HEMODYNAMIC-EFFECTS OF CARDIOMYOPLASTY IN AN EXPERIMENTAL-MODEL OF ACUTE HEART-FAILURE AND ATRIAL-FIBRILLATION

The aim of our work was to study the hemodynamic effects of dynamic ca rdiomyoplasty on an acute animal model of atrial fibrillated heart fai lure. Eight anesthetized open chest dogs suffering from atrial fibrill ation and heart failure, obtained by topic acetylcholine and propranol ol, were treated by a cardiomyoplasty procedure performed with an elec trostimulated latissimus dorsi muscle flap (LDMF). Values considered f or analysis during LDMF stimulation were selected from cardiac cycles with R-R intervals similar to those when the LDMF was not stimulated ( +/-20 ms). Atrial fibrillated heart failure showed a significant incre ase of systemic vascular resistance, end diastolic left ventricular pr essure (EDLVP) and right atrial pressure (p < 0.05), and a significant decrease in cardiac output, systolic left ventricular pressure (SLVP) , and mean aortic pressure (p < 0.05) compared with control values. LD MF stimulation in atrial fibrillated heart failure resulted in a signi ficant increase of SLVP, cardiac output, and mean aortic pressure (p < 0.05) and a significant decrease of systemic vascular resistance, EDL VP, and right atrial pressure (p < 0.05) compared with nonstimulated v alues. The highest LVP values were obtained with R-R intervals long en ough to allow an adequate LV filling. We conclude that dynamic cardiom yoplasty provides an appropriate recovery in this animal model of atri al fibrillated heart failure. Cardiomyoplasty is an appropriate proced ure for cardiac assist when R-R intervals allow an adequate LV filling .