Evaluation of Demand Pacemakers by Chest Wall Stimulation

Barold, S. Serge; Gaidula, John J.; Castillo, R; Masood, Anwer; Keller, J. Walter

doi:10.1378/chest.63.4.598

Cited by 12 publications

(2 citation statements)

References 33 publications

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“…5, November-December, 1982) pacemaker dependence, underlying heart rhythm, spontaneous heart rhythm, chest wall stimulation, sick sinus syndrome, atrioventricular block During long-term follow-up a substantial number of paced patients show spontaneous cardiac activity faster than the basic rate of their pulse generators. However, in approximately 40 percent of patients' requiring permanent cardiac pacemakers because of symptomatic bradyarrhythmias, continuous pacemaker-induced rhythm obscures the intrinsic cardiac activity at consecutive follow-up examinations.Overdrive suppression of QRS-inhibited pacemakers by chest wall stimulation>" permits pacing to be stopped briefly and safely, [2][3][4][5]7,8,11 This easily applicable and non-invasive technique enables the clinician or investigator to evaluate the underlying cardiac rhythm.…”

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confidence: 99%

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The Underlying Heart Rhythm in Patients with an Artificial Cardiac Pacemaker

Staessen¹,

Ector²,

Geest³

1982

Pacing Clinical Electrophis

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One-hundred forty-two patients with atrioventricular block (AVB) and 61 patients with sick sinus syndrome (SSS) were followed for an average of 50 months after permanent pacemaker insertion. Their underlying heart rhythms (UHR) were evaluated repeatedly by chest wall stimulation (CWS). A deficient UHR was defined as ventricular asystole lasting 4 seconds or longer. The underlying conduction disturbance increased in 14% of AVB patients, decreased in 14%, and remained constant in 68%. The occurrence of Adams-Stokes attacks before pacemaker implantation was associated with a higher incidence of deficient UHR both in AVB and SSS; a deficient UHR was seen more frequently in AVB than in SSS. Among AVB patients (1) atrial fibrillation, flutter or tachycardia and (2) sinus rhythm with incomplete AVB, especially Mobitz 1, when present before pacemaker implantation, were associated with a significantly lower incidence of deficient UHR during subsequent pacing in comparison with other AVB patients. CWS is a non-invasive method which allows the evaluation of UHR and which can contribute to the early recognition of pacemaker-dependent patients.

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confidence: 99%

“…Overdrive suppression of QRS-inhibited pacemakers by chest wall stimulation>" permits pacing to be stopped briefly and safely, [2][3][4][5]7,8,11 This easily applicable and non-invasive technique enables the clinician or investigator to evaluate the underlying cardiac rhythm.…”

mentioning

confidence: 99%