery was reviewed. A total of 339 patients undergoing cardiac surgery were studied with regard to postoperative pacing therapy. Postoperative pacing was performed in 186 of 339 patients to treat supraventricular bradycardia or tachyarrhythmias. Rapid atrial pacing was performed to interrupt re-entrant supraventricular tachyarrhythmias. In bradycardic patients, haemodynamics could be improved as the result of significant increase of blood pressure and oxygen saturation in the pulmonary artery (SVO2) caused by atrial pacing. Premature beats could be suppressed in 63% and supraventricular tachyarrhythmias could be interrupted in 66% of the patients only by atrial pacing. Temporary atrial pacing is safe, rapid and effective as the treatment of choice; it is believed that the technique should be applied in preference to pharmacological treatment in the management of patients after cardiac surgery.

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