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Pacemaker

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41. Effect of increasing heart rate on finger photoplethysmography fitness index (PPGF) in subjects with implanted cardiac pacemakers. (PubMed)

Effect of increasing heart rate on finger photoplethysmography fitness index (PPGF) in subjects with implanted cardiac pacemakers. Finger photoplethysmography (PPG) is a noninvasive method that measures blood volume changes in the finger. The PPG fitness index (PPGF) has been proposed as an index of vascular risk and vascular aging. The objectives of the study were to determine the effects of heart rate (HR) on the PPGF and to determine whether PPGF is influenced by blood pressure (BP) changes (...) . Twenty subjects (78±8 years, 3 female) with permanent cardiac pacemakers or cardioverter defibrillators were prospectively recruited. HR was changed by pacing, in a random order from 60 to 100 bpm and in 10 bpm increments. At each paced HR, the PPGF was derived from a finger photoplethysmogram. Cardiac output (CO), stroke volume (SV) and total peripheral resistance (TPR) were derived from the finger arterial pressure waveform. Brachial blood pressure (BP) was measured by the oscillometric method

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2018 PLoS ONE

42. Same-day CIED implantation and discharge: Is it possible? The E-MOTION trial (Early MObilization after pacemaker implantaTION). (PubMed)

Same-day CIED implantation and discharge: Is it possible? The E-MOTION trial (Early MObilization after pacemaker implantaTION). Despite the increasing number of cardiac implantable electronic devices (CIED) procedures worldwide, no guideline assessed postoperative mobilization protocols. Lacking evidences in literature, many centers require 24-hour immobilization and bed rest to minimize the risk of pacing lead (PL) dislodgement. Prolonged immobilization may futilely delay discharge, induce (...) was any major intra-procedural complication (cardiac perforation, pericardial tamponade, valve damage, haemothorax, pneumothorax, myocardial infarction, peripheral embolus, TIA/stroke or death).Among 200 enrolled patients, 86% underwent pacemaker implantation (28% single-chamber, 72% dual-chamber device), 14% underwent ICD implantation (75% single-chamber, 25% dual-chamber device). PL fixation was mostly passive (97% atrial PL, 88% ventricular PL), without differences between EMG and CG (p = 0.99

2019 International journal of cardiology

43. Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation? (PubMed)

Sinus node dysfunction in patients with Fontan circulation: could heart rate variability be a predictor for pacemaker implantation? Sinus node dysfunction (SND) causes significant morbidity in patients after Fontan surgery. Heart rate variability (HRV) reflects the autonomic regulation of the heart, and changes in HRV have been associated with SND in adults. We aimed to study whether changes in HRV could be detected in 24-h electrocardiographic (ECG) recordings in Fontan patients with SND. We (...) compared HRV results from two patient groups; patients with Fontan circulation who later required a pacemaker due to severe SND (n = 12) and patients with Fontan circulation and SND, without indication for pacemaker treatment (n = 11), with two control groups; patients with Fontan circulation without SND (n = 90) and healthy controls (n = 66). The Poincaré plot index SD2 (representing changes in heart rate over 24-h) and the very low-frequency (VLF) HRV component were significantly higher in both SND

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2019 Pediatric Cardiology

44. Prevalence of and Risk Factors for Permanent Pacemaker Implantation after Aortic Valve Replacement. (PubMed)

Prevalence of and Risk Factors for Permanent Pacemaker Implantation after Aortic Valve Replacement. Damage to the cardiac conduction system requiring permanent pacemaker implantation is a complication of aortic valve replacement (AVR) that may importantly affect quality of life. We investigated prevalence of and pre-procedure risk factors for new permanent pacemaker after surgical (SAVR) and transcatheter AVR (TAVR) at a single institution.Preoperative variables and baseline electrocardiograms (...) were reviewed for 5,807 patients undergoing elective SAVR ± coronary artery bypass grafting (CABG) and 1,292 undergoing TAVR ± percutaneous coronary intervention from 2006 to 2017 at Cleveland Clinic. Patients with previous permanent pacemakers were excluded. Risk factors for permanent pacemaker implantation were identified using multivariable logistic regression analysis.New permanent pacemakers were implanted in 151 (2.6%) after SAVR and 125 (9.7%) after TAVR (whole group P SAVR vs TAVR <.0001

