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Biomedical subjects

C G Schmitt

Publications and source records attributed to C G Schmitt.

At least 19 recordsLinked to original sources
PubMed1988

Effects of lidocaine and procainamide on normal and abnormal intraventricular electrograms during sinus rhythm.

The effect of lidocaine (n = 6) and procainamide (n = 12) on electrogram characteristics from electrically normal right ventricular and electrically abnormal left ventricular endocardial sites was determined in 18 patients with prior myocardial infarction. Bipolar electrograms were recorded during sinus rhythm with No. 6F catheters positioned at a left ventricular abnormal site (electrograms fulfilling two of the following criteria: amplitude less than 3 mV, duration greater than 70 msec, or an amplitude to duration ratio less than .046) and normal sites at the right ventricular apex (RVA) and right ventricular outflow tract (RVOT). All electrograms were recorded from the same location before and after intravenous lidocaine or procainamide administered to obtain mean serum concentrations of 4.2 +/- 0.6 and 9.42 +/- 2 micrograms/ml respectively. Lidocaine and procainamide had no significant effect on sinus cycle length or electrogram amplitude. After lidocaine, no significant change in QRS width (112 +/- 23 vs 114 +/- 24 msec), left ventricular electrogram duration (76 +/- 21 vs 78 +/- 15 msec), or right ventricular electrogram duration (RVA 33 +/- 9 vs 33 +/- 10 msec, RVOT 31 +/- 9 vs 33 +/- 11 msec) was noted during sinus rhythm. At a paced cycle length of 600 msec, there was also no change in the paced QRS duration (197 vs 198 msec), the RVA electrogram duration (30 vs 32 msec), the RVOT electrogram duration (49 vs 52 msec), or the left ventricular electrogram duration (102 vs 108 msec).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗
PubMed1984

Irregular pacemaker tachycardia in a patient with WPW syndrome and an A-V universal pacemaker.

We describe a case of an irregular pacemaker circus movement tachycardia in a patient with the Wolff-Parkinson-White syndrome and a normally functioning A-V universal (DDD) pacemaker (Cordis Sequicor 233 D). The mechanism of the artificial circus movement tachycardia, which uses the pacemaker as the anterograde limb and a septally located accessory atrioventricular pathway as the retrograde limb, is discussed.

Atrioventricular Node↗
PubMed1981

[Circumscribed reticular telangiectatic erythema following implantation of a heart pacemaker].

This is a short report of an erythema arising suddenly after implantation of a cardiac pacemaker on the right side of the thorax. The patient, the results of examination and histology, the thermophysiologic reactions are described and the diagnosis of cutaneous passive hyperemia offered, caused by the position of the pacemaker in connection with the multiple regional operation scars.

Erythema↗
PubMed1980

[Abnormal pacing following defibrillation - exit block after microdislocation of the electrode (author's transl)].

Two days after a 52-year-old patient with coronary heart disease (third degree-av-block and ventricular rhythm, permanent pacemaker treatment) had a pacemaker replacement, bradycardia and pacemaker exit block occurred. After defibrillation with 300 Ws pacemaker for spontaneous ventricular fibrillation, entrance block and new fibrillation were observed. Further defibrillation lead to raising the frequency of the pacemaker and to abnormal stimulation, which in turn triggered irreversibly ventricular fibrillation and the death of the patient. Autopsy showed a micro-dislocation of the electrode and the pacemaker showed a defect of the Zener diode and abnormal stimulation with 4000 Hz ith a pulse width of 240-275 ms and a pulse interval of 1010 ms. We like to point out the importance of the stimulation threshold measurement following pacemaker replacement because of early diagnosis of electrode dislocation that can lead to ventricular fibrillation. We also describe the complication of defibrillation with a pacemaker patient and give advice for prevention of its occurrence.

Bradycardia↗
PubMed1978

[The cost of pacemaker therapy from 1970 to 1975 with particular reference to the new hospital legislation (author's transl)].

