检索结果-内蒙古大学图书馆

Electrocardiographic interpretation of pacemaker algorithms enabling minimal ventricular pacing

HEART RHYTHM 2020年第10期17卷 1784-1792页

作者： Mond, Harry G. Univ Melbourne Royal Melbourne Hosp Dept Cardiol Parkville Vic Australia CardioScan Pty Ltd Camberwell Vic Australia

Cardiac pacing from the apex of the right ventricle has been shown to result in left ventricular dysfunction, atrial fibrillation, and increased mortality. To counter these effects, one of the strategies developed is avoidance of ventricular pacing when not necessary, using programmable algorithms to minimize ventricular pacing. Seven algorithms are available from 5 manufacturers. Four of the manufacturers have mode conversion algorithms that pace AAI(R) but, in the presence of failed atrioventricular (AV) conduction, demonstrate algorithm-offset and convert to DDD(R) with ventricular pacing. Three manufacturers do not have mode conversion but rather AV extension to encourage AV conduction. Each of these algorithms has a unique design and, when ventricular pacing is present, will regularly schedule conduction testing to encourage AV conduction and hence algorithm-onset. All of these algorithms seem to violate the rule of AV conduction by allowing the AV delay for sensed ventricular events to be longer than for ventricular paced events. The result is frequently bizarre electrocardiographic (ECG) appearances that often are unique to the company's algorithm but also suggest pacemaker malfunction. This review highlights and illustrates the features of these algorithms as they appear on ECG, and discusses other situations that result in unintended ventricular pacing.

关键词： Atrioventricular delay Cardiac failure Electrocardiography Minimize ventricular pacing pacemaker algorithms pacemaker programming

来源：评论

学校读者我要写书评

暂无评论

The electrocardiographic interpretation of ventricular pacing suppression algorithms in the pacemaker

引用

JOURNAL OF ELECTROCARDIOLOGY 2022年 72卷 1-5页

作者： Zabek, Andrzej Boczar, Krzysztof Nowosielska-Zabek, Ewa Golinska-Grzybala, Karolina Debski, Maciej Ulman, Mateusz Malecka, Barbara John Paul 2 Hosp Dept Electrocardiol Pradnicka 80 St PL-31202 Krakow Poland Scanmed Multimedis SA Krakow Poland John Paul 2 Hosp Noninvas Cardiovasc Lab Krakow Poland Univ East Anglia Norfolk & Norwich Univ Hosp Dept Cardiol Norwich NR4 7TJ Norfolk England Jagiellonian Univ Med Coll Inst Cardiol Krakow Poland

algorithms designed to reduce the right ventricular (RV) pacing burden are widely available in modern dual chamber implantable pacing devices. These algorithms allow the atrioventricular delay for sensed ventricular events to be longer than for ventricular paced events. However, since these features are unique to pacemaker manufacturers, they often produce unfamiliar electrocardiographic (ECG) appearances that suggest pacemaker dysfunction. We describe a Vp suppression algorithm used in Biotronik dual-chamber pacemakers and implantable cardioverter-defibrillator devices. (c) 2022 Published by Elsevier Inc.

关键词： Dual-chamber devices Electrocardiogram pacemaker algorithms Vp suppression

来源：评论

学校读者我要写书评

暂无评论

Endless loop tachycardia among patients with devices having advanced preventive algorithms: A case series and brief review

引用

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 2024年第9期47卷 1252-1265页

作者： Bera, Debabrata Halder, Antareep Ray, Adrita Bhattacharyya, Debdatta Bhattacharyya, Kuntal Agarwal, Kishan Kumar Mukherjee, Sanjeev S. Majumder, Suchit Joshi, Radhey Shyam Choudhury, Saroj Kumar Kar, Ayan RTIICS Dept Cardiol Kolkata India AIIMS Dept Cardiol Kalyani India Apollo Gleneagles Hosp Dept Cardiol Kolkata India

