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25 years of implanted intracardiac pacers.

https://arctichealth.org/en/permalink/ahliterature55503
Source
Lancet. 1988 Mar 19;1(8586):636-8
Publication Type
Article
Date
Mar-19-1988
Author
H. Lagergren
Author Affiliation
Department of Surgery, Huddinge University Hospital, Karolinska Institute, Sweden.
Source
Lancet. 1988 Mar 19;1(8586):636-8
Date
Mar-19-1988
Language
English
Publication Type
Article
Keywords
Aged
Animals
Arrhythmia - physiopathology - therapy
Cardiac Pacing, Artificial - history - methods
Dogs
Electrodes, Implanted
Heart Block - physiopathology - therapy
Heart rate
History, 20th Century
Humans
Pacemaker, Artificial - history
Sweden
Abstract
In 1962, a simplified method of transvenously inserting an intracardiac electrode and implanting the whole pacemaker system under local anaesthesia was reported from the Karolinska Hospital in Stockholm. This simplified method has been universally adopted and pacemakers are now probably implanted too freely in many places. In the Stockholm area pacemakers are implanted half as frequently as in the rest of Sweden and as often as in the United Kingdom.
PubMed ID
2894560 View in PubMed
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Acute changes in electromechanical parameters during different pacing configurations using a quadripolar left ventricular lead.

https://arctichealth.org/en/permalink/ahliterature112559
Source
J Interv Card Electrophysiol. 2013 Oct;38(1):61-9
Publication Type
Article
Date
Oct-2013
Author
Cinzia Valzania
Maria J Eriksson
Mauro Biffi
Giuseppe Boriani
Fredrik Gadler
Author Affiliation
Cardiovascular Department, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy, cinzia.valzania@gmail.com.
Source
J Interv Card Electrophysiol. 2013 Oct;38(1):61-9
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Aged
Cardiac Pacing, Artificial - methods - statistics & numerical data
Comorbidity
Electrodes, Implanted - statistics & numerical data
Female
Heart Conduction System - physiopathology
Humans
Italy - epidemiology
Male
Myocardial Contraction
Pacemaker, Artificial - statistics & numerical data
Prevalence
Risk factors
Sweden - epidemiology
Treatment Outcome
Ventricular Dysfunction, Left - diagnosis - epidemiology - prevention & control
Abstract
Quadripolar left ventricular (LV) leads allow for several pacing configurations in candidates for cardiac resynchronization therapy (CRT). Whether different pacing configurations may affect LV dyssynchrony and systolic function is not completely known. We aimed to evaluate the acute effects of different pacing vectors on LV electromechanical parameters in patients implanted with a quadripolar LV lead.
In this two-centre study, within 1 month of implantation 21 CRT patients (65 ± 8 years, 76 % men, 38 % ischemic) receiving a quadripolar LV lead (Quartet 1458Q, St Jude Medical) underwent LV capture threshold assessment, intracardiac electrogram optimization, and two-dimensional echocardiography during four pacing configurations: D1-P4, P4-RV coil, D1-RV coil, and P4-M2. LV dyssynchrony and contractile function were expressed by septal-to-lateral delay and global longitudinal strain (GLS).
LV capture threshold varied between the configurations (P
PubMed ID
23818121 View in PubMed
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Adaptation to myocardial ischemia during repeated ventricular pacing in patients with coronary artery disease.

