Registration of Pacemaker-induced Skin Potentials in the Routine Control of Implanted Pacemakers

Grendahl, H

doi:10.3109/00365516909080160

Cited by 4 publications

(5 citation statements)

References 2 publications

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“…This proved to be one of the most useful applications to the test procedures and we feel a diagnosis of exit block should not be made without the demonstration that pacemaker function remains normal. Grendahl (1969) reports similar experiences. Alternative diagnoses, which must be considered when all tests remain normal but pacing ceases, include perforation of the heart or displacement of a transvenous electrode.…”

Section: Resultssupporting

confidence: 71%

“…They can be accurately and rapidly performed by a trained technician and the results are available at once. Pacemaker clinics organized along these lines are now in existence in many centres (Grendahl, 1969;Edhag, Hofvendahl, Karlof, and Morgensen, 1970;Furman, Escher, Parker, and Solomon, 1969;Irnich and Effert, 1970) and experience supports our conclusions that patient supervision in this way provides additional safety against pacemaker failure and is an aid to rapid correction of pacemaker faults should they develop (Davies and Siddons, 1969;Parsonnet, Myers, Gilbert, and Zucker, 1970). The information obtainable is still limited but the methods are applicable to all pacemakers.…”

Section: Resultsmentioning

confidence: 49%

“…Small reductions in plateau duration may occur over the first three months following attachment of electrodes to the heart and are probably due to changes in either direction suggest a fault in the electrode wire in its insulation or at the point of attachment to the pacemaker. This finding has been used clinically by us and also by Grendahl (1969). One particular fault is the penetration of tissue fluid into the electrode/pacemaker junction with the consequent development of an alternative pathway for the electrical impulse to follow to reach the positive indifferent electrode which is usually attached to the side of the pacemaker.…”

Section: Resultsmentioning

confidence: 99%

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Clinical testing of implanted pacemakers

Sowton¹,

Gray²

1971

Thorax

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The function of implanted pacemakers was assessed at a special pacemaker clinic at intervals of three to six months. Measurements of the basic discharge rate of the pacemaker were made and the waveform was recovered from skin electrodes and displayed on an oscilloscope screen. The impulse was photographed from the screen and subsequent waveform analysis was carried out. Reproducible results were obtained for measurements of peak amplitude and impulse duration provided unipolar electrodes were in use and the patients were studied in the same position.The range of variation of the measurements during the lifetime of different models of normally functioning pacemakers is given. Test measurements taken before failing pacemakers were removed have been correlated with the subsequently established cause of failure and the waveform analysis test has been shown to be clinically reliable. The value of the test depended largely upon the type of pacemaker but it correlated well with rate changes in pacemakers designed to slow as battery exhaustion developed.The clinical value of waveform analysis tests is in the diagnosis of exit block, electrode failure, and premature battery exhaustion and in determining the optimum time for pacemaker replacements. The indications for replacement of pacemakers at the National Heart Hospital are given. Initial experience with an automatic analyser with three types of pacemaker shows that rapid measurements of the waveform parameters can be achieved with accuracy.

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Section: Resultssupporting

confidence: 71%

Section: Resultsmentioning

confidence: 49%

Section: Resultsmentioning

confidence: 99%

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Clinical testing of implanted pacemakers

Sowton¹,

Gray²

1971

Thorax

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“…The value of the pacemaker impulse test now in routine use in our laboratory cannot yet be estimated, but it is expected to reduce the need for emergency changz of a worn-out impulse generator. Especially the increased impulse duration seems to be a useful indicator of impending failure of ElemaSchonander pacemakers (9,23,28).…”

Section: Discussionmentioning

confidence: 99%

Permanent Endocardial Pacing

Inberg

Kallio

Linna

et al. 1971

Journal of Internal Medicine

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Abstract. Forty‐nine patients have been treated with permanent pacing, 48 of them with endocardial electrode. In four patients the pacing was begun with epicardial electrodes, which were later substituted by endocardial electrodes in three of them. Altogether 101 impulse generators were implanted. The early postoperative mortality was 2% (1/48). The cumulative survival rates at one, two and three years were 90, 69 and 63%, respectively. The battery life‐time was 15.2 months on the average. The commonest complication was dislocation of the endocardial electrode, which happened in five patients as an early complication and in three patients later during the follow‐up period. This complication was treated successfully in all instances. The advantages of endocardial in comparison to epicardial electrode technique are discussed.

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“…In the past, analysis of pulse waveform was proposed in order to ensure more accurate examination of pacemaker implants. 12 – 14 These old prototype systems relied on a direct electrical connection between patient’s skin electrodes and an oscilloscope. Although the use of an oscilloscope fulfils the wide bandwidth requirement, it is not compliant with patient’s electrical safety issues (eg, general standards for medical electrical equipment 15 ) and does not allow reliable capture of small amplitude pacemaker spikes.…”

Section: Introductionmentioning

confidence: 99%

A simple, wide bandwidth, biopotential amplifier to record pacemaker pulse waveform

Bifulco

Romano

Cesarelli

2016

MDER

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Reliable detection of pacemaker pulses is getting more and more important in electrocardiography (ECG) diagnosis. Many studies recommend ECG amplifiers with higher bandwidth to prevent errors. In the past, few pilot studies showed that analysis of pacemaker pulses waveform can enhance diagnosis (eg, lead failure and fractured wire), but they were carried out with inadequate instrumentations for clinical practice. Typically, pacemaker pulses last hundreds of microseconds, edges of pulses elapse in few microseconds, and amplitude may exhibit large variations from few millivolts to volts. Pulse waveforms change often and depend on pacemaker type and programming. A simple, biopotential amplifier made of a few off-the-shelf components is proposed. The circuit fulfills specifications for biopotential amplifiers and offers a large bandwidth (~1 MHz). Therefore, it is able to accurately record time course of pacemaker pulses and allows highly accurate pulse detection and timing. Signals can be easily displayed and acquired by means of a standard, battery-powered oscilloscope. Pacemaker pulse vectorcardiography can be obtained by using two or more, wideband channels. Some exemplificative waveforms recorded during patient’s periodic medical examination are reported. The proposed circuit offers simultaneous conventional ECG signal as an additional output.

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Registration of Pacemaker-induced Skin Potentials in the Routine Control of Implanted Pacemakers

Cited by 4 publications

References 2 publications

Clinical testing of implanted pacemakers

Clinical testing of implanted pacemakers

Permanent Endocardial Pacing

A simple, wide bandwidth, biopotential amplifier to record pacemaker pulse waveform

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