2019 Annals of Thoracic Surgery

45. First clinical experience with the Kora pacemaker system in congenital complete heart block in newborn infants. (PubMed)

First clinical experience with the Kora pacemaker system in congenital complete heart block in newborn infants. To report first clinical experience on three cases of congenital complete heart block and the use of a pacemaker system with a maximum lower rate interval of 95 beats per minute.We retrospectively analyzed three patients treated with a pacemaker system with a maximum lower rate interval of 95 beats per minute suffering from congenital complete heart block. We report a follow up period (...) of 2.9 years, focusing on the patients' growth, development, and adverse events, as well as pacemaker function.In all three patients pacemaker function was impeccable, including minute ventilation sensor rate adaption. All patients showed limited growths as expected, adequate development, good feeding tolerability and circadiane heart rate adaption. One patient experienced skin traction and revision. All patients showed high aortic velocity time integral values after birth.The use of a pacemaker

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2019 BMC Pediatrics

46. Transvenous dual-chamber pacemaker implantation in patients with persistent left superior vena cava. (PubMed)

Transvenous dual-chamber pacemaker implantation in patients with persistent left superior vena cava. Persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly. Permanent pacemaker implantation (PPI) in patients with PLSVC can be challenging because of the venous anomalies. We reported a case series of patients with PLSVC who underwent PPI with double active fixation leads.From January 2012 to July 2016, 9 patients (three male and six females, mean age 68 ± 11 years (...) ) with PLSVC who received a dual-chamber pacemaker with double active fixation leads were enrolled retrospectively in this observational study. The indications for pacemaker implantation were symptomatic third-degree atrioventricular block in one and sick sinus syndrome in eight patients.PPI were implanted successfully in all 9 patients. Successful positioning of the ventricular leads at the right ventricular outflow tract (RVOT) septum with a "C" shaped stylet was achieved in 7 patients (77.8

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2019 BMC Cardiovascular Disorders

47. Cardiac Resynchronization Therapy Using Pacemakers versus Defibrillators in Patients with Non-Ischemic Cardiomyopathy: The United States Experience from 2007 to 2014. (PubMed)

Cardiac Resynchronization Therapy Using Pacemakers versus Defibrillators in Patients with Non-Ischemic Cardiomyopathy: The United States Experience from 2007 to 2014. The impact of implantable defibrillator therapy on outcomes of patients with non-ischemic cardiomyopathy (NICM) who receive a cardiac resynchronization therapy (CRT) device is controversial.To examine the outcomes of NICM patients who receive a CRT pacemaker (CRT-P) versus defibrillator (CRT-D).Using 2007-2014 claims data for a 5

2019 Heart Rhythm

48. Dextrocardia with complete AV block and the implantation of a temporary pacemaker before cesarean section: A case report. (PubMed)

Dextrocardia with complete AV block and the implantation of a temporary pacemaker before cesarean section: A case report. Patients with situs inversus totalis (SIT) and complete atrioventricular (AV) block are extremely rare, and only few cases have been reported up to now. Due to the rarity of such condition and its anatomical complexity, we reported this case as a reference for obstetricians, providing valuable insights into potential clinical treatment.We reported a case of 30-year-old (...) patient with complete AV block, and her heart rate was only about 45 beats per minute.The patient was diagnosed with term delivery with SIT and complete AV block.A temporary pacemaker (TPM) was implanted before cesarean section (CS) because of complete AV block.CS was performed successfully after the implantation of a TPM. The heart rate remained stable, and the 24-hour blood loss was limited.This study presents a complex heart disease case which needed more frequent antenatal examination

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2019 Medicine

49. Impact of Leadless Pacemaker Therapy on Cardiac and Atrioventricular Valve Function Through 12 Months of Follow-Up. (PubMed)

