Hemodynamic effects of cardiomyoplasty in an experimental model of acute heart failure and atrial fibrillation

EDMUNDO I. CABRERA FISCHER; JUAN CARLOS CHACHQUES; ALEJANDRA CHRISTEN; MARCELO RISK; ALAN CARPENTIER

ARTIFICIAL ORGANS

WILEY-BLACKWELL PUBLISHING, INC

Lugar: Boston, MA USA; Año: 1996 vol. 20 p. 1215 - 1219

0160-564X

The aim of our work was to study the hemodynamic effects of dynamic cardiomyoplasty on an acute animal model ofatrial fibrillated heart failure. Eight anesthetized open chest dogs suffering from atrial fibrillation and heart failure,obtained by topic acetylcholine and propranolol, were treated by a cardiomyoplasty procedure performed with anelectrostimulated latissimus dorsi muscle flap (LDMF). Values considered for analysis during LDMF stimulation wereselected from cardiac cycles with R-R intervals similar to those when the LDMF was not stimulated (+/- 20 ms). Atrialfibrillated heart failure showed a significant increase of systemic vascular resistance, end diastolic left ventricularpressure (EDLVP) and right atrial pressure (p < 0.05), and a significant decrease in cardiac output, systolic leftventricular pressure (SLVP), and mean aortic pressure (p < 0.05) compared with control values. LDMF stimulation inatrial fibrillated heart failure resulted in a significant increase of SLVP, cardiac output, and mean aortic pressure (p <0.05) and a significant decrease of systemic vascular resistance, EDLVP, and right atrial pressure (p < 0.05) comparedwith nonstimulated values. The highest LVP values were obtained with R-R intervals long enough to allow an adequateLV filling. We conclude that dynamic cardiomyoplasty provides an appropriate recovery in this animal model of atrialfibrillated heart failure. Cardiomyoplasty is an appropriate procedure for cardiac assist when R-R intervals allow anadequate LV filling.