BackgroundEndless loop tachycardia (ELT) is the commonest pacemaker mediated tachycardia (PMT) encountered among patients with cardiac implantable electronic devices (CIEDs). Despite being enabled with various preventive algorithms, we encountered several cases having recurrent, long, and symptomatic *** and MethodsWe retrospectively analyzed consecutive device checkups at device clinic at a single center of eastern India between January 2019 to March *** were 20 cases of confirmed and sustained ELT among 4520 device checks. Although mostly benign, in two cases ELT led to clinical worsening in patients having left ventricular (LV) systolic dysfunction. Even with good ventricular function, ELT resulted in improper atrioventricular (AV) synchrony leading to disabling symptom in one case. The differentiation of ELT from sinus tachycardia and atrial tachycardia (AT) was not always easy. Magnet application is certainly useful to differentiate. The situations that provoked ELT in this study were-long AV delays, VIP (ventricular intrinsic preferences)/MVP (managed ventricular pacing), atrial non-capture, atrial under/over sensing, premature ventricular contractions (PVCs)/couplets, premature atrial contractions (PAC) and slower ventriculo-atrial (VA) conduction. Rate responsive shortening of post-ventricular atrial refractory period (PVARP) also promoted its occurrence and hindered troubleshooting. When ELT occurred despite post-PVC extension of PVARP, lowering the atrial sensitivity, switching to bipolar sensing and manual setting of longer PVARP after measuring VA conduction time were useful. "Rate responsive PVARP" had to be turned off in a few cases to prevent ELT. On the contrary, an over aggressive prolongation of PVARP led to repetitive non-reentrant ventriculo-atrial synchrony (RNRVAS) in two cases. Checking VA conduction during implantation and noninvasive program stimulation (NIPS) during follow up were useful to check the tendency for ELT

关键词： devices endless loop tachycardia pacemaker algorithms pacemaker mediated tachycardia

来源：评论

学校读者我要写书评

暂无评论

Postatrial pacing ventricular refractory period, RYTHMIQ^TM and ventricular tachycardia response: "An Algorithmic Conflict"

引用

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY 2023年第11期34卷 2370-2375页

作者： Parlavecchio, Antonio Coluccia, Giovanni Accogli, Michele Palmisano, Pietro Card G Panico Hosp Cardiol Unit Tricase Italy Univ Messina Dept Clin & Expt Med Cardiol Unit Via Consolare Valeria 1 I-98124 Messina Italy

来源：评论

学校读者我要写书评

暂无评论

Loss of atrial capture resulting in hemodynamic compromise in the context of flecainide and amiodarone administration with normal electrolyte function

引用

HeartRhythm Case Reports 2025年

作者： Marzetti, Adam Thorp, Iain Goff, Lauren Emerton, Hannah William Harvey Hospital Kent Ashford United Kingdom

来源：评论

学校读者我要写书评

暂无评论

Health care cost analysis of enhanced pacing modalities in bradycardia patients: Portuguese case study on the results of the MINERVA trial

引用

REVISTA PORTUGUESA DE CARDIOLOGIA 2018年第12期37卷 973-978页

作者： de Sous, Joao Marques, Pedro Martins, Vitor Hipolito-Reis, Antonio Duarte, Luis Joaquim, Ines Monteiro, Diogo Boriani, Giuseppe Wolff, Claudia Grammatico, Andrea Padeletti, Luigi Ctr Hosp Lisboa Norte Lisbon Portugal Hosp Distrital Santarem Santarem Portugal Ctr Hosp Porto Porto Portugal Unidade Local Saude Baixo Alentejo Beja Portugal Medtronic Lisbon Portugal Univ Bologna S Orsola Malpighi Univ Hosp Bologna Italy Medtronic Tolochenaz Switzerland Medtronic Rome Italy Univ Florence Florence Italy

Introduction: The MINERVA trial established that atrial preventive pacing and atrial antitachycardia pacing (DDDRP) in combination with managed ventricular pacing (MVP) reduces progression to permanent atrial fibrillation (AF) in patients with paroxysmal or persistent AF and bradycardia who need cardiac pacing, compared to standard dual-chamber pacing (DDDR). It was shown that AF-related health care utilization was significantly lower in the DDDRP + MVP group than in the control group. Cost analysis demonstrated significant savings related to this new algorithm, based on health care costs from the USA, Italy, Spain and the UK. Objective: To calculate the savings associated with reduced health care utilization due to enhanced pacing modalities in the Portuguese setting. Methods: The impact on costs was estimated based on tariffs for AF-related hospitalizations and costs for emergency department and outpatient visits in Portugal. Results: The MINERVA trial showed a 42% reduction in AF-related health care utilization thanks to the new algorithm. In Portugal, this represents a potential cost saving of 2323 euros per 100 patients in the first year and 17 118 euros over a 10-year period. Considering the number of patients who could benefit from this new algorithm, Portugal could save a total of 75 369 euros per year and 555 410 euros over 10 years. Additional savings could accrue if heart failure and stroke hospitalizations were considered. Conclusion: The combination of atrial preventive pacing, atrial antitachycardia pacing and an algorithm to minimize the detrimental effect of right ventricular pacing reduces recurrent and permanent AF. The new DDDRP + MVP pacing mode could contribute to significant costs savings in the Portuguese health care setting. (C) 2018 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

关键词： Atrial fibrillation Bradycardia pacemaker algorithms Health care cost

来源：评论

学校读者我要写书评

暂无评论

Should we treat severe vasovagal syncope with a pacemaker?

引用

JOURNAL OF INTERNAL MEDICINE 2017年第6期281卷 554-561页

作者： Sutton, R. Imperial Coll Natl Heart & Lung Inst London England

Cardiac pacing for vasovagal syncope (VVS) addresses the cardioinhibitory component of the reflex but cannot directly affect vasodepression, which occurs in every reflex even when hidden by dominant cardioinhibition. The randomized controlled trials of pacing in VVS have, after almost 2 decades, determined that a small number of patients can benefit because their vasodepressor component is not severe. Early studies compared pacing with no therapy yielding highly significant benefits. Subsequently, all study patients had implanted devices with half being switched off. No benefit was seen. The ISSUE-3 study found significant benefit (P < 0.039) in prevention of syncope recurrence in older patients. A sub-study later showed those with negative tilt tests, otherwise indistinguishable from tilt-positives, had 5% recurrence in 21 months (P < 0.004). There is acceptance that pacing must be dual chamber, but the question of how pacing is delivered remains open. Relying on falling heart rate is insufficient, probably because it occurs too late. Other algorithms which indirectly detect neuroendocrine changes earlier than heart rate fall may have useful application. In clinical terms, the patient to be considered for pacing should not be young and have severe symptoms. Ideally, tilt testing should be negative implying vasodepression of lesser severity and, therefore, yielding fewer syncope recurrences. When selecting pacing, additional concern must be given to regression to the mean of symptoms, severe to less severe. Patients seek help when they are at their worst. Moreover, many years of pacing are unlikely to be free of complications related to implanted hardware.

关键词： cardioinhibition dual-chamber cardiac pacing pacemaker algorithms pacemaker complications regression of symptoms to the mean vasodepression vasovagal syncope

来源：评论

学校读者我要写书评

暂无评论

Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial

引用

HEART RHYTHM 2015年第6期12卷 1192-1200页

作者： Boriani, Giuseppe Mano, Antonis S. Tukkie, Raymond Mont, Lluis Puererfellner, Helmut Santini, Massimo Inama, Giuseppe Serra, Paolo Gulizia, Michele Sannoilenko, Icor Vasilyevich Wolff, Claudia Holbrook, Reece Gavazza, Federica Padeletti, Luigi Univ Bologna S Orsola Malpighi Univ Hosp Inst Cardiol Dept Expt Diagnost & Specialty Med Bologna Italy Evagelismos Gen Hosp Dept Cardiol 1 Athens Greece Kennemer Gasthuis Haarlem Netherlands Univ Barcelona Hosp Clin Dept Cardiol Barcelona Spain Akad Lehrkrankenhaus Elisabethinen Linz Austria S Filippo Neri Hosp Dept Cardiol Rome Italy Maggiore Hosp Inst Cardiol Crema Italy G Mazzini Hosp Dept Cardiol Ieramo Italy Garibaldi Nesima Hosp Dept Cardiol Catania Italy Municipal Hosp 4 Dept Hlth Moscow Russia Medtronic Dept Hlth Econ Tolochenaz Switzerland Medtronic Inc Dept Hlth Econ Minneapolis MN USA Medtron Clin Res Inst Reg Clin Ctr Rome Italy Univ Florence Inst Internal Med & Cardiol Florence Italy

BACKGROUND Many patients who suffer from bradycardia and need cardiac pacing also have atrial fibrillation (AF). New pacemaker algorithms, such as atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), have been specifically designed to reduce AF occurrence and duration and to minimize the detrimental effects of right ventricular pacing. The randomized MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial established that DDDRP + MVP pacing modality reduced permanent AF in bradycardia patients as compared with standard dual-chamber pacing (DDDR). OBJECTIVE The aim of this study was to estimate the cost savings due to lower AF-related health care utilization events based on health care costs from the United States and the European Union. METHODS Dual-chamber pacemaker patients with a history of paroxysmal or persistent AF were randomly assigned to receive DDDR (n = 385) or the advanced features (DDDRP + MVP;n = 383). We used published health care costs from the United States and the European Union (Italy, Spain, and the United Kingdom) to estimate the costs associated with AF-related hospitalizations and emergency visits. RESULTS The rate of AF-related hospitalizations was significantly Lower in the DDDRP + MVP group than in the conventional pacemaker group (DDDR group;42% reduction;incidence rate ratio 0.58). Similarly, a significant reduction of 68% was observed for AF-related emergency department visits (incidence rate ratio 0.32;P <.001). As a consequence, DDDRP + MVP could potentially reduce health care costs by 40%-44%. Over a ten-year period, the cost savings per 100 patients ranged from $35,702 in the United Kingdom to $121,831 in the United States. CONCLUSION New pacing algorithms such as DDDRP + MVP used in the MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial successfully reduced AF-related health care utilization, resulting in signif

关键词： Atrial fibrillation Bradycardia pacemaker algorithms Pacing Health care costs Hospitalization

来源：评论

学校读者我要写书评

暂无评论

Alternating pacemaker AV Delays: The Long and Short of It

引用

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 2012年第10期35卷 1276-1279页

作者： Prutkin, Jordan M. Mitchell, Robin J. Univ Washington Div Cardiol Seattle WA 98195 USA Medtronic Inc Minneapolis MN USA

The article presents a case study of a 65-year-old woman with a Medtronic EnPulseTM dual chamber pacemaker implanted five years previously for tachycardia- bradycardia syndrome, noting a routine follow-up indicated increased ventricular pacing percentage and intermittent complete heart block, and discusses why the two atrioventricular delays occurred.

关键词： pacemaker noncompetitive atrial pacing AV delay PR interval pacemaker algorithms

来源：评论

学校读者我要写书评

暂无评论

pacemaker ECG quiz no. 22.A CRT non-responder with atrial fibrillation

引用

Herzschrittmachertherapie und Elektrophysiologie 2010年第2期21卷 141-145页

作者： Israel, C.W. Klinik für Innere Medizin - Kardiologie Ev. Krankenhaus Bielefeld Haus Gilead i 33617 Bielefeld Burgsteig 13 Germany

A patient with heart failure functional class NYHA III and permanent atrial fibrillation received a system for cardiac resynchronization therapy. Unfortunately, he reports at a follow-up visit about a completely unchanged poor exercise capacity with dyspnea during exercise at a very low level. The ECG reveals an unusual mode of stimulation. © Springer-Verlag 2010.

关键词： Atrial fibrillation Cardiac resynchronization therapy pacemaker algorithms pacemaker ECG

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：