Overdrive suppression of implanted pacemakers in patients with AV block.

Grendahl, H; M, Miller; Kjekshus, J.

doi:10.1136/hrt.40.2.106

Cited by 11 publications

(5 citation statements)

References 8 publications

(6 reference statements)

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“…In our study, PM dependency was found in 43.5% of the cases, similar to what has been reported in the human literature, where the time of onset is approximately 3 years …”

Section: Discussionsupporting

confidence: 91%

“…[45][46][47] In our study, PM dependency was found in 43.5% of the cases, similar to what has been reported in the human literature, where the time of onset is approximately 3 years. 24,26,48 Limitations of this study include its retrospective nature, which influenced particularly the timing of re-evaluation: T1 and T2 were homogeneous whereas T3 and T4 had wider CI. Intrinsic rhythm was evaluated during a limited time frame, and for this reason paroxysmal AVB could not be completely ruled out.…”

Section: Discussionmentioning

confidence: 99%

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Long‐term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block

Santilli¹,

Vázquez²,

Vezzosi

et al. 2015

Veterinary Internal Medicne

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BackgroundAtrioventricular block (AVB) is a conduction abnormality along the atrioventricular node that, depending on etiology, may lead to different outcomes.ObjectivesTo evaluate variations of intrinsic rhythm (IR) in dogs that underwent pacemaker implantation (PMI).AnimalsMedical records of 92 dogs affected by 3rd degree atrioventricular block (3AVB), advanced 2nd degree AVB (2AVB), paroxysmal 3AVB, 2:1 2AVB, or 3AVB with atrial fibrillation (AF) were retrospectively reviewed.MethodThe patient IR was documented with telemetry on the day of 1 – (95% CI, 1–2), 33 – (95% CI, 28–35), 105 – (95%CI, 98–156), and 275 days (95%CI, 221–380) after PMI. According to AVB grade at different examinations, AVB was defined as progressed, regressed, or unchanged.ResultsIn 48 dogs, 3AVB remained unchanged, whereas in 7 it regressed. Eight cases of 2AVB progressed, 3 regressed and 2 remained unchanged. Eight cases of paroxysmal 3AVB progressed and 3 remained unchanged. Four dogs affected by 2:1 2AVB progressed, 2 regressed, and 1 remained unchanged. All cases with 3AVB with AF remained unchanged. Regression occurred within 30 days after PMI, whereas progression was documented at any time. Variations in IR were associated with type of AVB (P < .03) and time of follow‐up (P < .0001).Conclusions and clinical importanceThe degree of AVB assessed at the time of PMI should not be considered definitive because more than one‐third of the cases in this study either progressed or regressed. Additional studies would be necessary to elucidate possible causes for transient AVB in dogs.

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“…In our study, PM dependency was found in 43.5% of the cases, similar to what has been reported in the human literature, where the time of onset is approximately 3 years …”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Long‐term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block

Santilli¹,

Vázquez²,

Vezzosi

et al. 2015

Veterinary Internal Medicne

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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.…”

mentioning

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%

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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“…1). In patients without bradycardia episodes the mean observation time was 5.4 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) months.…”

Section: Follow-upmentioning

confidence: 99%

Clinical Experience with a Bradycardia Indicating Pacemaker

Rosenqvist

Edhag

Vallin

1983

Pacing Clinical Electrophis

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The beneficial effect of permanent pacing is controversial in certain patient groups. Once pacing has been instituted it is seldom terminated and an evaluation of pacemaker dependence is therefore not possible. An implantable pulse generator, detecting bradycardia below 30 bpm has been developed in order to broaden our knowledge about the natural history of bradyarrhythmias treated by permanent pacing. This pacemaker has been implanted in 38 patients who did not have clear-cut indications for permanent pacing. They have been followed for a mean of 13 months. Bradycardia was detected in 33 patients 1 to 21 months (4.6 mean) after implantation. Twenty-one patients did not have a detected bradycardia for long periods (months-years). Minor symptoms of lightheadedness attributable to bradycardia were reported by 15 patients during periods when the pacemaker had been activated. Holter monitoring for at least 24 hours was carried out in all patients and electronic analysis of explanted generators was performed in eleven cases. No technical failure related to the bradycardia-detecting facility was observed. The combination of diagnostic and therapeutic properties in the bradycardia-indicating pacemaker provides means for safe evaluation of pacemaker dependency over long time periods in patient groups with controversial indications for permanent pacing.

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Overdrive suppression of implanted pacemakers in patients with AV block.

Cited by 11 publications

References 8 publications

Long‐term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block

Long‐term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block

The Underlying Heart Rhythm in Patients with an Artificial Cardiac Pacemaker

Clinical Experience with a Bradycardia Indicating Pacemaker

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