J Babotai | PubMed Health

PubMed1981

[Differentiated pacemaker therapy].

17 patients were treated by atrial (AAI) or atrial-triggered ventricular pacing (VAT). The atrial electrode was placed using a new endocardial screw-in technique. No complications occurred during a follow-up period of 3 months. Cardiac output at rest was measured in 12 patients before pacemaker implantation and was 3.571/min with VVI pacing at a heart rate (HR) of 70/min and 3.97 l/min (HR 75/min) with AAI or VAT pacing (p less than 0.001). Measurement of cardiac output was repeated in 7 patients with AV-block III degrees 10 weeks after pacemaker implant and the result was 4.40 l/min (HR 77/min) on VAT stimulation. During dynamic exercise in 5 patients, cardiac output under VAT pacing was 20% higher than with VVI pacing. This difference remained unchanged after 10 weeks. It is concluded that atrial electrodes can be placed reliably by the new technique. In contrast to VVI pacing, the hemodynamic benefits of atrial-triggered ventricular pacemakers appear to be long lasting.

Adult↗

PubMed1980

[Five years' experience with an epimyocardial screw-in electrode in cardiac pacemakers].

197 myocardial sutureless screw-in electrodes were implanted between the years 1973 and 1978. A subxyphoidal transmediastinal route and general anaesthesia were used. All patients had initially good pacing results. In 93% the electrode was placed into the right, in 7% into the left ventricle. The peroperative mortality rate was 0, peroperative complications were seen in 1%. Of the 19% of the complications which needed some kind of a treatment, 7.6% were confined to the lead and 11.4% were other complications. The lead, placed into the right ventricle, had to be replaced in five patients (2.7%) because of exit block or sensing problems. The postpericardiotomy syndrome was the most frequent complication but it did not impair the function of the pacemaker. 4% of the patients died within 30 days after the implantation. In 46 patients the pacemaker was replaced after a mean time of 32,5 months. The measurement of the threshold rose from a mean of 0.8 mAmp to 3.2 mAmp and the mean resistance was 530 Ohms. In 44 patients the electrode could be reused.

Adult↗