Implantation of atriobiventricular pacemaker during cabg procedure ¿ description of 3 cases

We report on three cases of cardiac resynchronization therapy (CRT) system implantation during coronary artery bypass grafting (CABG) procedure. All 3 patients were men with coronary artery disease and postinfarction congestive heart failure in NYHA class III despite optimal medical treatment and without classical indications for permanent pacing. In echocardiography, intraventricular dyssynchrony was present in all patients. Methods During on-pump CABG epicardial bipolar leads (Medtronic CapSure Epi) were fixed on the right atrium, the right and left ventricle and connected to the CRT pacemaker (Medtronic InSync III) located in the left subclavicular portion. Postoperative period was uncomplicated. After 2 months pacing and sensing parameters remained excellent and significant clinical improvement was observed in all patients. Patients' characteristics and results (b=before, a=2 months after CABG + CRT) View this table: View this table: Conclusion CRT can be regarded as important supplement to surgical revascularization in still growing population of patients with severe heart failure and systolic dyssynchrony, for optimization of treatment results.