Timing Markers Showing Pacemaker Behavior to Aid in the Follow-Up of a Physiological Pacemaker (original) (raw)
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Pacemaker Follow-Up: Its Role in the Detection and Correction of Pacemaker System Malfunction
Pacing and Clinical Electrophysiology, 1986
GRIFFIN, J.C., ET AL.: Pacemaker follow-up: its role in the detection and correction of pacemaker system malfunction. The goal of pacemaker foUow-up is not only to detect battery depletion but also to detect all malfunctions of the pacing system and, when possible, to correct such problems using programming. During one year, we discovered 61 such inal/unctions in a clinic of W65 patients (5.7%). These were more frequent in the first year {7.7%) than in the third io fifth years of foWow-up (range 3.1-4.8%). The incidence rose again in the sixth and subsequent years {7-7.7%). Despite a significant occurrence of malfunctions (5.2%J among muKiprogrammable pacemakers, the necessity for operative intervention for their correction was low (1.2%). Sensing problems were the most common {57%) and the most likely io be corrected hy reprogromming (85%]: problems involving loss of capture were less likely io he corrected by programming (38.5%). Baiiery depletion accounted for only 18% of malfunctions, occurring earliest in (he forty-tbird month of foIJow-up. Pulse generator longevity of those devices reaching end of battery life during the sfudy period was 68.6 ± W.7 months (mean + SD). We conclude that specialized pacemaker follow-up continues io he necessary des[i[te improved pulse generator reliobility and longevity. Indeed, with reprogramming, ii presently plays an even more important vole than in the past. Follow-up should he oriented noi only to the detection of battery depletion but also toward o comprehensive surveillance of pacemaker system function. (PACE, Vol. 9, May-/une, 1966) pacemaker artijiciaJ, pacemaker follow-up, pacemaker clinic, pulse generator, pacing eledrode
Reversible End-of-Life Indicator Leading to Erroneous Pacemaker Replacement-Pitfalls of Telemetry
Pace-pacing and Clinical Electrophysiology, 1984
In several modern pacemakers, end-of-life (EOL) is indicated by a single-step rate drop, which is initiated by a voltage-sensitive electronic switch. This switch may also be activated by other causes, such as very short voltage drops, low temperatures, and electrocautery. We report a case in which a Cordis 233 F Sequicor II pulse generator was operating at 51.6 bpm in VOO mode at the time of implantation. As telemetry seemed to indicate that back-up pacing (the EOL indicator in this model was “off”, it was erroneously assumed that the pacemaker was not working properly. The unit was replaced by another impulse generator. At laboratory testing, the pacemaker was within specifications, when back-up pacing was separately programmed off. In conclusion, physicians should be aware of the new phenomenon of reversible EOL indicators, and that they may not rely on telemetry in this respect. Future pacemakers should incorporate a telemetry message which prevents similar misunderstandings.
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.
Pacing and Clinical Electrophysiology, 1996
Pacemaker Follow-Up Clinic. Many pacemaker patients have vague symptoms following implantation. It is often difficult for the physician to ascertain if they are cardiac in origin. A new pacemaker feature has been introduced, Patient-Triggered Event Records (PTER), to help the physician with this diagnosis. The PTER is a continuously running event record which stores the cardiac rhythm and rate. Brief application of a magnet will transfer the record into the device's memory. The data recorded will be the 97 events prior to the magnet application and the 30 events following magnet removal. The exact state of pacing (atriai and ventricular sensing/pacing, or premature ventricular events) and the rate ofthe ventricular events will be graphically displayed by the programmer for all 127 events. Thus, the exact pacer and cardiac rhythm can be determined during the period of the symptomatic episode. A total of three PTER's can be stored within the device. If a fourth is recorded, it will replace the oldest record. Three pacemakers with the PTER feature were tested in vitro with five different simulated cardiac rhythms. A beat-bybeat comparison between the PTEH and the 15 simulated test rhythms revealed a 100% accurate documentation by PTER. Sixteen pacemaker patients which have the PTER feature were monitored using a King of Hearts™ for a total of 43 symptomatic events. The PTER records produced clinically relevant information 98% ofthe time while the King of Hearts'™ produced clinically relevant information 81% ofthe time. A comparison of costs ofthe two different methods of monitoring these patients, was 2,432versus2,432 versus 2,432versus4,480 for the PTER and loop event monitor respectively. The PTER is an accurate, lower cost method for monitoring and diagnosing symptomatic pacemaker patients. The PTER can be used as the first diagnostic tool in troubleshooting patients with paroxysmal symptoms in the pacemaker clinic population
Permanent cardiac pacemakers: issues relevant to the emergency physician, part I
The Journal of Emergency Medicine, 1999
e Abstract-Many people benefit from the implantation of cardiac pacemakers for management of certain cardiac dysrhythmias. These patients are seen regularly in the emergency department with a variety of pacemaker complications and malfunctions. The presence of a pacemaker may also affect management of unrelated medical problems. This two-part series reviews the medical issues related to patients with permanent pacemakers. Part I covers pacing modes and terminology, complications of the implant procedure, and the approach to a patient with a permanent pacemaker. Part II covers the causes, diagnosis and management of pacemaker malfunction; the pacemaker syndrome; the pacemaker Twiddler's syndrome; and other considerations in the paced patient including diagnosis of acute myocardial infarction, ACLS protocols, trauma, and sources of interference. Indications for permanent pacemaker implantation and temporary external pacing will not be covered. © 1999 Elsevier Science Inc. e Keywords-pacemaker; electrocardiogram; diagnosis; malfunction; ventricular-paced rhythm