Impact of Leadless Pacemaker Therapy on Cardiac and Atrioventricular Valve Function Through 12 Months of Follow-Up. Endocardial pacemaker leads and right ventricular (RV) pacing are well-known causes of tricuspid valve, mitral valve, and cardiac dysfunction. Lead-related adverse consequences can potentially be mitigated by leadless pacemaker (LP) therapy by eliminating the presence of a transvalvular lead. This study assessed the impact of LP placement on cardiac and valvular structure (...) and function.Echocardiographic studies before and 12±1 months after LP implantation were performed between January 2013 and May 2018 at our center and compared with age- and sex-matched controls of dual-chamber transvenous pacemaker recipients.A total of 53 patients receiving an LP were included, of whom 28 were implanted with a Nanostim and 25 with a Micra LP device. Tricuspid valve regurgitation was graded as being more severe in 23 (43%) patients at 12±1 months compared with baseline ( P<0.001). Compared with an apical

2019 Circulation. Arrhythmia and electrophysiology

50. Prognosis after pacemaker implantation in extreme elderly. (PubMed)

Prognosis after pacemaker implantation in extreme elderly. Significant comorbidities may limit the potential benefit of pacemaker (PM) implantation in extreme elderly. A short-term mortality risk prediction score, able to identify high-risk patients, may be a useful tool in this population.We retrospectively analyzed 538 patients aged >80 years at the time of implant who underwent PM implantation. Kaplan-Meier survival and multivariable Cox regression analyses were performed to identify patient

2019 European journal of internal medicine

51. Management of anticoagulation in patients undergoing leadless pacemaker implantation. (PubMed)

Management of anticoagulation in patients undergoing leadless pacemaker implantation. The Micra transcatheter pacing system (Micra TPS) is often implanted in patients with atrial fibrillation and thus with increased thromboembolic risk. It is unknown whether the use of anticoagulants, associated with the use of a large venous introducer, implies an increased risk of bleeding in this group of patients.The purpose of this study was to assess the incidence of bleeding and thromboembolic

2019 Heart Rhythm

52. Safety of thoracic magnetic resonance imaging for patients with pacemakers and defibrillators. (PubMed)

Safety of thoracic magnetic resonance imaging for patients with pacemakers and defibrillators. During magnetic resonance imaging (MRI), cardiac implantable electronic device (CIED) leads can be antennae to focus energy onto myocardium, leading to heating and arrhythmias. Clinical data on thoracic MRI safety for patients with legacy devices are limited.The purpose of this study was to identify patients undergoing thoracic MRI with legacy devices, compare the incidence of adverse events of those

2019 Heart Rhythm

53. The outcome of patients with functional single ventricular heart after pacemaker implantation-what makes it poor and what can we do? (PubMed)

The outcome of patients with functional single ventricular heart after pacemaker implantation-what makes it poor and what can we do? Pacemaker implantation in patients with single ventricle is associated with poor outcomes.The purpose of this study was to determine the reasons for the poor outcomes of pacemaker implantation.We performed a retrospective chart review of patients with single ventricle who had undergone permanent pacemaker implantation. Patients were categorized into 3 groups based (...) on the site of pacing and the proportion of ventricular pacing (VP) as follows: (1) atrial pacing group with atrial pacing only (n = 11); (2) low VP group with low daily VP proportion (<50%; n = 12); and (3) high VP group with high daily VP proportion (≥50%; n = 15). Pacing leads were placed at the epicardium in all patients.No patients in the atrial pacing or low VP groups died, whereas the survival rate in the high VP group was 58.9% and 39.3% at 10 and 20 years, respectively, after pacemaker

2019 Heart Rhythm

54. Familial Clustering of Cardiac Conduction Defects and Pacemaker Insertion. (PubMed)

Familial Clustering of Cardiac Conduction Defects and Pacemaker Insertion. The etiopathogenesis of electrocardiographic bundle branch and atrioventricular blocks is not fully understood. We investigated familial clustering of cardiac conduction defects and pacemaker insertion in the FHS (Framingham Heart Study). Additionally, we assessed familial clustering of pacemaker insertion in the Danish general population.In FHS, we used multivariable-adjusted logistic regression models to investigate (...) the association of parental atrioventricular block (PR interval, ≥0.2 s), complete bundle branch block (QRS, ≥0.12 s), or pacemaker insertion with the occurrence of cardiac conduction abnormalities in their offspring. The Danish nationwide administrative registries were interrogated to assess the relations of parental pacemaker insertion with offspring pacemaker insertion.In FHS (n=371 cases with first-degree atrioventricular block, complete bundle branch block, or pacemaker insertion, and 1471 age- and sex

