Abstract
In 306 patients who underwent elective coronary artery bypass graft (CABG) between January 2005 and July 2008, low cardiac functions (EF<35%) were seen in 24 patients. Of these, 7 (EF, 22.7±5.4%, NYHA 3.4±0.4) had a left ventricular epicardial lead implanted during surgery. On completion of bypass anastomosis, a screw-in-type epicardial lead was implanted. The mean threshold at implantation was satisfactory (1.1±0.4 V). There were no complications related to intraoperative lead placement. In the aforementioned 7 patients, combined Cardiac resynchronization therapy defibrillator (CRT-D) implantation was performed in 4 during the postoperative period while they were still in the hospital. In 1 other patient, the procedure was conducted when he was readmitted for heart failure 3 months after discharge. The threshold for the left ventricular myocardial lead was satisfactory (1.0±0.1 V). No postoperative complications, such as infections, hemorrhage, or twitching, were noted. For those patients who are likely to have a CRT-D placed after CABG, a left ventricular lead showed be implanted if possible for the safe and fast postoperative placemens of a defibrillator. However, the indications of myocardial lead implantation must be considered carefully.
