[ECG diagnosis of myocardial infarct in patients with artificial pacemakers].
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Electrocardiography↗
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Results for “Pacemaker, Artificial”
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[Indication for the artificial pacemaker in the field of internal medicine].
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Humans↗
[Complications due to artificial pacemaking, with special reference to the examination of generator failures by chest wall stimulation method].
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Adolescent↗
[Is there any risk interaction between electromagnetic field generated by mobile phones and artificial pacemakers].
Electromagnetic noise is rapidly increasing in the environment. Electromagnetic fields (EMF) originating from a variety of different sources have been shown to interfere with the function of implanted cardiac pacemaker. The authors present the effect of EMF generated by wireless telephones on different types of artificial pacemakers. In addition, instructions on safe use of mobile phones addressed to people with implanted artificial pacemaker are provided.
Arrhythmias, Cardiac↗
Artificial cardiac pacemakers.
Artificial pacemakers are electronic devices used primarily to control cardiac rate in patients in whom the intrinsic heart rate is inadequate for a normal life style. These devices automatically and rhythmically provide electrical impulses to stimulate the heart. Electrical stimulation of various organs of the human body was already in practice more than two centuries ago. These applications, however, were in experimental stages until recently when electrical stimulation of the heart has emerged as a new therapy. In view of the astonishing progress made in the field of pacemaker technology and the current indications for the specific types of pacing systems, it behooves physicians caring for patients with heart disease to become familiar with the use of cardiac pacemakers and the not infrequent problems associated with their use. The primary purpose of this review is to present fundamental knowledge in the electrical stimulation of the heart and the various pacing systems available.
Cardiac Output↗
[Cardiac drugs severe intoxications requiring artificial pacemakers].
In this study we present 11 cases of severe drug's intoxications connected with serious rhythm disorders, in which establishment an endocavital electrode and artificial pacemaking were saving-life interventions. Among them Ca-antagonists, digoxin, beta-blockers, angiotensin convertase inhibitors intoxications were observed. 9 cases were treated successfully, 2 patients died. In 2 cases we established electrode, but it wasn't useful. Previous conventional treatment of intoxicated patients with disorders of atrioventricular conductance and impulse creation requires complementation with more aggressive procedures of using artificial pacemaking in properly quick time.
Adolescent↗
[Cardiac memory in patients with permanent artificial pacemakers].
PURPOSE: To correlate the direction of QRS complex of paced beats and postpacing T wave, in patients with artificial pacemaker. METHODS: Thirty five patients with spontaneous rhythm obtained by chest wall stimulation or by programmability of the automatic interval. It was correlated in all patients, the direction forces of QRS complexes of paced beats and postpacing T waves in all 12 ECG leads. It was considered as a cardiac memory phenomenon when QRS complexes of paced beats and postpacing T waves had the same polarity. The phenomenon was correlated with the 12 ECG leads and with specific variables like spontaneous rhythm, QRS complex duration, type and modality of artificial stimulation and chronicity of the implant. RESULTS: The artificial QRS complexes and spontaneous T waves had the same direction in 5 or more leads of the frontal plane in 77% of the patients and in 50% of the patients in the horizontal plane. In patients with supraventricular command, this correlation was found in 82% of the patients and in 50% of the patients with idioventricular rhythm. Regardless of the type of spontaneous command, the phenomenon was better observed with normal intraventricular conduction. It was not found correlation between type, modality of stimulation and chronicity of the implant and cardiac memory. It was better observed in aVF, D2, D3 and V3, V4. CONCLUSION: The phenomenon of cardiac memory in patients with artificial pacemaker is very frequent. The most important factor to develop the phenomenon seem to be a normal pattern of ventricular activation.
Adult↗
[Nursing care of the patient with an artificial pacemaker].
The construction of high technology electronic artificial cardiac pacemaker and its application by the medical science has changed the way and the prognosis of the diseases of the cardiac conducting system. Nursing presence is essential in care of the patient with a cardiac pacemaker. In the operating theatre the nurse creates the most ideal environment and assists at the application of the artificial pacemaker; in the ward she observes with watchful glance for prevention of complications providing individual and holistic nursing care, and helps the patient and his family with rehabilitation and adaptation to his new way of life. In addition, the nurse teaches the patient how to observe the function of his pacemaker, and emphasizes the importance of keeping the doctor's orders and regularly visiting the outpatients cardiac pacemakers control department to check his pacemaker.
