Technical papers, Pacing:

70 Extractions Of Telectronics Accufix Leads With a Safe and Simple Technique

Author: G. Laborde, P. Dalous, J-P. Baixas et al.

Having taken the responsibility to implant in our centrein our centre more than 100 Accufix leads, we were very concerned by the problem related to the J retention wire of this lead. The explant indications we decided were based on the presence of a fract...

Accufix Imperatives Modified

Author: Victor Parsonnet, MD

More than 20,000 Telectronics Accufix atrial J leads have been implanted in the United States, and more than 40,000 worldwide. According to recent reports from the manufacturer’s committee of experts, presented at the recent meeting of the Internationa...

Atrial Oversensing in a Dual Chamber Implantable Cardioverter-Defibrillator due ...

Author: Todd J. Cohen, MD, Bassiema Ibrahim MD, et.al.

Recently, dual chamber implantable cardioverter-defibrillators have been approved by the United States Food and Drug Administration and released for the treatment of life-threatening ventricular tachyarrhythmias. These devices offer increased sensing and ...

Atrial Pacing Results in Patients Implanted with a Single-Lead, DDD OLBI Stimula...

Author: Carlos F M Queiroz, MS; Fabrício P Cazorla, MS, et.al.

The aim of this study was to evaluate the atrial stimulation performance with atrial floating electrodes using the overlapping biphasic impulse (OLBI) configuration after one year of follow-up. For 11 patients with severe AV block, the mean atrial thresho...

Autocapture Pacing: The End Of a Challenge

Author: D. Gascon, F. Perez-Vico, A. Herruzo et al.

Pacemaker programming based on initial pacing thresholds has long been a standard, but may not optimize battery life. Now, the use of an autocapture algorithm to correctly sense ventricular evoked response (ER) under varying conditions in order to adjust ...

Cardioverter - Defibrillator Twiddler’s Syndrome In A Subpectoral Transvenous Sy...

Author: G. Lolli, MD, C. Menozzi, MD, et.al.

Some cases of defibrillator twiddler’s syndrome have been previously described with epicardial-abdominal implant and one with pectoral implant. The following illustrates a case in which the twiddling didn’t result in lead dislodgment, fracture or device m...

Does Maximal Exercise Heart Rate Predict Working Capacity in Pacemaker Patients?

Author: Heiner Langenfeld, MD, Bettina Schembra, MD, Michael Kirstein et al.

In rate-adaptive pacing a higher exercise heart rate should improve patients' working capacity. However, up to now there is a lack of an analysis of the factors which determine the working capacity in pacemaker patients in physiological exercise. Therefor...

DRUG REFRACTORY DILATED CARDIOMYOPATHY TREATED WITH DDD PACING. EVALUATION OF TH...

Author: Athanasios G. Manolis, Kostas Liagas, et.al.

The aim of this study was to assess the long term efficacy of DDD pacing mode in selected patients (pts) with idiopathic dilated cardiomyopathy (IDCM) and drug refractory heart failure. The pts were evaluated according to the long term alteration of the s...

Dual Chamber Pacemakers In Patients With Paroxysmal Atrial Fibrillation

Author: Karel den Dulk, MD, Barbara Dijkman, MD et al.

Mode switching algorithms have been developed to avoid tracking of atrial fibrillation (AF) or flutter (AFL) during DDD(R) pacing. Upon recognition of AF or AFL, the mode is switched to a non-tracking sensor driven mode. Mode switching to a sensor driven ...

Dual-Chamber AutoCapture System Algorithm that Saves Pacing Energy and Avoids Fu...

Author: Gene A. Bornzin, Ph.D. Joseph Florio, Larry Sloman et al.

Fusion activity occurs frequently if the AV/PV delay is coincident with the AR/PR delay. Fusions confound an autocapture algorithm because fused evoked potentials are often small or non-existent. Evoked potential (EP) sensing failures can drive the pacer ...

DYNAMICITY OF THE VENTRICULAR REPOLARIZATION IN PACED PATIENTS WITH CONGESTIVE…

Author: Athanasios G. Manolis, Dimitrios Koutsogeorgis, et.al.