The changes introduced by the new legislation on hospital allowances are discussed with reference to the costs (1970 to 1975) for inpatient treatment of patients with pacemakers. As a result of the new legislation, centralizing pacemaker therapy must cause a great strain on the regional statutory insurance authorities if the area served by the pacemaker center is greater than that of the health insurance authority.

Age Factors↗
PubMed1977

[The importance of inputimpedance of QRS-regulated pacemakers (author's transl)].

As smaller the inputimpedance of a QRS-inhibited or synchronous pacemaker as higher the necessary energy for regulation. A method for measurement of inputimpedance of pacemakers is described. These impedances from several types are determined. It is a necessity to lead an intracardial ECG with a loading resistor like the used pacemaker.

Electricity↗
PubMed1977

[X-ray-examination-time during implantation of pervenous leads for permanent cardiac pacing (author's transl)].

From February 1974 to December 1975 we performed 295 pacemaker operations. 165 of those were primary implantations of pervenous leads for permanent cardiac pacing. The X-ray examination time was between 0.1 and 17.0 minutes, their mean value was 2.6, their median 1.7 minutes. In those 165 cases there was a dislocation of the lead in 10.9 percent. Although our X-ray examination time was extremely short however in comparison with the literature we found no arise of our dislocation rate. Some hinces to keep radiation small are discussed.

Electrodes, Implanted↗
PubMed1977

[Extraction of tricuspid valve tissue and myocardium as a complication of transvenous cardiac pacing (author's transl)].

In a patient with transvenous cardiac pacemaker a piece of tissue, 5,5 cm in length, was removed from the wall of the right heart during the extraction of a "shouldered" electrode (Biotronik IE 85-K-O). Histologically it consisted of fibrous tissue as usually found around transvenous electrodes, tricuspid valve tissue, chordae tendineae, and myocardium. Detrimental consequences to the patient following this complication were not observed. Some problems caused by trapped endocardial electrodes and adequate therapeutic possibilities are discussed.

Electrodes, Implanted↗
PubMed1977

[About some rare complications caused by transvenous pacemaker electrodes. Morphological and clinical findings (author's transl)].

Early and late dislocation of electrodes incl. perforation of myocardium and infections of pacemaker systems are the most frequent complications during endocardial pacing. Next functional disorders caused by a risen threshold for stimulation and sensing problems as well as pure technical defects have to be mentioned. The following rare complications were observed in three autopsies: 1. Electrode located in the vena cordis media. 2. Bipolar pacemaker electrode in unstable position near the atrioventricular boundary. 3. Infected transvenous pacemaker electrode migrated into the right vena iliaca externa. Letal thromboemboli sm of the pulmonary arteries. 4. Electrode fragment causing chronic cervical fistula. Consecutive death of the patient by bacterial endocarditis of the mitral valves. Some morphological and clinical aspects of these complications are discussed, the literature is reviewed. Special sight is kept on "trapped" electrodes and coincident infection. It is considered how to avoid those accidents.

Aged↗
PubMed1977

[Experiences with transvenously implanted pacemaker electrodes with special remarks on the treatment of leads out of function (author's transl)].

From 1965 to 1976, implantations of 502 pacemaker electrodes were performed. In 59 patients the first lead had to be changed. In December 1976, 355 patients were under our control. At this time, 11.7 percent were no longer paced via their first lead. Dislocations of the lead, increased threshold, insulation defect, skin perforation of the lead, myocardial perforation, adaptor defects, fracture, infection, and loops of the electrode were the reasons. In cases of exit block alone, you should try to take a high output pacemaker. In cases of entrance block, a pacemaker with increased input-impedance will do its work. If those two kinds of treatment will fail, you may speak about a lead out of function. Considering extraction of the electrode, except in cases of infection, you should exercise restraint, for severe complications may result. An electrode out of function has to be protected against disappearing in a safe way. A synopsis of electrode complications including cause, therapy, and prevention is given.

Electrodes, Implanted↗