Effects of defibrillator implantation testing on myocardial metabolism

Citation
U. Wolfhard et al., Effects of defibrillator implantation testing on myocardial metabolism, THOR CARD S, 47(3), 1999, pp. 157-161
Citations number
18
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
THORACIC AND CARDIOVASCULAR SURGEON
ISSN journal
01716425 → ACNP
Volume
47
Issue
3
Year of publication
1999
Pages
157 - 161
Database
ISI
SICI code
0171-6425(199906)47:3<157:EODITO>2.0.ZU;2-8
Abstract
Background: The effects of fibrillation/defibrillation episodes (FDEs) duri ng defibrillator implantation on myocardial metabolism were investigated at various defibrillation energies in patients with different cardiac patholo gies. Methods: Myocardial lactate extraction (MLE) was examined during defi brillation threshold (DFT) testing in patients with either coronary artery disease (CAD, n = 20) or non-ischemic cardiomyopathy (CM, n = 10). Defibril lation pulses were released 15 seconds after induced fibrillation. A test c ycle of four FDEs separated by 2-minute intervals was applied in each case. Results: Mean MLE decreased significantly from 28+/-4% before FDEs to 8+/- 5% immediately after all episodes in CAD patients, but recovered to 27+/-7% within 2 minutes even in patients with reduced left-ventricular function. In patients with CM mean MLE decreased markedly from 29+/-3% to -11+/-3% im mediately after each FDE but increased to baseline (33+/-8%) within the rec overy period. MLE changes were independent of defibrillation energy in all cases. Conclusions: Myocardial lactate production, suggesting cardiac ische mia, was observed in patients with CM, but not in patients with CAD. But re covery of myocardial lactate extraction was not faster in CAD patients, ind icating that the fixed FDE cycle used was well tolerated by all patients.