METHOD FOR SURGICAL MANAGEMENT OF LEFT VENTRICULAR MYOCARDIAL INSUFFICIENCY Russian patent published in 2019 - IPC A61N1/36 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, more specifically to cardiovascular surgery. Stimulation thresholds are determined using an external pacemaker with detecting acute endocardial threshold values. Performing fixation of heads of electrodes in atrium and ventricle of heart, successively extracting electrodes stilettos, stiletto of ventricle electrode in lower one-third is spiral-shaped, and atrial stiletto is formed in curved or wavy shape with their subsequent introduction into appropriate electrode. An acute threshold equal to or less than 0.2 mA is detected on the endocardium to fix the electrode heads in these regions. Atrial electrode is inserted into the upper third of the interatrial baffle of the Bachkman bundle at points where the acute threshold is equal to or less than 0.2 mA, and the ventricular electrode is inserted into the interventricular septum under the tricuspid valve by 1–1.5 cm from the fibrous ring of the tricuspid valve in the body of the bundle in points where the acute threshold is equal to or less than 0.2 mA. Thereafter, current is fed to electrodes of 1 A at power of 6.5 W; at that, the ventricular electrode is fed with atrioventricular delay of 400 ms, and active fixation of electrodes is carried out at points the power value of which is equal to 0.7 W at measurement.

EFFECT: method provides higher clinical effectiveness as a result of normalizing the left ventricular output tract, reducing the gradient, improving myocardial contractility and blood supply, which improves the quality and length of life of the given category of patients.

1 cl, 1 ex