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Hemodynamic Benefit of Atrial Pacing in Right Ventricular Myocardial Infarction
- ERIC J. TOPOL, M.D.;
- NORA GOLDSCHLAGER, M.D.;
- THOMAS A. PORTS, M.D.;
- LORENZO A. DICARLO, Jr, M.D.;
- NELSON B. SCHILLER, M.D.;
- ELIAS H. BOTVINICK, M.D.; and
- KANU CHATTERJEE, M.B.
Abstract
Right ventricular and inferior-posterior myocardial infarctions in four patients were complicated by low-output syndrome unresponsive to increasing intravascular volume. Ventricular pacing was started because of bradyarrhythmias, but failed to increase cardiac output; atrial pacing at identical rates resulted in dramatic increases in cardiac output. The importance of atrial contribution to ventricular function, as well as the role of the pericardium in this clinical setting, are discussed. In treating right ventricular myocardial infarction, atrial or atrioventricular sequential cardiac pacing may be preferable to ventricular pacing.
Article and Author Information
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▸From the Cardiovascular Division of the Department of Medicine, H. C. Moffitt and San Francisco General Hospitals, University of California; San Francisco, California.
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▸Requests for reprints should be addressed to Kanu Chatterjee, M.B.; Room 1186, Division of Cardiology, 3rd and Parnassus Avenues, University of California, San Francisco, CA 94143.
