Skip to main content

Essence of Pacemakers and Its Application After CPB

  • Chapter
  • First Online:
Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery
  • 1455 Accesses

Abstract

Placement and utilization of temporary epicardial pacing wires is a fundamental step in the perioperative care of the cardiac surgical patient. Epicardial pacing wires allow for the diagnosis, prevention and treatment of dysrhythmias—one of the most common complications of cardiac surgery. Additionally, temporary epicardial pacing provides clinicians with a quick and efficacious means of increasing cardiac output in patients with marginal hemodynamics after cardiopulmonary bypass.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mulpuru SK, Madhavan M, McLeod CJ, Cha YM, Friedman PA. Cardiac pacemakers: Function, troubleshooting, and management: Part 1 of a 2-part series. J Am Coll Cardiol. 2017;69:189–210.

    Article  PubMed  Google Scholar 

  2. Ellenbogen KaK, K. Cardiac pacing and icds. 2014.

    Google Scholar 

  3. Shen MJ, Zipes DP. Role of the autonomic nervous system in modulating cardiac arrhythmias. Circ Res. 2014;114:1004–21.

    Article  CAS  PubMed  Google Scholar 

  4. Fudim M, Boortz-Marx R, Ganesh A, Waldron NH, Qadri YJ, Patel CB, Milano CA, Sun AY, Mathew JP, Piccini JP. Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: a systematic review and meta-analysis. J Cardiovasc Electrophysiol. 2017;28(12):1460–7.

    Article  PubMed  Google Scholar 

  5. Mathew JP, Fontes ML, Tudor IC, Ramsay J, Duke P, Mazer CD, Barash PG, Hsu PH, Mangano DT, Investigators of the Ischemia R, Education F, Multicenter Study of Perioperative Ischemia Research G. A multicenter risk index for atrial fibrillation after cardiac surgery, Jama. 2004;291:1720–9.

    Google Scholar 

  6. Mitchell LB, Exner DV, Wyse DG, Connolly CJ, Prystai GD, Bayes AJ, Kidd WT, Kieser T, Burgess JJ, Ferland A, MacAdams CL, Maitland A. Prophylactic oral amiodarone for the prevention of arrhythmias that begin early after revascularization, valve replacement, or repair: Papabear: a randomized controlled trial. JAMA. 2005;294:3093–100.

    Article  CAS  PubMed  Google Scholar 

  7. Kertai MD, Li YW, Li YJ, Shah SH, Kraus WE, Fontes ML, Stafford-Smith M, Newman MF, Podgoreanu MV, Mathew JP, Duke Perioperative G, Safety Outcomes Investigative T. G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving beta-blockers. Circ Cardiovasc Genet. 2014;7:625–33.

    Article  CAS  PubMed  Google Scholar 

  8. Arsenault KA, Yusuf AM, Crystal E, Healey JS, Morillo CA, Nair GM, Whitlock RP. Interventions for preventing post-operative atrial fibrillation in patients undergoing heart surgery. Cochrane Database Syst Rev. 2013:CD003611.

    Google Scholar 

  9. LaPar DJ, Speir AM, Crosby IK, Fonner E Jr, Brown M, Rich JB, Quader M, Kern JA, Kron IL, Ailawadi G, Investigators for the Virginia Cardiac Surgery Quality I. Postoperative atrial fibrillation significantly increases mortality, hospital readmission, and hospital costs. Ann Thorac Surg. 2014;98:527–33. discussion 533

    Article  PubMed  Google Scholar 

  10. Mouws E, Yaksh A, Knops P, Kik C, Boersma E, Bogers A, de Groot NMS. Early ventricular tachyarrhythmias after coronary artery bypass grafting surgery: is it a real burden? J Cardiol. 2017;70:263–70.

    Article  PubMed  Google Scholar 

  11. Ascione R, Reeves BC, Santo K, Khan N, Angelini GD. Predictors of new malignant ventricular arrhythmias after coronary surgery: a case-control study. J Am Coll Cardiol. 2004;43:1630–8.

    Article  PubMed  Google Scholar 

  12. Bethea BT, Salazar JD, Grega MA, Doty JR, Fitton TP, Alejo DE, Borowicz LM Jr, Gott VL, Sussman MS, Baumgartner WA. Determining the utility of temporary pacing wires after coronary artery bypass surgery. Ann Thorac Surg. 2005;79:104–7.

    Article  PubMed  Google Scholar 

  13. Khorsandi M, Muhammad I, Shaikhrezai K, Pessotto R. Is it worth placing ventricular pacing wires in all patients post-coronary artery bypass grafting? Interact Cardiovasc Thorac Surg. 2012;15:489–93.

    Article  PubMed  Google Scholar 

  14. Koplan BA, Stevenson WG, Epstein LM, Aranki SF, Maisel WH. Development and validation of a simple risk score to predict the need for permanent pacing after cardiac valve surgery. J Am Coll Cardiol. 2003;41:795–801.

    Article  PubMed  Google Scholar 

  15. Rene AG, Sastry A, Horowitz JM, Cheung J, Liu CF, Thomas G, Ip JE, Lerman BB, Markowitz SM. Recovery of atrioventricular conduction after pacemaker placement following cardiac valvular surgery. J Cardiovasc Electrophysiol. 2013;24:1383–7.

    Article  PubMed  Google Scholar 

  16. Siontis GC, Juni P, Pilgrim T, Stortecky S, Bullesfeld L, Meier B, Wenaweser P, Windecker S. Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing tavr: a meta-analysis. J Am Coll Cardiol. 2014;64:129–40.

