The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 3 , Pages 574-578 , September 2007

Left ventricular pacing site and timing optimization during biventricular pacing using a multielectrode patch in pigs

  • George Berberian, MD

      Affiliations

    • Departments of Surgery,
    • ,
  • T. Alexander Quinn, MS

      Affiliations

    • Biomedical Engineering,
    • ,
  • Santos E. Cabreriza, MBA

      Affiliations

    • Departments of Surgery,
    • ,
  • Jon-Emile S. Kenny, BS

      Affiliations

    • Departments of Surgery,
    • ,
  • Cara A. Garofalo, MD

      Affiliations

    • Pediatrics,
    • ,
  • Alan D. Weinberg, MS

      Affiliations

    • Biostatistics, Columbia University, College of Physicians and Surgeons, New York, NY
    • ,
  • Henry M. Spotnitz, MD

      Affiliations

    • Departments of Surgery,
    • George H. Humphreys, II Professor of Surgery.
    • Corresponding Author InformationAddress for reprints: Henry M. Spotnitz, MD, Department of Surgery, Columbia College of Physicians and Surgeons, 622 West 168th St, PH 14-103, New York, NY 10032

Received 21 September 2006 ,Revised 11 March 2007 ,Accepted 25 April 2007.

  • Image Result

    Diagram of the multielectrode patch with 5 bipolar electrodes and corresponding left ventricular sites. Dimensions are indicated in centimeters. Apical leads were sewn in. APEX, Apical; CIRC, circumfl

    Diagram of the multielectrode patch with 5 bipolar electrodes and corresponding left ventricular sites. Dimensions are indicated in centimeters. Apical leads were sewn in. APEX, Apical; CIRC, circumflex; IL, inferolateral; IM, inferomedial; OM, obtuse margin; PDA, posterior descending.

  • Image Result
    Diagram of the anatomic location of the multielectrode patch and contained electrodes on the left ventricle (dark circles). Pacing leads were also placed on the apex (open circle), anterior surface of

    Diagram of the anatomic location of the multielectrode patch and contained electrodes on the left ventricle (dark circles). Pacing leads were also placed on the apex (open circle), anterior surface of the right ventricle (square), and right atrium (triangle).

  • Image Result
    A representative plot of beat-to-beat cardiac output measurements over 27 minutes of continuous data collection during 1 experiment. CO, Cardiac output.

    A representative plot of beat-to-beat cardiac output measurements over 27 minutes of continuous data collection during 1 experiment. CO, Cardiac output.

  • Image Result
    Surface plot demonstrating percentage change from mean cardiac output for all possible left ventricular pacing site/right–left ventricular delay combinations averaged over 8 experiments. Contour lines

    Surface plot demonstrating percentage change from mean cardiac output for all possible left ventricular pacing site/right–left ventricular delay combinations averaged over 8 experiments. Contour lines indicate a 1% change in cardiac output. The highest values are represented by red. APEX, Apical; CIRC, circumflex; CO, cardiac output; IL, inferolateral; IM, inferomedial; LVPS, left ventricular pacing site; OM, obtuse margin; PDA, posterior descending artery; RLD, right ventricular–left ventricular delay.

  • Image Result
    Response surfaces relating left and right ventricular dP/dtmax and the area of the normalized right ventricular–left ventricular pressure diagram, APP, to all possible left ventricular pacing site/rig

    Response surfaces relating left and right ventricular dP/dtmax and the area of the normalized right ventricular–left ventricular pressure diagram, APP, to all possible left ventricular pacing site/right ventricular–left ventricular delay combinations averaged over 7 experiments. Contour lines represent 1% changes in measured values. For surfaces of dP/dtmax, the highest values are represented by red, and for surfaces of APP, complete synchrony (APP = 0) is represented by white. APEX, Apical; APP, area of the normalized right ventricular–left ventricular pressure diagram; CIRC, circumflex; dP/dtmax, maximum rate of pressure rise; IL, inferolateral; IM, inferomedial; LV, left ventricle; OM, obtuse margin; PDA, posterior descending artery; RV, right ventricle.

 Supported in part by the National Heart, Lung and Blood Institute of the National Institutes of Health (RO1 HL 48109 to Dr Spotnitz) and in part by the Department of Surgery, Columbia University College of Physicians and Surgeons.

PII: S0022-5223(07)00872-0

doi: 10.1016/j.jtcvs.2007.04.050

The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 3 , Pages 574-578 , September 2007

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