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Ann Thorac Surg 2006;82:2292-2294
© 2006 The Society of Thoracic Surgeons

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Case Reports

Left Ventricular Pacing Site-Timing Optimization During Biventricular Pacing Using a Multi-Electrode Patch

^a Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, New York
^b Department of Biomedical Engineering, Columbia University, College of Physicians and Surgeons, New York, New York
^c Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, New York

Accepted for publication April 27, 2006.

^_* Address correspondence to Dr Spotnitz, Department of Surgery, Columbia College of Physicians and Surgeons, 622 W 168th St, New York, NY 10032. (Email: hms2{at}columbia.edu).

A 71-year-old man with class IV congestive heart failure and an infected pacemaker/implantable cardioverter defibrillator (ICD) underwent median sternotomy for removal of endocardial leads with a 15-mm vegetation. Cardiac output during biventricular pacing was optimized with an aortic flow probe, a multi-electrode left ventricular patch, and a randomized protocol assessing 54 combinations of pacing site and right ventricle–left ventricle delay. Results that were assessed with response surface methodology determined permanent epicardial lead position and timing. The difference between the best and worst site-timing combinations altered cardiac index by nearly 70%. This experience demonstrates potential importance of the epicardial approach to site-timing optimization for biventricular pacing.

This article has been cited by other articles:

				T. A. Quinn, S. E. Cabreriza, M. E. Richmond, A. D. Weinberg, J. W. Holmes, and H. M. Spotnitz Simultaneous variation of ventricular pacing site and timing with biventricular pacing in acute ventricular failure improves function by interventricular assist Am J Physiol Heart Circ Physiol, December 1, 2009; 297(6): H2220 - H2226. [Abstract] [Full Text] [PDF]

				G. Berberian, T. A. Quinn, S. E. Cabreriza, J.-E. S. Kenny, C. A. Garofalo, A. D. Weinberg, and H. M. Spotnitz Left ventricular pacing site and timing optimization during biventricular pacing using a multielectrode patch in pigs J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 574 - 578. [Abstract] [Full Text] [PDF]