Timing Markers Showing Pacemaker Behavior to Aid in the Follow-Up of a Physiological Pacemaker (original) (raw)
Atrial Pacing: Who do We Pace and What do We Expect? Experiences with 100 Atrial Pacemakers
Pacing and Clinical Electrophysiology, 1990
KOLETTIS, T.M., ET AL.: Atrial Pacing: Who do We Pace and What do We Expect? Experiences with 100 Atrial Pacemakers. The records of 100 patients with permanent atriaJ pacemakers implanted over a 7-year period were reviewed to assess the role and results 0/ this mode of pacing. Indications for pacing were sick sinus syndrome in 91, carotid sinus hypersensitivity in 3, and use of an antitachycardia device in 6 patients. The mean follow-up period was 32.9 months. Symptomatic relief was good. Lead dislodgment occurred in 11 patients (usually in the jirst weekj. Threshold rises not amenable to reprogramming occurred in three patients and loss of sensing occurred in seven patients but only one required intervention. Overall, 21 patients required reoperation. The type of lead did not influence the need for reoperation that appeared to he related to the experience of the operator. Complete atrioventricular block occurred in three patients, two of whom had carotid sinus hypersensitivity and one had sick sinus syndrome. Chronic atrial fibrillation occurred in five patients, none 0/whom required revision of the pacemaker system. Atrial pacing is a satisfactory pacing mode in patients with sick sinus syndrome. Provided satisfactory atrioventricular conduction has been shown by incremental atrial pacing to at least 120 beats/min and carotid hypersensitivity is absent, progression to complete atrioventricular block is uncommon. Greater implanting skills are required for good results. (PACE, Vol. 13, May 1990} atrial pacing, sick sinus syndrome, atrioventricular block
Revista Española de Cardiología (English Edition)
Introduction and objectives: This report describes Spanish cardiac pacing activity during 2019: quantities and types of devices and demographic and clinical factors. Methods: The analysis is based on data obtained from the European Pacemaker Patient Identification Card, data submitted to the online platform cardiodispositivos.es, and supplier-reported data on the total number of implanted pacemakers. Results: Information was received on 15 833 procedures from 102 implantation centers, representing 39% of the estimated total activity. The implantation rates of conventional and resynchronization pacemakers were 832 and 32 units per million population, respectively. A total of 431 leadless pacemakers were implanted. Most implantations were performed in elderly patients (mean age, 78.7 years). Most electrodes were bipolar and with active fixation and 34.1% were magnetic resonance imaging-compatible. Atrioventricular block was the most common electrocardiographic abnormality. Dual-chamber sequential pacing predominated; nonetheless, up to 20% of patients in sinus rhythm received a single-chamber ventricular pacemaker, mainly those older than 80 years of age and women. Remote monitoring capability was present in 41% of cardiac resynchronization therapy pacemakers and in 14.8% of conventional pacemakers. Conclusions: Consumption of pacing generators increased by 1.6%, mainly due to a 15.1% increase in cardiac resynchronization therapy pacemakers. Sequential pacing predominates; its use is influenced by age and sex. Remote monitoring increased by 20.6% in cardiac resynchronization therapy pacemakers and continues to be scarce in conventional pacemakers.
Update on Arrhythmias and Cardiac Pacing 2013
Revista Española de Cardiología (English Edition), 2014
This report discusses a selection of the most relevant articles on cardiac arrhythmias and pacing published in 2013. The first section discusses arrhythmias, classified as regular paroxysmal supraventricular tachyarrhythmias, atrial fibrillation, and ventricular arrhythmias, together with their treatment by means of an implantable cardioverter defibrillator. The next section reviews cardiac pacing, subdivided into resynchronization therapy, remote monitoring of implantable devices, and pacemakers. The final section discusses syncope.
Pacemaker malfunction or non-physiological ventricular pacing?
Europace, 2008
Pacemaker manufacturers have developed new algorithms to preserve intrinsic conduction in order to reduce unnecessary stimulation and looking for physiological pacing. This case report highlights some of the new challenges related to these algorithms which include possible ECG misinterpretations and inaccurate programming leading to potential negative consequences.
Revista Española de Cardiología (English Edition), 2014
Introduction and objectives: The present report summarizes the analysis of pacemaker implantation and replacement data sent to the Spanish Pacemaker Registry in 2013, with specific discussion of pacing mode selection. Methods: This study was based on information obtained from the European Pacemaker Patient Identification Card. Results: Information was received on 118 hospital centers, with a total of 12 831 cards, or 35% of the estimated activity. There were 755 and 58.1 conventional and resynchronization devices per million population, respectively. The mean age of patients receiving an implant was 77.4 years. Men received 59.5% of first implantations and 56.6% of replacements. Most implantations and generator replacements were performed in patients older than 80 years. Almost all endocardial leads used were bipolar, and 78.7% of leads had an active fixation mechanism. Despite being in sinus rhythm, 24% of patients with sick sinus syndrome and 25% of those with atrioventricular block were paced in VVIR mode. Conclusions: The use of pacemaker generators and resynchronization devices per million population continues to increase in Spain. Active fixation mechanisms predominate for leads but just 20% of leads are compatible with magnetic resonance imaging. The factors influencing the correct selection of pacing mode were age and, to a lesser extent, the type of atrioventricular block, and sex. Implementation of home monitoring of pacemakers remains low.
Noninvasive Assessment of the Biventricular Pacing System
Annals of Noninvasive Electrocardiology, 2004
Cardiac resynchronization using biventricular (BiV) pacing systems has been introduced for the treatment of symptomatic heart failure in patients with bundle branch block or prolonged QRS duration. Recent controlled clinical trials 1,2 have concluded and the results indicate that the majority of carefully selected patients will experience clinical improvement. The Food and Drug Administration has recently approved BiV pacing systems for implantation in patients with NYHA class III-IV heart failure despite optimal medical therapy when the QRS duration is >130 ms. The BiV pacing system differs from the conventional permanent pacemaker by incorporating a third lead that is positioned on the epicardial surface of the left ventricle (LV) via the coronary venous system. Simultaneous stimulation of the right ventricle (RV) (via a conventional endocardial lead) and the LV accomplishes BiV pacing and "resynchronizes" ventricular activation. This nontraditional format of ventricular stimulation may present new challenges in the assessment of pacing function, and will necessitate a greater understanding of basic and complex features of BiV pacing and its effect on noninvasive modalities such as the electrocardiogram (ECG) and intracardiac recordings on the pacemaker programmers. Initial systems utilized a conventional pulse generator with a modified header where LV and RV signals and output were linked; systems with separate ports for the LV and RV are now available.