The QT interval dynamicity is related to the autonomous nervous system influence on the ventricular myocardium and it is associated to the severity of structural heart disease. Aim of the study was to evaluate the dynamicity of ventricular repolarization ...

EFFICACY OF DIFFERENT PACING MODES IN PATIENTS WITH INTACT SINUS NODE FUNCTION W...

Author: Athanasios G. Manolis, Apostolos Katsivas, et.al.

Previous studies have demonstrated that in patients (pts) with drug refractory paroxysmal atrial fibrillation (AF) and intact sinus node, RF AV junctional ablation and permanent pacemaker implantation is an alternative therapy with excellent long term res...

EFFICACY OF INTRAVENOUS ATENOLOL FOR PREVENTION OF NEURALLY MEDIATED SYNCOPE I…

Author: Javier G. Seara, Antonio H. Madrid, et.al.

The treatment of neurocardiogenic syncope is still a clinical problem. The beta-blockers have been widely used for this purpose as a first line drug. In spite of that, there are not many studies that establish the real efficacy of those drugs in patients ...

Evaluation Of A New Sensor-Based Protection Algorithm In Patients With Paroxysma...

Author: Thomas Fahraeus MD, Yves Verboven, MScEng, Annette Bruls, MScEng

Modern dual-chamber pacemakers use different detection criteria for mode switching algorithms to avoid tracking high atrial rates. However, the detection response time may sometimes result in temporary high ventricular rates. This study assessed a new sen...

Failure of Short Atrioventricular Delay Pacing to Improve Hemodynamic Function in Patients With Congestive Heart Failure

Author: Michael R. Gold MD, PhD, Michael L. Fisher, MD, Stephen S. Gottlieb, MD

The hemodynamic effects of dual chamber pacing in patients with congestive heart failure (CHF) remain controversial. In initial anecdotal reports, right ventricular apical pacing with a 100-msec atrioventricular (AV) delay was reported to cause marked imp...

First Clinical Experience Of An Automatic Follow-Up Procedure For DDDR Pacing An...

Author: Thomas Fahraeus, M.D.

While sophisticated dual-chamber pulse generators provide a substantial amount of data required for optimal programming, retrieval of those data demands specific knowledge and experience and is rather time-consuming. This study evaluated the clinical usef...

Gender Differences in Pacemaker Therapy?

Author: Margarethe Hochleitner, MD, Claudia Gschnitzer, MD

Several studies have documented gender differences in cardiological care. Sex differences exist in pacemaker therapy, too. In 1994, 55.8% of pacemakers were implanted in men and 44.2% in women. Over a period of ten years (1984-1993) these figures remained...

Hemodynamic Benefits Of Dual Chamber Pacing With Optimized AV Delay In Congestiv...

Author: Capucci A, Villani GQ, Pagani M., et. al.

We report on the results on 26 patients in sinus rhythm and with chronic heart failure due to congestive cardiomyopathy prospectively randomized to optimal medical therapy (group 1, 13 patients) or optimal medical therapy plus dual chamber pacemaker progr...

High Degree AV Block Complicating Cardiac Surgery or Interventional Catheterizat...

Author: Michael Kindermann, MD, Bernhard Schwaab, MD, et.al.

Longterm Follow-Up of Underlying AV-Conduction Status After Pacemaker Implantation. This is a retrospective report on 38 patients (pts) with different cardiac diseases who underwent pacemaker implantation because of high (2° and 3° ) degree atrioventricul...

Implantation Of Permanent Dual Chamber Pacemaker In A Pregnant Women By Transeso...

Author: Dante Antonelli MD, Lev Bloch MD, Tiberio Rosenfeld MD

A 37 year old woman complained of fatigue and dizziness because of intermittent sinus arrest and asystole up to 5.2 sec. She was 3 months into her pregnancy and a dual chamber permanent pacemaker was implanted by transesophageal echocardiographic guidance...

IN CARDIAC PACING, COSTS AND EFFICIENCY ARE COMPATIBLE? FIRST 8 YEARS RESULTS OF...