    Article  PubMed  Google Scholar 

  17. Regueiro A, Abdul-Jawad Altisent O, Del Trigo M, Campelo-Parada F, Puri R, Urena M, Philippon F, Rodes-Cabau J. Impact of new-onset left bundle branch block and periprocedural permanent pacemaker implantation on clinical outcomes in patients undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis. Circ Cardiovasc Interv. 2016;9:e003635.

    Article  PubMed  Google Scholar 

  18. Wallace A, Lam HW, Nose PS, Bellows W, Mangano DT. Changes in systolic and diastolic ventricular function with cold cardioplegic arrest in man. The multicenter study of perioperative ischemia (mcspi) research group. J Card Surg. 1994;9:497–502.

    Article  CAS  PubMed  Google Scholar 

  19. Maisel WH, Epstein AE, American College of Chest P. The role of cardiac pacing: American college of chest physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128:36S–8S.

    Article  PubMed  Google Scholar 

  20. Reade MC. Temporary epicardial pacing after cardiac surgery: a practical review: Part 1: General considerations in the management of epicardial pacing. Anaesthesia. 2007;62:264–71.

    Article  CAS  PubMed  Google Scholar 

  21. Hurle A, Gomez-Plana J, Sanchez J, Martinez JG, Meseguer J, Llamas P. Optimal location for temporary epicardial pacing leads following open heart surgery. PACE. 2002;25:1049–52.

    Article  PubMed  Google Scholar 

  22. Curtis J, Walls J, Boley T, Reid J, Flaker G, Madigan N, Alpert M. Influence of atrioventricular synchrony on hemodynamics in patients with normal and low ejection fractions following open heart surgery. Am Surg. 1986;52:93–6.

    CAS  PubMed  Google Scholar 

  23. Goette A, Mittag J, Friedl A, Busk H, Jepsen MS, Hartung WM, Huth C, Klein HU. Pacing of Bachmann’s bundle after coronary artery bypass grafting. PACE. 2002;25:1072–8.

    Article  PubMed  Google Scholar 

  24. Prinzen FW, Vernooy K, Auricchio A. Cardiac resynchronization therapy: state-of-the-art of current applications, guidelines, ongoing trials, and areas of controversy. Circulation. 2013;128:2407–18.

    Article  PubMed  Google Scholar 

  25. Berberian G, Quinn TA, Kanter JP, Curtis LJ, Cabreriza SE, Weinberg AD, Spotnitz HM. Optimized biventricular pacing in atrioventricular block after cardiac surgery. Ann Thorac Surg. 2005;80:870–5.

    Article  PubMed  Google Scholar 

  26. Eberhardt F, Heringlake M, Massalme MS, Dyllus A, Misfeld M, Sievers HH, Wiegand UK, Hanke T. The effect of biventricular pacing after coronary artery bypass grafting: a prospective randomized trial of different pacing modes in patients with reduced left ventricular function. J Thorac Cardiovasc Surg. 2009;137:1461–7.

    Article  PubMed  Google Scholar 

  27. Seo Y, Ishizu T, Sakamaki F, Yamamoto M, Machino T, Yamasaki H, Kawamura R, Yoshida K, Sekiguchi Y, Kawano S, Tada H, Watanabe S, Aonuma K. Mechanical dyssynchrony assessed by speckle tracking imaging as a reliable predictor of acute and chronic response to cardiac resynchronization therapy. J Am Soc Echocardiogr. 2009;22:839–46.

    Article  PubMed  Google Scholar 

  28. Elmi F, Tullo NG, Khalighi K. Natural history and predictors of temporary epicardial pacemaker wire function in patients after open heart surgery. Cardiology. 2002;98:175–80.

    Article  PubMed  Google Scholar 

  29. Madhavan M, Mulpuru SK, McLeod CJ, Cha YM, Friedman PA. Advances and future directions in cardiac pacemakers: Part 2 of a 2-part series. J Am Coll Cardiol. 2017;69:211–35.

    Article  PubMed  Google Scholar 

  30. Sullivan BL, Bartels K, Hamilton N. Insertion and management of temporary pacemakers. Semin Cardiothorac Vasc Anesth. 2016;20:52–62.

    Article  PubMed  Google Scholar 

  31. Durbin CG Jr, Kopel RF. Optimal atrioventricular (av) pacing interval during temporary av sequential pacing after cardiac surgery. J Cardiothorac Vasc Anesth. 1993;7:316–20.

    Article  PubMed  Google Scholar 

  32. Crossley GH, Poole JE, Rozner MA, Asirvatham SJ, Cheng A, Chung MK, Ferguson TB Jr, Gallagher JD, Gold MR, Hoyt RH, Irefin S, Kusumoto FM, Moorman LP, Thompson A. The heart rhythm society (hrs)/american society of anesthesiologists (asa) expert consensus statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: Facilities and patient management this document was developed as a joint project with the american society of anesthesiologists (asa), and in collaboration with the american heart association (aha), and the society of thoracic surgeons (sts). Heart Rhythm. 2011;8:1114–54.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nathan Waldron .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Waldron, N., Mathew, J. (2021). Essence of Pacemakers and Its Application After CPB. In: Cheng, D.C., Martin, J., David, T. (eds) Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-47887-2_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-47887-2_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47886-5

  • Online ISBN: 978-3-030-47887-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics