The Underlying Heart Rhythm in Patients with an Artificial Cardiac Pacemaker

Staessen, Jan A.; Ector, Hugo; Geest, H De

doi:10.1111/j.1540-8159.1982.tb06560.x

Cited by 16 publications

(20 citation statements)

References 12 publications

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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%

“…In our study, most cases of 2:1 2AVB progressed to 3AVB in a variable period of time that ranged from 33 to 105 days. These results are not in agreement with findings in human patients where 2:1 2AVB is considered a stable AV conduction disturbance . These findings support the need for PMI in dogs with 2:1 2AVB, if other causes of AVB have been ruled out.…”

Section: Discussioncontrasting

confidence: 87%

“…In our population, 87% of cases showed persistent (65.2%) or progressive (21.8%) AV conduction disturbance, whereas in 13% of the dogs improvement of AV block was recorded. The majority of dogs reported here presented with similar changes in AV conduction disturbances over time as have been described in human patients, where 83% of the cases affected by AVB and treated with permanent PMI show persistent and progressive AVB at long‐term follow‐up . Progressive idiopathic fibrosis of the conduction system related to aging of the cardiac skeleton (Lev's disease) is the most common cause of chronic acquired AVB in humans .…”

Section: Discussionsupporting

confidence: 68%

“…Interestingly, 13% of dogs in our study had transient AVB. Improvement in AV conduction is reported to occur in approximately 15% of human patients diagnosed with AVB, whereas in veterinary medicine only 1 study described 2 cases of transient AVB that reverted to sinus rhythm within 6 months after PMI . The most common cause of transient AVB in humans is acute myocarditis .…”

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: Discussioncontrasting

confidence: 87%

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Long‐term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block

Santilli¹,

Vázquez²,

Vezzosi

et al. 2015

Veterinary Internal Medicne

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show abstract

“…Permanent pacemaker recipients who have no intrinsic or escape rhythm may develop complications under conditions of electromagnetic interference, lead dysfunction, or battery depletion. Few studies have examined the incidence of pacemaker dependency after device implantation 1‐3 . A recent report from the Canadian Trial of Physiologic Pacing (CTOPP) Investigators indicated that pacemaker dependency, defined as an intrinsic heart rate ≤60 beats/min, has an important influence on cardiovascular and total mortality, as does the selection of pacing mode 1 .…”

Section: Introductionmentioning

confidence: 99%

New Onset of Pacemaker Dependency After Permanent Pacemaker Implantation

Nagatomo¹,

Abe²,

Kikuchi³

et al. 2004

Pacing Clinical Electrophis

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Pacemaker dependency has dangerous consequences under conditions of electromagnetic interference, unrecognized lead dysfunction, and battery depletion, and has been associated with cardiovascular and overall mortality. The aim of this study was to examine the incidence of new onset of pacemaker dependency during long-term follow-up after pacing system implantation. The study included 518 patients (mean age 72.9 +/- 10.4 years) who presented with intrinsic rhythms at the time of implantation. Indications for pacing were sick sinus syndrome (SSS) in 275 (53%) patients, AV block in 209 (40%), and AF with bradycardia in 34 (7%) patients. The mean follow-up was 3.7 +/- 2.7 years (range 1-17). Pacemaker dependency was defined as the absence of an intrinsic rhythm during backup pacing at 30 beats/min for 30 seconds. New onset of pacemaker dependency was observed in 23 (4.4%) of the 518 patients at a mean of 3.1 +/- 2.7 years of follow-up. Pacing indications were SSS in 6 (2.2%) of 275 patients, AV block in 15 (7.2%) of 209, and AF with bradycardia in 2 (5.9%) of 34. Patients with AV block had a significantly higher incidence of pacemaker dependency than patients with SSS (odds ratio 3.51; 95% CI 1.3 to 9.3; P = 0.012). The average annual rate of new pacemaker dependency was 1.6% during an 8-year follow-up. The incidence of new onset of pacemaker dependency varied among pacing indications, and was significantly higher in patients with AV block than patients with SSS.

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Stability of intrinsic rhythm in pacemaker‐dependent patients during pacemaker replacement: Can we predict the need for temporary pacing?

Kimura

Sumiyoshi

Inoue

et al. 2018

Journal of Arrhythmia

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BackgroundIn pacemaker‐dependent patients, the risk of asystole must be managed during device replacement. This study aimed to examine whether we could predict the indication for temporary pacing (TP) during the generator replacement.MethodsWe studied 105 consecutive patients who underwent pacemaker replacement due to battery depletion at Juntendo Nerima Hospital between September 2005 and December 2016. We examined the relationship between the stability of the intrinsic rhythm (IR) during pacemaker replacement and several clinical factors including age, gender, sick sinus syndrome or atrioventricular (AV) block, duration of pacing, structural heart disease, use of anti‐arrhythmic drugs, and the presence/absence of a stable IR (>40 bpm) at the outpatient clinic (OPC) just before pacemaker replacement.ResultsOf the 105 patients, we excluded 1 patient who required TP because of bradycardia‐dependent torsades de points. Therefore, we evaluated 104 patients for the indication for TP. TP was underwent in 19 patients (18%) because of an absence or instability of the IR during pacemaker replacement. The indication for TP was significantly correlated with AV block (84% vs 48%, P = .0044) and the absence of a stable IR at the last OPC visit (89% vs 24%, P < .0001). For predicting the indication for TP, the following values of no stable IR at the last OPC visit were obtained: 89% sensitivity, 77% specificity, 46% positive predictive value, and 97% negative predictive value.ConclusionsThe presence of a stable IR at the last OPC visit was a good predictor (97%) of no indication for TP during pacemaker replacement.

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The Underlying Heart Rhythm in Patients with an Artificial Cardiac Pacemaker

Cited by 16 publications

References 12 publications

Long‐term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block

Long‐term Intrinsic Rhythm Evaluation in Dogs with Atrioventricular Block

New Onset of Pacemaker Dependency After Permanent Pacemaker Implantation

Stability of intrinsic rhythm in pacemaker‐dependent patients during pacemaker replacement: Can we predict the need for temporary pacing?

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