Author: DANILO CERVELLATI, GIORGIO VISANI and CLAUDIA CAMANINI

A total of 500 Pace-maker (PM) implants performed consecutively in the Dept. of Cardiology at Imola between October 1989 and October 1997 were studied. These implants were divided into four periods: I) Oct. 89-Oct. 91; II) Oct. 91-Oct. 93; III) Oct. 93-Oc...

In-vitro Study of the Interaction of Cellular Phones with Cardiac Pacemakers

Author: Schlegel, Robert E.; Raman, Shivakumar; et.al.

The interaction of cardiac pacemakers with various types of wireless devices has been investigated by several groups, with special emphasis on cellular phones. This paper reports an in-vitro study of the electromagnetic interaction of cellular phones with...

Infranodal AV Block In Acute Inferior Myocardial Infarction

Author: S. Serge Barold, Helen S. Barold

It is widely accepted clinically that atrioventricular (AV) block in inferior myocardial infarction (MI) often occurs in the AV node and uncommonly in the His bundle. Pathologic examination of hearts of patients dying of inferior MI has documented lesions...

Initial Clinical Experience with a New Automatic PMT Detection and Termination A...

Author: Douglas A. Cameron, MD, Richard D. Gentzler et al.

Pacemaker mediated tachycardia (PMT) algorithms based on rate alone do not discriminate between sinus tachycardia (ST) and PMT. The PMT Auto-Detect algorithm in Trilogy DR+ (Pacesetter, Inc.) uses both rate and stability of the retrograde ventriculo-atria...

Initial Experience With a New Endocardial Steroid Screw-in Lead

Author: Charles J. Love, MD, Howard Frumin, MD, James L. Duncan et al.

The use of endocardial screw-in electrodes in permanent pacemaker implants is becoming increasingly popular for multiple reasons. This study compares a new steroid eluting, titanium nitride coated, retractable screw-in permanent pacing lead to an identica...

Interatrial Conduction and Optimal Atrial Timing In Dual Chamber Pacing

Author: B.Grzegorzewski, Z.Gasior, W.Kargul

The effect of a synchronous dual chamber pacing mode (DDD) on left ventricular function was evaluated in group 38 patients (21 patients with third degree A-V block and 17 patients with Sick Sinus Syndrome). Thirty eight patients (22 men, 16 women)mean age...

Ipsilateral Implantation of ICD and Pacemaker

Author: Chetan P. Shah, MD, DM, Ranjan K. Thakur, MD, et.al.

The implantable cardioverter defibrillator (ICD) has dramatically changed the management of sudden cardiac death due to ventricular tachycardia (VT) or fibrillation. An estimated 15-20% of patients with an ICD also require cardiac pacing. The first genera...

Is There an Effect Of a (Digitally Operating) Cellular Telephone On Pacemaker Fu...

Author: P.E.Polak MD, W.A.A.J. van Ekelen MD, M.J. van der Horst MD

During a routine visit to our outpatient clinic, 98 patients, all equipped with Medtronic pacemakers, were asked to participate in a study, investigating the possibility of dysfunction of their pacemaker by using a digitally operating telephone. Simulatin...

Long Time Benefit of Rate Adaptation - Results in Spiroergometry and Submaximal ...

Author: Heiner Langenfeld, MD, Martine van Geneygen, NM, Michael Kirstein et al.

It is well known that rate adaptive pacing acutely improves exercise capacity. However, there is a lack of studies dealing with the long time effect of rate adaptation. Thus we examined 11 patients (age 63 + 11 years) with a rate adaptive single chamber p...

NASPE Guidelines: Are They Being Followed?

Author: Mary McGrory-Usset, Robert Genovese, Thomas Arnfelt, and Brenda Hagen

Six hundred forty-six clinics provided input on their pacemaker follow-up practices in July, 1995. The results of this survey indicate there is much diversity in how pacemaker patients are followed on a long term basis. Many clinics were not following NAS...

NONINVASIVE NEUROMONITORING PREDICTS PACEMAKER SYNDROME

Author: Igor Singer MD, Harvey Edmonds, et.al.