Adaptation, Psychological↗
Echocardiographic demonstration of tricuspid valvulitis and right atrial thrombus complicating an infected artificial pacemaker:a case report.
A right ventricular artificial demand pacemaker was implanted into a 59-year-old man with supra-Hisian complete heart block. His postoperative course was complicated by Staphylococcal aureus septicemia, which was controlled with antibiotics. A year later, S. aureus was again isolated from the blood. Echocardiography showed thickening of the tricuspid valve leaflet and multiple echoes in the right atrium. Autopsy findings included tricuspid leaflet thickening and an overlying right atrial thrombus. The echocardiogram is thus useful in localizing an infected valve in bacterial endocarditis and in demonstrating the presence of the thrombus.
Echocardiography↗
[Evaluation of the state of cardiodynamics in patients with artificial pacemaker].
Cardiodynamic parameters were studied in 23 patients with an implanted cardiostimulator both at rest and in conditions of an isometric exercise test. Three types of blood circulation were identified, namely eu-, hypo-, and hyperkinetic. The individual types of circulation were shown to be correlated with the severity of the clinical course of the underlying disease. The isometric exercise test allowed the researchers to differentiate between adequate and inadequate responses of hemodynamics in patients with an artificial pacemaker. It is concluded advisable to investigate the hemodynamic state of patients with an implanted artificial pacemaker so as to decide on any corrective measures that may be needed.
Adams-Stokes Syndrome↗
Computer simulation of cardiac rhythm and artificial pacemakers using a ten-element heart model.
This paper describes a universal simulation system which enables simulation models of cardiac rhythm disturbances and of artificial pacemaker actions to be constructed. Three types of heart element are introduced according to the way in which excitation impulses are propagated or produced. Cycle rate dependence of repolarization periods and of impulse transmission speeds is incorporated. Random and predetermined deviations from natural behavior are also allowed for in the model. Using the universal system, a model of simple configuration has been developed. There are five physiological and five pathological heart components joined together by uni- and bidirectional connectors. Additional bidirectional channels allow a variety of pacemakers to be "implanted" in the simulated heart.
Arrhythmias, Cardiac↗
[Pacemaker syndrome in the absence of artificial pacemaker (pseudopacemaker syndrome)].
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Aged↗
[Effectiveness of long-term treatment with vasodilators in patients with artificial pacemakers].
The effect of long-term use of venular and arterial vasodilators (molsidomin and nifedipin) on the clinical course and hemodynamic indices was studied in 52 patients with artificial pacemakers. The choice of vasodilator was based on an acute drug test. In the presence of hypertensive disease the calcium antagonist nifedipin was used, in cases of dilatation of the cardiac compartments molsidomin was used. Combination of both drugs was used in patients in whom the acute drug test did not allow to prefer any of the drugs. It is concluded that three-month's treatment resulted in positive changes of the hemodynamics, reduction of the severity of cardiac insufficiency. Side-effects were practically absent.
Adult↗
[Effects of antihypertensive drugs with different mechanism of action on cardiac hemodynamics in patients with artificial pacemaker].
Cardiohemodynamic effects of obsidan, nifedipin, captopril and prasosine were compared when the drugs were given in a 4-week course regarding circulation type and stimulation regime to 74 patients with artificial pacemaker suffering from mild or moderate essential hypertension. A peculiar action of obsidan, nifedipin and prasosine in cardiac pacing found at echocardiography is explained by the absence of frequency-dependent (chronotropic) cardiohemodynamic effects. Obsidan lowered blood pressure most effectively in hyperkinetic circulation. Nifedipine, captopril and prasosine were more potent in eu- and hypokinetic circulation. Reduction of arterial pressure by the above peripheral vasodilators in patients with hyperkinetic circulation results from a fall of total peripheral vascular resistance initially elevated by 16.5%, on the average. In isolated ventricular stimulation (regime VVI) vs atrial one (AAI regime) hypotensive action of the above drugs was more potent, but side effects were more frequent.
Adult↗
Pregnancy with an artificial pacemaker.
