Author + information
- Received December 18, 1989
- Revision received May 1, 1990
- Accepted May 15, 1990
- Published online November 1, 1990.
- Mark G. Midei, MD∗,
- Kenneth L. Baughman, MD, FACC,
- Stephen C. Achuff, MD, FACC,
- Gary D. Walford, MD, FACC,
- William Baumgartner, MD and
- Jeffrey A. Brinker, MD, FACC
- ↵∗Address for reprints: Mark G. Midei, MD, Division of Cardiology, The Johns Hopkins Hospital, 601 North Wolfe Street, Baltimore, Maryland 21205.
Because of the distortion of alrial morphology that occurs during cardiac allograft transplantation in humans, the beneficial effects of properly sequenced atrial and ventricular activation are unclear in these patients. To evaluate the atrial contribution to ventricular pump performance in heart transplant recipients, arterial pressure and cardiac output during pacing from either chamber were measured in nine patients 10 ± 1 days after transplantation.
Systolic, diastolic and mean systemic arterial pressures were significantly higher during atrial pacing compared with ventricular pacing: 143 ± 23 versus 125 ± 20 mm Hg, 73 ± 15 versus 66 ± 14 mm Hg and 94 ± 17 versus 84 ± 16 mm Hg, respectively (p < 0.05 for all). In addition, cardiac output decreased from 5.5 ± 1.4 to 4.6 ± 1.5 liters/min (p < 0.005) for atrial versus ventricular pacing.
Thus, there is a significant atrial contribution to cardiac performance in patients after heart transplantation. This may have clinical implications in those patients who later require a permanent pacemaker.
☆ This work was presented in part at the 38th Annual Meeting of the American College of Cardiology, Anaheim, California, March 1989. It was supported by National Research Service Award No. 5 T32 HL 07227-10 and 9 from the National Institutes of Health, Bethesda, Maryland.
- Received December 18, 1989.
- Revision received May 1, 1990.
- Accepted May 15, 1990.