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2001, Número 2

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Arch Cardiol Mex 2001; 71 (2)


Resincronización biatrial en el tratamiento de la fibrilación atrial paroxística. Marcapaso tres y cuatro cámaras

Robledo NR, Buenfil MJC, Soto SJ, Juárez PN, Zaragoza RG, Flores FJ, Sánchez PJL, Blanco CM, Ortiz ÁM, Valencia JM

Idioma: Español
Referencias bibliográficas: 35
Paginas: 151-159
Archivo PDF: 499.30 Kb.


RESUMEN

La finalidad de la estimulación multisitio es corregir la sincronía eléctrica y mecánica atrial y ventricular que se presenta en pacientes con fibrilación atrial paroxística (FAP) y miocardiopatía dilatada. Reportamos los dos primeros casos, en México, con estimulación biatrial para el tratamiento de la FAP, a uno se le implantó marcapaso tricameral y al otro tetracameral. El primero era un hombre joven al cual se le realizó modificación de la conducción atrioventricular con radiofrecuencia para el control de la frecuencia ventricular durante la fibrilación atrial. El segundo caso era una mujer con transposición corregida de los grandes vasos y fracción de expulsión (FE) del 30%, el cual presentaba bloqueo atrioventricular completo. El modo de estimulación fue DDD para el primer paciente y DDDR para el segundo, con función nocturna y cambio automático de modo en ambos. Se estimularon ambas aurículas, en la orejuela derecha y la izquierda a través del seno coronario. Los episodios de FAP se presentaron solamente en el primero pero en menor número y duración. La FE y la clase funcional mejoraron en el paciente con sincronización atrial y ventricular. Concluimos que la estimulación biatrial es efectiva en el control de la FAP.


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