Effect of dobutamine combined with intra-aortic balloon counterpulsation on left ventricular function early after acute myocardial infarction: experimental study

Intra-Aortic Balloon Pump Catheter Insertion Using a Novel Left External Iliac Artery Approach in A Case of Chronic Heart Failure Due to Dilated Cardiomyopathy

Patient: Female, 67-year-old

Final Diagnosis: Heart failure

Symptoms: Chest pain • dyspnoea • poor exercise tolerance

Medication: —

Clinical Procedure: Intraoartic baloon pump insertion – new technique

Specialty: Cardiac surgery

Effect of left ventricular pacing mode and site on hemodynamic, torsional and strain indices

INTRODUCTION

Several reports have indicated that left ventricular (LV) lead placement at an optimal pacing site is an important determinant of short- and long-term outcome. This study investigated the effect of pacing mode (atrioventricular [AV] or ventricular) and site (LV apical or lateral) outside the ischemic region on the LV hemodynamic, torsional and strain indices in the ischemic myocardium.

METHODS

Experiments were conducted in anesthetized open-chest pigs (n = 15) 30 min after LAD ligation to investigate the hemodynamic effects of temporary epicardial AV and ventricular LV pacing at the LV apical (outside the ischemic region) or lateral wall. LV hemodynamic data were recorded (ejection fraction, stroke volume, dP/dt_max, systolic pressure, cardiac output and e/e΄ ratio) and torsional (twist, rotation), as well as deformation (radial and circumferential strain), indices of LV function were assessed using two-dimensional speckle tracking imaging.

RESULTS

The LV function was highly dependent on the pacing mode and site. LV dP/dt_max, systolic pressure and twist decreased significantly during LV pacing in comparison to sinus rhythm (p = 0.004, p<0.001, p = 0.002, respectively). Torsion in sinus rhythm decreased significantly during AV-pacing at the lateral wall (0.11±0.04°/mm vs. 0.06±0.02°/mm, p = 0.005) but did not change significantly during AV-pacing at the apex (0.07±0.05°/mm).

CONCLUSIONS

LV pacing at the apical or lateral wall, in the ischemic myocardium, leads to a suboptimal response in comparison to sinus rhythm. LV pacing at the apex outside the ischemic area exhibits a better response than pacing at the lateral wall, possibly because pacing from this site leads to a more physiological propagation of electrical conduction.

Artificial organs 2011: a year in review

In this Editor's Review, articles published in 2011 are organized by category and briefly summarized. As the official journal of The International Federation for Artificial Organs, The International Faculty for Artificial Organs, and the International Society for Rotary Blood Pumps, Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level."Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ replacement, recovery, and regeneration from all over the world. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers, the quality expected from such a journal would not be possible. We also express our special thanks to our Publisher, Wiley-Blackwell, for their expert attention and support in the production and marketing of Artificial Organs. In this Editor's Review, that historically has been widely well-received by our readership, we aim to provide a brief reflection of the currently available worldwide knowledge that is intended to advance and better human life while providing insight for continued application of technologies and methods of organ replacement, recovery, and regeneration. We look forward to recording further advances in the coming years.