Short-Term Atrial Pacing and Hemodynamics After Cardiac Surgery

Launched by SAINT-JOSEPH UNIVERSITY · Jul 16, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether a temporary heart pacing method called atrial pacing can help improve heart function right after heart surgery. Specifically, it looks at patients who have had surgery using a heart-lung machine (called cardiopulmonary bypass). The study aims to find out if pacing the heart at different rates (70, 80, or 90 beats per minute) helps the heart pump blood better and if it can lower the chance of developing an irregular heartbeat called atrial fibrillation after surgery.

Adults who are having planned heart surgery, such as bypass or valve repair, and who have special pacing wires and a monitoring catheter placed during their operation may be eligible to join. Participants will be closely monitored for the first 24 hours after surgery to see how different pacing rates affect their heart’s performance. It’s important to know that this study is not for patients having emergency surgery or those with certain heart rhythm problems or implanted pacemakers. If you qualify and decide to participate, you can expect careful monitoring to help doctors learn the best way to support the heart right after surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients aged 18 years or older
• • Cardiac surgery under CPB (coronary artery bypass grafting, valve replacement or repair, or combined procedures)
• • Placement of epicardial atrioventricular pacing wires during surgery
• • Placement of a Swan-Ganz catheter intraoperatively
• • Signed informed consent
• Exclusion Criteria:
• • Emergency surgery
• • Patients with an internal pacemaker
• • History of permanent atrial fibrillation
• • Complete atrioventricular block upon weaning from CPB
• • Junctional rhythm upon weaning from CPB
• • Sinus rhythm \< 50 bpm upon weaning from CPB
• • Failure of atrial or dual-chamber pacing (patients paced in ventricular mode VVI)
• • Contraindication to Swan-Ganz catheter placement
• • Hemodynamic instability defined by significant bleeding or tamponade requiring surgical re-intervention, or the need for escalating doses of vasopressors (Norepinephrine \> 1 μg/kg/min, Dobutamine \> 10 μg/kg/min)