Biomedical subjects

F Hidden-Lucet

Publications and source records attributed to F Hidden-Lucet.

11 recordsLinked to original sources

PubMed2006

[Survey into cardiac pacing in the Ile-de-France area for the year 2001: evaluation of indications].

UNLABELLED: A survey into the implantation of cardiac pacemakers during 2001 in the Ile-de-France area was carried out by the French National Insurance Medical Service in order to evaluate performance in all centres performing more than 10 primary implantations per year. METHODS AND RESULTS: In 2001, 12 centres out of a total of 49 performed less than 50 primary implantations per year, representing 5% of the total regional activity, which was estimated to be 6414 procedures. The remaining 95% of procedures were spread evenly among 8 high-throughput centres (> 200 primary implantations per year) and 29 medium-throughput centres (50 to 200 primary implantations per year). Indications for pacing were analysed retrospectively by a team of regulatory doctors on a sample of 2176 patients with reference to the ACC/AHA/NASPE guidelines. After examination of the medical records, the indication was ranked as being class I, II or Ill (absence of indication). A valid indication was lacking in 8.2% of cases. Sinus node dysfunction represented 74.6% of the non-indications, and this classification had the predictive factors of asymptomatic dysfunction, and treatment with anti-arrhythmic or bradycardic medication. The proportion of class III interventions was significantly lower in the high-throughput centres (5.8 vs 9.9%, p < 0.05). CONCLUSION: 8.2% of primary pacing procedures were not indicated and resulted principally from asymptomatic sinus node dysfunction.

Aged↗

PubMed2003

[Wolff-Parkinson-White syndrome in the child. A case report with associated atrial fibrillation].

UNLABELLED: In children, Wolff-Parkinson-White (WPW) syndrome is often revealed by reentrant tachycardia episodes. Rarely, this syndrome can be the cause of syncope or of sudden death, resulting from rapid conduction of atrial fibrillation to the ventricles through the accessory pathway. CASE REPORT: The authors report the case of a child, who had a WPW syndrome diagnosed after birth because of a supraventricular tachycardia and who was later asymptomatic. At ten years of age, he was admitted because of palpitations due to atrial fibrillation and rapid conduction through the accessory pathway. CONCLUSION: In a child with WPW syndrome, tachycardia with wide and irregular QRS complexes should evoke the involvement of atrial fibrillation, with rapid conduction to the ventricle. Drugs blocking conduction through the atrio-ventricular node are contra-indicated and the condition is an indication for radiofrequency ablation.

Atrial Fibrillation↗

PubMed2003

Clinical relevance of isoproterenol challenge in tilt table testing in a patient with nonspecific repolarization abnormalities and exercise-induced syncope.

Explore the source record for details and available documents.

Adult↗

PubMed2003

[Effects of 50 to 60 Hz and of 20 to 50 kHz magnetic fields on the operation of implanted cardiac pacemakers].

UNLABELLED: The effect of 50 Hz and 60 Hz (frequencies of current distribution) and 20 kHz to 50 kHz (frequencies of induction cooktop) magnetic interference on implanted pacemakers have been assessed with the present generation of device technology. Sixty patients implanted in 1998 and 1999 with dual chamber pacemakers from 9 different manufacturers were monitored with telemetry while passing through, and standing between a system of two coils. They generated a 50 Hz or a 60 Hz magnetic field at 50 microT. Then, patients used a cooktop at different power. The recordings were made with the standard setting of "medically correct" sensing parameters chosen for the patients. Then pacemakers were reprogrammed to the unipolar mode, with the highest atrial (A) and ventricular (V) sensitivity that did not induce muscular inhibition while moving. Between each exposure (50 Hz, 60 Hz or 20 kHz to 50 kHz), the pacemaker programmation was controlled. At the end of the tests, pacemakers will be reprogrammed with the standard setting. The medical observer being blind to the existence or not of the magnetic field. No pacemaker was influenced by the vicinity of the magnetic field at medically correct settings. At unipolar high sensitivity, no inhibition nor reprogramming was observed. Transient reversion to interference mode was observed in 6 cases, 3 transient acceleration due to atrial detection of the interference, and one T wave detection by the ventricular lead. All were observed with the 60 Hz, and only 3 with the 50 Hz magnetic field. One device (Biotronik) shifted out of its special program (hysteresis research) during the tests with the induction cooktop, but it maintained its standard program, and the event could not be repeated despite further testing. CONCLUSION: Actual pacemakers do not present any electromagnetic interference with 50 Hz and 60 Hz or induction cooktop frequency working. They are insensitive with medically correct settings. Unusual high sensitivity leads only to noise reversion mode, or transient ventricular tracking.

Dose-Response Relationship, Radiation↗

PubMed2003

[Cardiac Pacemakers, implantable defibrillators and IRM].

The IRM is formally contraindicated to the pacemaker and cardiac defibrillator wearers because of the risk of inhibition or inappropriate stimulations during the examination. However if the examination is essential, suitable programming of the apparatus and a constant monitoring of the heartbeat rate by a qualified doctor in cardiac stimulation must make it possible to avoid any accident.

Defibrillators, Implantable↗

PubMed2000

Ventricular tachycardia catheter ablation in arrhythmogenic right ventricular dysplasia: a 16-year experience.

