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August 16, 1971

Assisted Circulation in Acute Myocardial Infarction

JAMA. 1971;217(7):957-958. doi:10.1001/jama.1971.03190070065019

Cardiogenic shock complicating acute myocardial infarction presents a formidable threat to life. Unlike "electrical" failure of the heart, which often can be corrected by defibrillators and pacemakers, "pump" failure until recently has derived little benefit from electronic-mechanical devices. This technological void is gradually being filled by the circulatory "assist" which exploits the hemodynamic advantages of counterpulsation by pumping blood into the aorta in diastole and out of the aorta in systole. Since coronary filling occurs mainly in diastole when myocardial tension is reduced, propulsion of blood into the aorta during this phase of the cardiac cycle would be expected to increase aortic diastolic pressure and thus augment coronary flow. By reducing the pressure in the aorta during systole, counterpulsation would also help reduce impedance to left ventricular empyting and thus diminish the workload of the heart.

Three basic techniques of aortic counterpulsation are now available, two of which—venoarterial pulsatile partial