共查询到20条相似文献,搜索用时 15 毫秒
1.
2.
3.
4.
Panos E. Vardas 《Journal of interventional cardiac electrophysiology》2003,9(2):183-187
Cardiac resynchronization has proven to be a useful adjunct therapy for heart failure patients with ventricular conduction disturbances. However, new issues have emerged including the follow-up and trouble-shooting of the biventricular devices. Peri-implant and immediate post-implant follow-up is necessary if procedure-related complications are to be revealed and proper system functioning ensured. Additionally, during the long-term follow-up the optimum device functioning should be evaluated, as should the patient's clinical and functional improvement. Finally, trouble-shooting resulting from the use of biventricular devices is another matter that needs to be addressed and physicians active in the field should continually upgrade their knowledge in the constantly evolving technologies of cardiac resynchronizers. 相似文献
5.
Pacing induced cardiomyopathy (PICM) is most commonly defined as a drop in left ventricle ejection fraction (LVEF) in the setting of chronic, high burden right ventricle (RV) pacing. Recent data suggest, however, that some individuals may experience the onset of heart failure symptoms more acutely after pacemaker implantation. Definitions of PICM which emphasize drop in LVEF may underestimate the incidence of deleterious effects from RV pacing. Treatment of PICM has primarily focused on upgrade to cardiac resynchronization therapy (CRT) when LVEF has dropped. However, emerging data suggest that conduction system pacing (CSP) may offer an opportunity to prevent PICM in the first place. 相似文献
6.
7.
Permanent cardiac pacing is an established treatment for the prevention of syncope or sudden death in patients with heart block or sinus node disease. Recent observations underscore the use of pacing in patients with various forms of cardiomyopathy, i.e. hypertrophic, dilated and tachycardia-induced cardiomyopathy. The evidence favouring the use of pacing in patients with cardiomyopathy is mainly derived from retrospective and uncontrolled investigations and the data from the scarce randomized investigations are rather disappointing. Therefore, the indications for pacing remain controversial. 相似文献
8.
Temporary Cardiac Pacing 总被引:1,自引:0,他引:1
Leonard I. Ganz 《Cardiac Electrophysiology Review》1999,2(4):389-392
9.
Non-invasive Dual-Chamber Pacing was performed with low threshold current using a newly developed trans-oesophageal lead-electrode in one healthy volunteer. 相似文献
10.
Pacing in children 总被引:1,自引:0,他引:1
H Ector G Dhooghe W Daenen G Stalpaert L van der Hauwaert H de Geest 《British heart journal》1985,53(5):541-546
Fourteen children had a permanent pacemaker implanted between May 1967 and July 1983. Postoperative complete heart block was the indication in nine cases, congenital complete heart block in three, and sick sinus syndrome in two. Two patients died, one suddenly and one after aortic valve replacement. A total of 48 pulse generators were implanted; five patients were given an isotopic pacemaker. Twelve patients had epicardial leads implanted initially, and two received a transvenous endocardial system. The lead system implanted initially remained without malfunction in only seven patients. In the other seven patients 20 lead malfunctions occurred. Psychological maturity and physical development seemed to be normal in all 14 children. Improvement in equipment and technique will improve the outlook for paced children in the future. 相似文献
11.
Cardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe heart failure and
a wide QRS complex. However, the amount of reverse remodeling and clinical improvement is highly variable and poorly predictable.
The left ventricular pacing site is of critical importance for the CRT response but is often imposed by the coronary sinus
anatomical constraints and may result in suboptimal resynchronization. Alternative pacing sites, such as endocardial LV pacing
or multisite pacing, have been proposed to improve CRT response rates and may be considered in nonresponders to standard resynchronization.
However, adequately powered randomized studies are required to determine whether these pacing strategies result in improved
outcome. 相似文献
12.
13.
