Recurrent Laryngeal Nerve Paralysis Following Pacemaker Introduction

Electrode insertion to the heart via subclavian vein puncture has become a commonplace procedure. A case is presented in which employment of this route led to permanent paralysis of the recurrent laryngeal nerve. (PACE, Vol. 5, July-August, 1982)     

The Effect of Metal Detector Gates on Implanted Permanent Pacemakers

The effect of metal detector security gates, such as are used in airports, was tested in 103 nonselected pacemaker patients. Various types of single and dual chamber units were examined, using telemetry during the test. Pulse rate and duration were measured immediately before and after the procedure. No ill effect was seen on any of the units tested, pacemaker inhibition was not observed, and programmability was not affected. Metal detector security gates have no effect on implanted permanent pacemakers.     

The Use of Transcranial Doppler in the Hemodynamic Assessment of Implanted Pacemakers

Twenty patients with DDD pacemakers had their intracranial cerebral circulation assessed in different pacing modes, using transcranial Doppler. The studies were performed at the vertebral artery in a sitting position. Although DDD pacing was pre/ered to VVI pacing in 18 of the 20 patients, the figures did not reach statistical significance. There was no stotistical difference in maximal blood flow velocity between DDD pacing at 60 and 80 beats/min. Varying the AV interval from 150–250 msec also demonstrated no clear difference in maximal peak Doppler velocity, in the group as a whole, though there was a greater individual preference for 150 msec. Transcranial Doppler assessment of the hemodynamics of the cerebral circulation is of limited value as an indicator of mode or rate preference in the pacemaker population.