Effects of pacing-induced and balloon coronary occlusion ischemia on left atrial function in patients with coronary artery disease
Christodoulos Stefanadis, MD, FESC, FACCa,
John Dernellis, MDa,
Eleftherios Tsiamis, MDa and
Pavlos Toutouzas, MD, FESC, FACCa
a Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
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Figure 1 Left lateral view of a radiographic image of the pigtail Millar catheter (which was inserted retrogradely) and the pacing wire. White arrows indicate the two tips of the micromanometers in the left atrium and left ventricle, respectively. Black arrow points to the tip of the pacing wire in the high lateral right atrial wall.
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Figure 2 Echocardiographic automatic boundary detection image (top) with the region of interest drawn around the left ventricle and the instantaneous cavity area displayed simultaneously with the electrocardiogram (ECG, bottom).
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Figure 3 Echocardiographic automatic boundary detection image (top) with the region of interest drawn around the left atrium and the instantaneous cavity area displayed simultaneously with the electrocardiogram (ECG, bottom).
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Figure 4 Representative left ventricular pressure–area loops, at baseline and immediately after pacing-induced ischemia from a patient with left anterior descending (LAD) coronary artery disease (A) and a patient with left circumflex (LCx) disease (B). An upward and rightward shift of the diastolic portion of the left ventricular pressure–area loop was observed as peak systolic pressure declined in both patients.
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Figure 5 Representative left atrial pressure–area loops, at baseline and immediately after pacing-induced ischemia from a patient with left anterior descending (LAD) coronary artery disease (A) and a patient with left circumflex (LCx) disease (B). An upward shift of the left atrial pressure–area loop was observed in the patient with LAD, whereas an upward and rightward shift of the left atrial pressure–area loop was observed in the patient with LCx. Furthermore, the area of the pressure–area A loop was significantly increased in the patient with LAD, whereas it decreased in the patient with LCx.
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