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RIGHT VENTRICULAR INFARCTION, BRADYARRHYTHMIAS, AND CARDIOGENIC SHOCK: IMPORTANCE OF ATRIAL OR ATRIOVENTRICULAR SEQUENTIAL PACING
Author(s) -
ABRAHAM K. A.,
BROWN M. A.,
NORRIS R. M.
Publication year - 1985
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1985.tb02735.x
Subject(s) - medicine , cardiogenic shock , cardiology , bradycardia , atrioventricular block , myocardial infarction , shock (circulatory) , infarction , central venous pressure , inotrope , anesthesia , heart block , blood pressure , electrocardiography , heart rate
:We report two patients with inferior myocardial infarction, complicated by bradyarrhythmia, hypotension, and clinical evidence of right ventricular infarction. Conventional therapy of volume expansion and inotropic support was insufficient to maintain an adequate blood pressure. Sequential atrioventricular (AV) pacing for AV block (Case 1) or atrial pacing for junctional bradycardia (Case 2) resulted in immediate and sustained improvement in blood pressure and clinical indices of perfusion. We recommend consideration of these pacing modes in patients with inferior infarction with evidence of right ventricular infarction, bradyarrhythmia, and cardiogenic shock. The likely mechanism of improvement is by restoration of atrial transport with consequent improvement in ventricular function.