Complete heart block in pregnancy is not a common encounter. The first case was reported in 1914 by Nanta and today some 100 cases are documented. Heart block may be congenital or acquired secondary to cardiac surgery, rheumatic heart disease, or infective disorders. Heart block, whether congenital or acquired, rarely creates any special obstetric problems. Today there is an increasing use of cardiac pacemakers in younger people and the first reported obstetric experience with a cardiac pacemaker implanted before pregnancy was by Shouse and Acker. This review will document the course and outcome of all reported pregnancies in women conceiving with an artificial pacemaker, and discuss complications and principles of management. We will also report our experience with a woman suffering from a complete heart block in whom an internal cardiac pacemaker was inserted before pregnancy.
Adult↗
The influence of atrial activity on ventricular capture by failing artificial pacemakers. I. Report of two new cases and review of the literature.
Atrial activity can influence the ability of a failing artificial pacemaker to excite the heart. An appropriately timed atrial beat may cause failure in excitation by pacemaker stimuli which are usually successful in ventricular capture. Conversely, stimuli which usually fail in excitation may be made to succeed by an appropriately timed atrial beat. Two case reports and a review of the literature are presented. Alternative mechanisms for this influence of atrial activity are electrotonic effects (Wedensky facilitation or inhibition) and mechanical effects (motion of the pacing catheter or ventricular myocardium). The authors consider the latter mechanism preferable.
Aged↗
Basic testing of an artificial pacemaker in the normal and incontinent anorectum.
The role of an artificial pacemaker (AP) in the control of idiopathic fecal incontinence was studied in 15 healthy volunteers (mean age 49.6 years) and 11 patients with idiopathic fecal incontinence (mean age 45.9 years). In the latter, EMG activity of the external anal sphincter (EAS) was diminished, and that of the internal sphincter (IAS) was normal. The pacemaker consisted of a needle, a flat metal piece, a battery and a telegrapher's key. The needle was applied to the IAS and EAS. The rectal and rectal neck pressures were measured by water-perfused tubes, and rectal distension was achieved by a condom-ended catheter. In normal subjects, electric pulsing of either the IAS or EAS caused a significant rectal neck pressure increase (p < 0.01), but insignificant changes in rectal pressure (p > 0.05). Rectal distension with 100 ml of air effected a rectal neck pressure decrease (p < 0.01) and balloon expulsion. IAS pulsing with the rectum distended led to a rectal neck pressure increase (p < 0.001) and rectal pressure decrease (p < 0.0001), but not to balloon expulsion. The rectal neck pressure increased more with EAS pulsing than with IAS pulsing (p < 0.01). In incontinent subjects, IAS pulsing produced a significant rectal neck pressure increase (p < 0.001), while EAS pulsing resulted in an insignificant one (p > 0.05). In the same subjects, IAS pulsing with rectal distension (50 ml air) caused a significant rectal neck pressure increase (p < 0.001) and a significant rectal pressure decrease (p < 0.0001); the rectal balloon was not expelled.(ABSTRACT TRUNCATED AT 250 WORDS)
Anal Canal↗
Problems of artificial pacemaker therapy.
Four hundred and sixty-seven cases with implantation of an artificial pacemaker were studied. The postoperative survival rate was 63% for 15 years. Seventy-two percent of type III patients of the sick sinus syndrome were free from postoperative thromboembolism and the lowest of the three types of the sick sinus syndrome. Comparing postoperative physical activity, cardiothoracic ratio and exercise tolerance time, physiological pacing was superior to ventricular pacing in hemodynamic effects and clinical symptoms. In a hundred cases of physiological pacing, complications and problems of physiological pacing were discussed. Atrial sensing failure and over-sensing were observed in seven and two cases respectively. A low amplitude of atrial potential and use of unipolar atrial leads were considered to be the main causes of these complications. Bipolar lead should be used as the atrial lead to avoid such complications, because the atrial potential by bipolar leads is not less than that by unipolar leads. Atrial sensing may be more sensitive without electromagnetic interference. The fixed A-V delay time whenever the atrium is sensed or paced, often results in a ventricular fusion beat and hemodynamic change on every beat, according to the interval of atrial and ventricular contractions. The A-V delay time should be changed in accordance with atrial sensing or pacing.
Cardiac Pacing, Artificial↗