Arrhythmogenic right ventricular dysplasia (ARVD) is a structural heart disease affecting young adults that leads to cardiac rhythm disorders including supraventricular and mostly ventricular arrhythmias. Sudden death may be the first presentation of the disease. Ablation techniques have been used for the treatment of ventricular tachycardia in cases resistant to drug therapy. Radiofrequency is appropriate as a first approach for ventricular tachycardia ablation in ARVD; however, its effectiveness is less than 40% at the first session. Fulguration is effective for ventricular tachy-cardia ablation and should be used in the same session after ineffective radiofrequency ablation. However, fulguration requires expertise, general anesthesia, and more than one session in half of all patients. Radiofrequency and fulguration plus other common forms of treatment including pacemakers and automatic implantable cardioverter defibrillators provides a clinical success rate of 81% to 93% in a series of 50 consecutive patients studied during 16 years. Earlier poor reputation of fulguration was the result of poorly understood technical problems concerning the physics and biophysics of the procedure under control with presently available methods. This in-depth study of a large population over a long time period demonstrates that fulguration should be rehabilitated.

Adolescent↗

PubMed2000

Low chronic pacing thresholds of steroid-eluting active-fixation ventricular pacemaker leads: a useful alternative to passive-fixation leads.

Active-fixation pacemaker leads enable pacing at various sites, have a low dislodgment rate, and are easier to extract than passive-fixation leads, though are usually not routinely implanted in the ventricle because of their higher pacing threshold. The long-term pacing threshold associated with an active-fixation steroid-eluting lead was prospectively measured in 18 women and 20 men. At a mean follow-up of 14 months (range 3-25 months), pacing threshold increased from 0.71 +/- 0.29 V to 0.96 +/- 0.28 V (P = 0.01) between implant and the first month of follow-up, then remained stable over time, consistently allowing the long-term programming of the ventricular output at 2.5 V, while lead impedance remained stable (from 647 +/- 161 omega at implant to 666 +/- 122 omega at last follow-up). If the long-term performance of this type of lead is confirmed, the routine implantation of ventricular steroid-eluting active-fixation leads should be considered since lead extraction has become a major concern.

Adult↗

PubMed2000

[Burst of idiopathic ventricular tachycardia complicated by arrhythmia-induced cardiomyopathy].

The authors report the case of a young man with idiopathic ventricular tachycardia occurring in bursts and arising from the pulmonary infundibulum. During follow-up, progressive, severe, dilated cardiomyopathy was observed. Radiofrequency ablation of the site of origin of this very active arrhythmia resulted in total regression of the cardiomyopathy. Contrary to generally accepted concepts, paroxystic ventricular tachycardia, usually qualified as benign, may be complicated by cardiomyopathy when the ventricular extrasystole is incessant and repetitive.

Adult↗

PubMed2000

[Effect of external electrical interference on pacemakers].

Cardiac pacemaker are sensitive to many kind of electromagnetic interference (EMI). However the low rate of reported effects is due to many protective features. Risks are minimal in everyday life conditions as airport detectors, electronic anti-thief systems, domestic electrical appliances and even mobile phones with the most recent models. Interference detection can be prevented by "medically correct" setting, with the use of bipolar sensing, and ventricular sensitivity above 2 mV. The effect of EMI from the industrial world are difficult to assess and need an individual study. The most important risks occur in the medical world, with the electrocutary, thransthoracic DC shocks, and magnetic resonance imaging.

Electromagnetic Fields↗

PubMed1999

Radiofrequency catheter ablation of common atrial flutter: role of the eustachian valve.

INTRODUCTION: During radiofrequency catheter ablation of a common atrial flutter between the tricuspid annulus and the Eustachian valve "septal isthmus", double potentials were recorded along the Eustachian valve, previously described as an anatomical line of conduction block between the coronary sinus ostium and the inferior vena cava. RESULTS: Just before flutter termination, lengthening and beat to beat delay variations between the 2 components of the double potentials were correlated with simultaneous modifications of the flutter cycle length. CONCLUSION: The "septal isthmus" is a common pathway for the flutter wavefront and the impulse generating the second component of the double potential. It is also a good target for flutter ablation.

Adult↗

PubMed1996

Effects of high energy shocks on pacing impedance during transvenous ICD implantation.

The purpose of the current study was to characterize the effects of transvenous ICD shocks on myocardial impedance. Rather than recording impedance during shocks, it was measured during continuous pacing in order to minimize confounding effects such as electrode polarization. Pacing impedance (reflecting the combined impedances of the electrode-tissue interface, myocardium, and blood pool) was measured every 5 seconds before and after 58 single shocks in 22 patients undergoing ICD implantation with a Transvene (n = 14) or Endotak (n = 8) lead. There was a progressive and long-lasting decrease in impedance after shocks. The magnitude of this change was similar for 0.6-J test shocks and shocks > or = 5 J (28 +/- 32 omega vs 23 +/- 16 omega; P = 0.8). However, the drop in impedance was more abrupt after high energy shocks. Because impedance continued to decline throughout the 5-minute interval between shocks, successive shocks had a cumulative effect, with a decrease of 46 +/- 42 omega after four discharges. In conclusion, a progressive decline in pacing impedance is a characteristic response to transvenous ICD discharges.

Adult↗