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Miroslav J Munclinger

Publications and source records attributed to Miroslav J Munclinger.

4 recordsLinked to original sources
PubMedDate not supplied

Long-term follow-up of single-lead VDD pacing.

Long-term outcomes of single-lead VDD pacing were studied retrospectively and partly prospectively. Records were analysed of 81 patients out of 133 in whom a single-lead VDD pacemaker was implanted between January 1993 and December 1997 and who attended a follow-up clinic more than two years after the implant. Forty-eight of them attended a prospective follow-up 54 +/- 15 months after the implant. Sinus rhythm was present in 91.5% of the patients and atrial fibrillation in the remaining 8.5%. A-V synchronous pacing was documented in 91.9 to 94.9% at different follow-up periods; however, an intermittent asynchronous ventricular (VVI) pacing of more than 10% occurred intermittently in 19.1% of the patients. Chronic sensed P-wave amplitude was significantly lower than the implant P-wave amplitude (by 70%) and did not correlate with the implant amplitude. Postural changes (supine, sitting, standing, with normal breathing and during deep inspiration) did not have a significant impact on sensed P-wave amplitude more than four years after the implant. Rate histograms were remarkably stable over the years, with dominant heart rate 70 to 79 beats per minute observed for 25 to 30% of the monitored periods. Single-lead VDD pacing was found to be a reliable method of long-term physiological pacing in patients with heart block who returned for follow-up. Routine testing more than four years after the implant does not require postural manoeuvres.

Adult↗
PubMedDate not supplied

Biventricular pacing for heart failure alters electro-mechanical coupling of both ventricles.

AIM: The exact mechanisms whereby biventricular pacing enables cardiac resynchronisation are not completely understood. This study looked at the effect of biventricular pacing on interventricular asynchrony in patients submitted to biventricular pacing. METHODS: A prospective series of 13 consecutive patients were selected from those referred for biventricular pacing. Criteria used included heart failure and QRS factors, as well as echocardiographic evidence of both intraventricular and interventricular asynchrony. Midterm follow-up of clinical and echocardiographic parameters are presented. RESULTS: All patients' clinical conditions improved significantly. Expectedly, diastolic filling parameters, ejection fraction and mitral regurgitation also improved significantly. The difference in the timing of left and right ventricular ejections of 65 ms at the baseline was corrected to 3 to 5 ms during six-month follow-ups after biventricular pacing. This effect was achieved by significant shortening of the left ventricular pre-ejection interval by 29 to 39 ms (p < 0.01) and by significant prolonging of the right ventricular pre-ejection interval by 18 to 30 ms (p < 0.01). CONCLUSION: Complete interventricular mechanical resynchronisation due to biventricular pacing occurred not only by the expected advancement in left ventricular ejection, but also by a delay in right ventricular ejection. The specific significance of correcting interventricular asynchrony with regard to the benefit and selection of patients for resynchronisation therapy remains to be fully established.

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