Cerebral mixed venous oxygen saturation (CVOS) and systolic pressure (BP) may be used to characterize patients with vasodepressor syncope. Relative CVOS changes are obtained by application of an adhesive patch to patient=s forehead containing a pair of in...

On Ventricular Stimulation Risk During Diagnostic Transesophageal Stimulation of...

Author: F. Prochaczek, I. Surma, J. Galecka

Transesophageal stimulation of atria is commonly used in electrophysiological studies of heart, evaluation of coronary reserve as well as for inducing or termination of fast atrial and atrioventricular dysrhythmias. Despite a broad application of this met...

One Year Follow-up of Single-Lead DDD Stimulation Using the OLBI Principle

Author: CENGIZ ÇELIKER, and NURAN YAZICIOGLU

A new pacing mode which significantly reduced atrial pacing threshold, the ‘overlapping biphasic impulse’ (OLBI) stimulation using the floating atrial dipole of a single-pass lead has been reported. In this study the performance of OLBI stimulation was ev...

Optimal Patient Selection and Programming of VDD Pacemakers

Author: David C. Harari, Emily J. Meyerowitz

Single lead VDD(R) pacing systems employing diagonal atrial bipolar electrodes and differential sensing circuitry have demonstrated reliable atrial sensing without a dedicated atrial lead. The single-pass concept offers the potential for AV synchrony when...

Optimizing the AV Delay in DDD-Pacemaker Patients with Preserved AV-Conduction

Author: Michael Kindermann, Gerd Fröhlig, MD Thomas Doerr, MD ad Hermann Schieffer, MD

There is conflicting data on whether or not intrinsic AV-conduction (ic) should be preserved in patients (pt) paced with dual chamber devices (DDD-PM) in the absence of overt high degree AV block. In 32 pt with DDD-PM implanted for sick sinus syndrome (n ...

Outcomes Of an Early Ambulation Program In Patients Submitted To a First Permane...

Author: Massimo Zoni-Berisso, Daniele Molini et al.

The duration of hospital stay after a new permanent pacemaker implantation is controversial and varies significantly among institutions. In the past years patients have been kept at bedrest aproximately 24 hours, ambulated the following day and dismissed ...

Outcomes of Six Monthly Stimulation Threshold Assessments in Patients with Progr...

Author: Marleen Irwin, RCRT, Mano Senaratne, MBBS, Bonnie Carbol et al.

The purpose of this review was to evaluate the yield of atrial and ventricular stimulation threshold assessments at each routine six monthly pacemaker clinic visit. Since 1983 six monthly stimulation thresholds have been performed in all patients with pro...

PACING-INDUCED ATRIAL ARRHYTHMIAS IN A PORCINE MODEL OF ACUTE ALCOHOLIC INTOXICA...

Author: María J. Anadon, MD, Jesús Almendral, MD, et.al.

We have previously described that, in a closed-chest porcine model, moderate alcoholic toxicity facilitates a variety of atrial tachyarrhythmias. The purpose of the present study was to analyze the electrophysiologic determinants and characteristics of ea...

Pitfalls In The Characterization Of Second-Degree AV Block

Author: S. Serge Barold, Helen S. Barold

Type I and type II second-degree AV block are subject to a number of diagnostic pitfalls. Type II second-degree AV block is generally defined as the occurrence of a single nonconducted P wave associated with constant PR intervals before and after the bloc...

Predominant Tricuspid Stenosis Secondary To Bacterial Endocarditis In A Patient ...

Author: Yilmaz Nisanci, Ercument Yilmaz, Aytac Oncul, and Onal Ozsaruhan

In a 49- year- old woman with sick sinus syndrome and a permanent VVI pacemaker, severe tricuspid stenosis and its clinical consequences developed 4 years after the attack of endocarditis. Besides the quite unusual occurrence of lead related tricuspid ste...

Rate Changes in Minute Ventilation Rate Responsive Pacemakers Upon Connection to...

