Korean J Thorac Cardiovasc Surg.  2013 Aug;46(4):289-292.

Cardiac Resynchronization Therapy Using a Dual Chamber Pacemaker in Patients with Severe Left Ventricular Dysfunction and a Left Bundle Branch Block

• Jung JJ
• Kim IS
• Jeong JH
• Lee YT
• Jeong DS

Abstract

Through the use of a dual chamber (DDD) pacemaker, we achieved a cardiac resynchronization effect in a 51-year-old female patient who was transferred to our hospital from another hospital for an operation for three-vessel coronary artery disease. Her electrocardiogram showed a left bundle branch block (LBBB) and a prolonged QRS interval of 166 milliseconds. Severe left ventricle (LV) dysfunction was diagnosed via echocardiography. Coronary artery bypass grafting (CABG) was then performed. In order to accelerate left atrial activation and reduce the conduction defect, DDD pacing using right atrial and left and right ventricular pacing wires was initiated postoperatively. The cardiac output was measured immediately, and one and twelve hours after arrival in the intensive care unit. The cardiac output changed from 2.8, 2.4, and 3.6 L/min without pacing to 3.5, 3.4, and 3.5 L/min on initiation of pacing. The biventricular synchronization using DDD pacing was turned off 18 hours after surgery. She was transferred to a general ward with a cardiac output of 3.9 L/min. In patients with coronary artery disease, severe LV dysfunction, and LBBB, cardiac resynchronization therapy can be achieved through DDD pacing after CABG.

Keyword

Bundle-branch block; Dual chamber (DDD) pacemaker; Cardiac resynchronization therapy

MeSH Terms

Bundle-Branch Block
Cardiac Output
Cardiac Resynchronization Therapy
Coronary Artery Bypass
Coronary Artery Disease
Dichlorodiphenyldichloroethane
Echocardiography
Electrocardiography
Female
Heart Ventricles
Humans
Intensive Care Units
Patients' Rooms
Ventricular Dysfunction, Left
Dichlorodiphenyldichloroethane