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Biomedical subjects

R Leman

Publications and source records attributed to R Leman.

4 recordsLinked to original sources
PubMed1992

Chronotropic incompetence: a common and progressive finding in pacemaker patients.

Thirty-eight patients (ages 40 to 77 years, mean 63) followed in a pacemaker clinic underwent exercise treadmill tests to determine chronotropic incompetence. There were 28 men and 10 women. Twenty-seven patients had atrioventricular (AV) block and 11 patients had sick sinus syndrome. All patients were exercised to fatigue. None of the patients were receiving beta-blockers or other drugs that could reduce heart rate. Maximum heart rate (MHR) and percent predicted maximum heart rate (% PMHR) were used as an index of chronotropic incompetence. Chronotropic incompetence was defined as inability to achieve a % PMHR of greater than 80%. The overall incidence of chronotropic incompetence was 58% (22 of 38 patients). We examined the relationship between chronotropic incompetence and the time to pacemaker implantation. We found that in patients who had pacemakers for less than 2 years, the mean MHR was 125 +/- 21.6 beats/min compared with 111.9 +/- 23.6 beats/min for patients who had pacemakers implanted for longer than 4 years. Similarly, the mean % PMHR decreased from 76.5 +/- 12.5% to 68.7 +/- 15.4% in patients with pacemakers less than 2 years versus those with pacemakers for more than 4 years. Fifty-three percent of the patients with a pacemaker less than 2 years old were chronotropic incompetent versus 70% of the patients with a pacemaker more than 4 years old. These data suggest that chronotropic incompetence worsens with time after pacemaker implant. To further support this, eight patients with AV block underwent a second stress test an average of 2 years following the first.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Forceps extraction of permanent pacing leads.

With the advent of tined transvenous cardiac pacing leads, the complete extraction of pacing leads in the treatment of an infected cardiac pacing system has become increasingly difficult. A method is described for the extraction of permanent pacing leads from the heart using alligator forceps inserted transvenously through the right internal jugular vein, grasping the lead near its insertion point in the cardiac muscle.

Electrodes, Implanted↗