l'Importance de la position des électrodes stimulatrices au cours du traitement d'un bloc auriculo-ventriculair post operatif

The disorders of the auriculo-ventricular conduction are a frequent cornplication of open heart surgery, and very of ten necessitate the use of an artificial pacemaker, the stimulating electrodes of which are fixed on the pericardium. Previous research has shown that the site of the epicm'dium which is prematurely activated is placed on the pretrabecular part of the right velltricle. At this point, the conduction system is the closest to the epicardium. In this study, it has been demonstrated that in a dog presenting an experimental total block, the stimulation of the heart from the pretrabecular part of the right ventrieIe brings a ventricular systolic ten sion which is higher than a stimulation from any other part on the left ventricle. The authors believe that because of electrocardiographical and hemodynamical reasons, the pretrabecular part of the right ventricle is the best place for the fixation of stimulating electrodes in case of total blocks developed during open heart surgical interventions