Pacemaker-induced cardiovascular failure

Haas, John M.; Strait, Gail B.

doi:10.1016/0002-9149(74)90293-8

Cited by 74 publications

(3 citation statements)

References 14 publications

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“…Unfortunately it is difficult to predict who might suffer from the syndrome prior to pacemaker implantation. The syndrome can arise in patients of either sex and of any age, with normal or impaired ventricular function, with or without retrograde V‐A conduction, and at any time after VVI pacemaker insertion 27 …”

Section: Which Pacing Mode?mentioning

confidence: 99%

Which Pacemaker?

Sulke¹

1991

Int J Clinical Practice

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INTRODUCTION The first fully implantable cardiac pacemaker was inserted by Elmqvist and Senning in 19591 into an electrical engineer suffering from complete atrioventricular (AV) block. He is still alive today. Since then, and more specifically in the last decade, cardiac pacing has been transformed by technological innovation, and has resulted in devices that no longer merely prevent the incidence of syncope and sudden death in patients with complete heart block, but actually restore appropriate chronotropic response to exercise, and maintain normal conduction between, and contraction of, the cardiac chambers. Modern ‘physiological’ pacemakers are thus designed to restore a normal quality of life to patients requiring cardiac pacing.

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Section: Which Pacing Mode?mentioning

confidence: 99%

Which Pacemaker?

Sulke¹

1991

Int J Clinical Practice

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“…RV pacing results in reduced stroke volume by the loss of the atrial contribution and by mitral and tricuspid insufficiency (8)(9)(10). When the cardiac reserve is adequate, RV pacing may be well tolerated, but it can be catastrophic (11) or bizarre (12) but more commonly worsens the neurological status of the patient, especially vertebral basilar symptoms (13). When this occurs, physiologic pacing may resolve the problem.…”

Section: Pacemaker Aggravation Of Neurological Symptomsmentioning

confidence: 99%

Pacemakers, Cardiac Mapping and EEG in the Community Hospital: A Concise Review of Background and Basic Technical Considerations

Anderson¹,

Carney²

1979

Clinical Electroencephalography

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The heart is a pump. The objective of cardiac pacing is to improve the cardiac output. The most popular method of cardiac pacing (RV) is not physiologic and results in reduced stroke output when compared to that of normal sinus or atrial paced rhythm. Recognition of pacemaker induced low output states and pacemaker aggravated neurological symptoms has quickened interest in physiologic atrial pacing. The increased complexity of atrial pacing has been discouraging in the past, but technical advances in electrode and pacemaker design are promising. Selection of the optimal pacing site appears critical and requires the determination of the focal electrical potential and stimulating threshold before electrodes are positioned. With minimal expense, the EEG can be adapted for this type of cardiac mapping in the community hospital.

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“…The mode of pacing most widely used for this pur pose has been ventricular (VVI) [4], VVI pacemakers are usually programmable in terms of fixed heart rate, but Dual-chamber pacemakers were introduced to enable the atrial contraction, whether it is spontaneous or paced, to be followed by ventricular contraction after a programmed atrioventricular delay period [4][5][6][7][8][9]. How ever, these complex devices add substantial cost and the documentation of the benefit of this methodology in the broad spectrum of patients receiving permanent pace makers is scant.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Exercise Testing in DDD Compared to VYI Pacing Modes

Salahi¹,

Systrom²,

DiCola³

et al. 1987

Am J Noninvas Cardiol

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To compare the effect of DDD and VVI pacing modes on exercise cardiopulmonary performance, 10 patients underwent rest and exercise first-pass radionuclide angiography in conjunction with gas exchange analysis in one pacing mode first, and 1 week later in the other mode. There were 9 males and 1 female, ages 50-79 years (mean 66). All patients had complete heart block with intact sinus mechanism. Of the 10 patients, 4 had clinical symptoms compatible with the pacemaker syndrome while in VVI. All 4 patients with pacemaker syndrome reported subjective improvement while in DDD mode. Compared with VVI mode, patients in DDD mode demonstrated a larger increase in heart rate (p < 0.001) and in oxygen uptake (p < 0.05) with exercise. There was no significant difference in peak workload, exercise duration, and peak systolic blood pressure. Both the peak exercise stroke volume and the end-diastolic volume were smaller (p < 0.002 and p < 0.01, respectively). The cardiac output and the ejection fraction increased with exercise in either mode. The cardiac output increase was the same in both modes. The ejection fraction increase was higher in WI than in DDD mode (p < 0.01). The subjective improvement in those patients with pacemaker syndrome by DDD pacing did not correlate with any measured parameter. In conclusion, cardiac output increases with exercise in both modes in different ways. In DDD mode the increase was mainly due to the heart rate increase, whereas in WI the increase was mainly due to the stroke volume increase.

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Pacemaker-induced cardiovascular failure

Cited by 74 publications

References 14 publications

Which Pacemaker?

Which Pacemaker?

Pacemakers, Cardiac Mapping and EEG in the Community Hospital: A Concise Review of Background and Basic Technical Considerations

Cardiopulmonary Exercise Testing in DDD Compared to VYI Pacing Modes

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