2019 Circulation. Arrhythmia and electrophysiology

55. Leadless Pacemaker Implant After Heart Transplant. (PubMed)

Leadless Pacemaker Implant After Heart Transplant. Conduction abnormalities are known to occur after heart transplantation. In some cases, a permanent pacemaker is required. Conventional transvenous pacemakers can result in several complications, mainly related to the leads and device pocket. Leadless pacemaker technology was developed to overcome these issues. We report what we believe is the first US case of a leadless pacemaker implant (specifically in a heart transplant recipient

2019 American Journal of Cardiology

56. Renal failure, shock, and loss of pacemaker capture: A case of flecainide intoxication. (PubMed)

Renal failure, shock, and loss of pacemaker capture: A case of flecainide intoxication. Flecainide intoxication is a severe intoxication that can lead to cardiogenic shock. We report on a 68-year-old female patient, who presented with a flecainide intoxication in the setting of renal failure. She was managed with invasive supportive therapy at the ICU and infusion of sodium bicarbonate and intravenous lipid emulsion (ILE, intralipid 20%), after which she made a complete recovery.

2019 Netherlands Journal of Medicine

57. His bundle has a shorter chronaxie than does the adjacent ventricular myocardium: Implications for pacemaker programming. (PubMed)

His bundle has a shorter chronaxie than does the adjacent ventricular myocardium: Implications for pacemaker programming. Strength-duration curves for permanent His bundle (HB) pacing are potentially important for pacemaker programming.We aimed to calculate strength-duration curves and chronaxies of the HB and of the adjacent right ventricular (RV) working myocardium and to analyze zones of selective HB capture and battery current drain when pacing at different pulse durations (PDs).Consecutive

2019 Heart Rhythm

58. Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation. (PubMed)

Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation. The incidence of permanent pacemaker (PPM) implantation is higher following mitral valve surgery (MVS) with ablation for atrial fibrillation (AF) compared with MVS alone.This study identified risk factors and outcomes associated with PPM implantation in a randomized trial that evaluated ablation for AF in patients who underwent MVS.A total of 243 patients with AF and without previous PPM placement were randomly

2019 Journal of the American College of Cardiology

59. Real-World Incidence of Pacemaker and Defibrillator Implantation Following Diagnostic Monitoring With an Insertable Cardiac Monitor. (PubMed)

Real-World Incidence of Pacemaker and Defibrillator Implantation Following Diagnostic Monitoring With an Insertable Cardiac Monitor. Insertable cardiac monitors (ICM) are used in patients with suspected or known cardiac arrhythmias; the resulting diagnosis can lead to therapeutic interventions such as a pacemaker (PPM) or defibrillator (ICD) implant. We investigated the incidence of these implants in a large, real-world, cohort of ICM patients. The Optum© EHR de-identified database was used (...) % in patients with another indication for ICM implant (p <0.001). There was a significantly greater number of PPM implants following an ICM in patients with history of syncope compared with another indication for ICM implant (23% vs 13% p <0.001); in contrast, there was no difference in ICD implants between the 2 groups (3% in both groups, p = 0.84). In conclusion, a PPM or ICD was ultimately implanted in 21% of ICM patients. Pacemaker implant rates varied significantly with indication for ICM implant

2019 American Journal of Cardiology

60. Deactivating a Pacemaker in Home Care Hospice: Experiences of the Family Caregivers of a Terminally Ill Patient. (PubMed)

Deactivating a Pacemaker in Home Care Hospice: Experiences of the Family Caregivers of a Terminally Ill Patient. Although the experiences of family members who care for relatives at the end of life have been researched extensively, little is known about the needs and experiences of families caring for hospice patients with pacemakers.To better understand the experiences of family caregivers of a terminally ill patient who received hospice care at home and chose deactivation of a pacemaker.The (...) "; "It is really difficult to watch, but you want to be there"; and "I will not have part of this." Caregivers struggled with lack of support, understanding, and acceptance from medical providers when their family member decided to have her pacemaker deactivated, and they believed that the hospice model of care was appropriate to support and help them in that process.This research aids in understanding the ramifications of family-provided end-of-life care to a patient whose pacemaker has been deactivated

2019 American Journal of Hospice and Palliative Medicine

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