Author: Richard Troughear

Subsequent to our study into the above occurrence we have observed another mechanism of rate interference in Telectronics META pacemakers by cardiac monitors. In this case a patient with a Telectronics META pacemaker sporadically increased his resting pa...

Right Ventricular Overdrive Pacing in Children With Nonsurgical Complete Heart B...

Author: Katarzyna Bieganowska, Krystyna Kubicka

It is known that asymptomatic patients with complete atrioventricular block (CAVB) may die suddenly. Still it is not possible to distinquish the patient at the risk from asymptomatic group. The purpose of the study was to present our results of right vent...

Significance Of Stimulator Impulse Artefact Suppression For Digital ECG Recordin...

Author: F. Prochaczek, P. Gibinski et al.

In recent years technical problems have arisen in obtaining ECG records with sufficiently good quality during coronary stimulation test and noninvasive electrophysiologic heart examination. Paradoxically, these problems have originated in connexion with t...

Simultaneous Using Of ECG And Blood Pressure Holter Registration In Patients Wit...

Author: W. Kargul, J. Wilczek, J. Kowalik et al.

The aim of the study was evaluation of usefulness of simultaneous 24 hours ECG (HECG) and 24 hours blood pressure registration (HRR) in diagnosis of pacemaker syndrome (PS).

Survey of Magnetic Resonance Imaging in Pacemaker Patients

Author: J. Rod Gimbel, M.D., Ronald J. Lorig, Ph.D., M.D., and Bruce L. Wilkoff, M.D.

Differences exist regarding the perceived safety of scanning pacemaker patients. Several pacemaker patients have safely undergone MRI. Serious concern remains regarding the overall safety of scanning PM patients. Specific safety issues must be addressed t...

Towards A New Standard For Cardiac Pacing

Author: D Gascón, K Stokes, F Pérez-Vico, A Herruzo et al.

Special functions and data storage increase the energy consumption of pacemakers. The most efficient way to decrease the current drain without an increase in threshold is to decrease the electrode size while mitigating tissue injury. Bipolar Capsure Z is ...

Transcutaneous Cardiac Pacing In Cardiac Emergencies - Analysis of Efficacy and ...

Author: S. Karczmarewicz, J. Kociszewska et al.

Transcutaneous cardiac pacing (TCP) has become an accepted therapeutic tool in cardiac emergencies. Some studies have shown that TCP is electrically and haemodynamically effective in a significant proportion of patients but little is known about clinical ...

Transesophageal Cardiac Pacing For Induction And Control Of Supraventricular Par...

Author: Dalia A. Giedrimiene, M.D., Ph.D. and Aldona J. Lukoseviciute, M.D., Ph.D.

The study was performed to estimate the efficacy and reliability of transesophageal cardiac pacing(TCP) for induction of supraventricular paroxysmal tachycardia(SPT) and control of the effectiveness of antiarrhythmic drugs (AD) on 784 pts(349 males and 43...

Transvenous Implantation of Dual Chamber Pacemaker in a Patient with Single Pers...

Author: Andrew R. Hordes MD, Rick Anderson MD, et.al.

A transvenous dual chamber pacemaker implantation was successfully achieved via right subclavian vein in a patient with a persistent left superior vena cava (PLSVC) and absent right superior vena cava (SVC). An active fixation atrial lead was placed in th...

Twiddler's Syndrome In A Patient With Emery-Dreifuss Muscular Dystrophy

Author: Roman Steckiewicz MD PhD, Grzegorz Opolski MD PhD, Marian Pieniak MD PhD

Nowadays, due to the shape and weight of pacemakers, Twiddler's Syndrome is a rare complication in permanent cardiac pacing. Occurrance of this syndrome requires certain favourable anatomic conditions in the pacemaker's region. In the presented case of a ...

Usefulness Of Transesophageal Echocardiography For The Diagnosis Of Pacemaker Le...

Author: Alberto Berenguer MD, Francisco J Chorro MD, et.al.

Permanent pacemaker lead infection is a rare condition but can be fatal, and may be accompanied by a number of complications. A clinical diagnosis is feasible, though it can be difficult. We report two patients with permanent pacemakers who developed feve...