Mohamed Abdelrahman Faiz A. Subzposh Dominik Beer Brendan Durr Angela Naperkowski Haiyan Sun Jess W. Oren Gopi Dandamudi Pugazhendhi Vijayaraman 《Journal of the American College of Cardiology》2018,71(20):2319-2330
Background
Right ventricular pacing (RVP) is associated with heart failure and increased mortality. His bundle pacing (HBP) is a physiological alternative to RVP.Objectives
This study sought to evaluate clinical outcomes of HBP compared to RVP.Methods
All patients requiring initial pacemaker implantation between October 1, 2013, and December 31, 2016, were included in the study. Permanent HBP was attempted in consecutive patients at 1 hospital and RVP at a sister hospital. Implant characteristics, all-cause mortality, heart failure hospitalization (HFH), and upgrades to biventricular pacing (BiVP) were tracked. Primary outcome was the combined endpoint of death, HFH, or upgrade to BiVP. Secondary endpoints were mortality and HFH.Results
HBP was successful in 304 of 332 consecutive patients (92%), whereas 433 patients underwent RVP. The primary endpoint of death, HFH, or upgrade to BiVP was significantly reduced in the HBP group (83 of 332 patients [25%]) compared to RVP (137 of 433 patients [32%]; hazard ratio [HR]: 0.71; 95% confidence interval [CI]: 0.534 to 0.944; p = 0.02). This difference was observed primarily in patients with ventricular pacing >20% (25% in HBP vs. 36% in RVP; HR: 0.65; 95% CI: 0.456 to 0.927; p = 0.02). The incidence of HFH was significantly reduced in HBP (12.4% vs. 17.6%; HR: 0.63; 95% CI: 0.430 to 0.931; p = 0.02). There was a trend toward reduced mortality in HBP (17.2% vs. 21.4%, respectively; p = 0.06).Conclusions
Permanent HBP was feasible and safe in a large real-world population requiring permanent pacemakers. His bundle pacing was associated with reduction in the combined endpoint of death, HFH, or upgrade to BiVP compared to RVP in patients requiring permanent pacemakers. 相似文献14.
Shengjie Wu Lan Su Pugazhendhi Vijayaraman Rujie Zheng Mengxing Cai Lei Xu Ruiyu Shi Zhouqing Huang Zachary I. Whinnett Weijian Huang 《The Canadian journal of cardiology》2021,37(2):319-328
BackgroundLeft bundle branch pacing (LBBP) is a novel method for delivering cardiac resynchronization therapy (CRT). We compared on-treatment outcomes with His bundle pacing (HBP) and biventricular pacing (BVP) in this nonrandomized observational study.MethodsConsecutive patients with left-ventricular ejection fraction (LVEF) ≤ 40% and typical left bundle branch block (LBBB) referred for CRT received BVP, HBP, or LBBP. QRS duration, pacing threshold, LVEF, and New York Heart Association (NYHA) class were assessed.ResultsOne hundred thirty-seven patients were recruited: 49 HBP, 32 LBBP, and 54 BVP; 2 did not receive CRT. The majority of patients had nonischemic cardiomyopathy. Mean paced QRS duration was 100.7 ± 15.3 ms, 110.8 ± 11.1 ms, and 135.4 ± 20.2 ms during HBP, LBBP, and BVP, respectively. HBP and LBBP demonstrated a similar absolute increase (Δ) in LVEF (+23.9% vs +24%, P = 0.977) and rate of normalized final LVEF (74.4% vs 70.0%, P = 0.881) at 1-year follow-up. This was significantly higher than in the BVP group (Δ LVEF +16.7% and 44.9% rate of normalized final LVEF, P < 0.005). HBP and LBBP also demonstrated greater improvements in NYHA class compared with BVP. LBBP was associated with higher R-wave amplitude (11.2 ± 5.1 mV vs 3.8 ± 1.9 mV, P < 0.001) and lower pacing threshold (0.49 ± 0.13 V/0.5 ms vs 1.35 ± 0.73 V/0.5 ms, P < 0.001) compared with HBP.ConclusionLBBP appears to be a promising method for delivering CRT. We observed similar improvements in symptoms and LV function with LBBP and HBP. These improvements were significantly greater than those seen in patients treated with BVP in this nonrandomized study. These promising findings justify further investigation with randomized trials. 相似文献
15.
本文观测204例右室起搏导管电极的嵌入位置,比较各种位置具有相同起搏阈值的例数、心腔内心电图图形及电极脱位的机会。认为除右室心尖部外,与其同一水平的右室流入道以及靠近室间隔的部位,亦有良好的起搏效果。由于有多个部位可供选择,故可缩短X线照射时间及手术时间,对高度依赖起搏的危重患者的抢救,更有裨益。 相似文献
16.
A. JOHN CAMM M.D. CLIFFORD GARRATT M.A. M.R.C.R VINCE PAUL M.B. M.R.C.R 《Journal of cardiovascular electrophysiology》1989,3(3):181-189
Ventricular rate adaptiie pacemaker are the pacing systems of choice in patients with atrioventricular block and permanent or persistent atrial arrhythmias. A number of different pacemaker models are available, relying on different sensors of activity or metabolic demand. None of the sensors are perfect, each having its own advantages and disadvantages. Rate adaptive pacing is possible in the atrium as well as the ventricle, and at rial systems have a role in the management of patients with a poor sinus node response to exercise (chronotropic incompetence). The major groups of rate adaptive pacemakers are discussed in the following article, together with indications for use and possible future developments. 相似文献
17.
18.
19.
20.