https://arctichealth.org/en/permalink/ahliterature46178
Source
Scand Cardiovasc J. 2000;34(2):134-41
Publication Type
Article
Date
2000
Author
K. Ylitalo
K. Peuhkurinen
Author Affiliation
Department of Internal Medicine, University of Oulu, Finland.
Source
Scand Cardiovasc J. 2000;34(2):134-41
Date
2000
Language
English
Publication Type
Article
Keywords
Cardiac Pacing, Artificial
Coronary Disease - therapy
Female
Hemodynamic Processes
Humans
Male
Middle Aged
Myocardial Ischemia - prevention & control
Abstract
OBJECTIVE: The purpose of our study was to evaluate whether repeated ventricular pacing is able to induce adaptation against ischemia in coronary artery disease patients. DESIGN: Fifteen patients with documented coronary artery disease were subjected to two successive periods of rapid ventricular pacing (150 bpm) of equal length (295+/-33 s), the first being limited by intolerable anginal pain. The second pacing period, of the same length as the first, was initiated after the disappearance of angina and ST depression, the mean resting time being 433+/-30 s. Blood samples for the determination of transcardiac differences in glucose, lactate, free fatty acids, K+, pCO2, pH, oxygen saturation and noradrenaline were taken from the femoral artery and coronary sinus before and at the end of each pacing period. The mechanical performance of the hearts was followed by continuous monitoring of intra-arterial blood pressure and pulmonary capillary wedge pressure, and the observed adaptation in the measured variables during the successive pacing tests was correlated with the duration of angina, severity of coronary artery disease and degree of collateralization. RESULTS: Changes in the transcardiac pH and K+ differences, ST segment and pulmonary capillary wedge pressure were less pronounced during the second pacing period. The subgroup with net lactate production before or after the first pacing period demonstrated metabolic adaptation manifested as improved lactate extraction during the second pacing period. Rate-pressure product and oxygen extraction, and thus presumably also overall oxygen consumption and oxygen delivery, were similar during both tests. The magnitude of adaptation did not correlate with the duration of angina, severity of coronary artery disease or overall collateral score. CONCLUSION: Rapid ventricular pacing is able to induce adaptation to myocardial ischemia, but the exact mechanisms in this process remain to be elucidated.
PubMed ID
10872698 View in PubMed
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Aging and heart failure: changing demographics and implications for therapy in the elderly.

https://arctichealth.org/en/permalink/ahliterature144487
Source
Heart Fail Rev. 2010 Sep;15(5):401-5
Publication Type
Article
Date
Sep-2010
Author
Bodh I Jugdutt
Author Affiliation
Division of Cardiology, Department of Medicine and Cardiovascular Research Group, Faculty of Medicine, 2C2 Walter MacKenzie Health Sciences Centre, University of Alberta, Edmonton, AB T6G 2R7, Canada. bjugdutt@ualberta.ca
Source
Heart Fail Rev. 2010 Sep;15(5):401-5
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging - physiology
Alberta - epidemiology
Antihypertensive Agents - therapeutic use
Cardiac Pacing, Artificial
Defibrillators, Implantable
Demography
Disease Progression
Female
Heart Failure - drug therapy - epidemiology - mortality - therapy
Humans
Male
Stroke Volume
Ventricular Dysfunction, Left - epidemiology - mortality
Ventricular Function, Left
Abstract
The elderly population (age > or =65) is increasing and with it morbidity, hospitalizations, costs and mortality due to heart failure (HF). HF is a progressive disorder that is superimposed on an on-going aging process. The two broad categories of HF, HF with left ventricular (LV) systolic dysfunction or low ejection fraction (HF/low-EF) and HF with preserved ejection fraction (HF/PEF) are equally prevalent in the elderly. Trials of therapy for HF/low-EF in primarily non-elderly patients showed mortality benefit in elderly patients. In contrast, trials for HF/PEF have not shown mortality benefit in elderly or non-elderly patients. HF pharmacotherapy in the elderly is challenging and needs to be individualized and consider several aging-related changes. More research into the biology of aging and more clinical trials in elderly patients are needed to improve morbidity and mortality in elderly HF patients.
PubMed ID
20364319 View in PubMed
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Anticoagulation of patients on chronic warfarin undergoing arrhythmia device surgery: wide variability of perioperative bridging in Canada.

https://arctichealth.org/en/permalink/ahliterature148842
Source
Heart Rhythm. 2009 Sep;6(9):1276-9
Publication Type
Article
Date
Sep-2009
Author
Andrew D Krahn
Jeffrey S Healey
Christopher S Simpson
Vidal Essebag
Soori Sivakumaran
David H Birnie
Author Affiliation
University of Western Ontario, London, Ontario, Canada, Hamilton Health Sciences Center, Hamilton, Ontario, Canada. akrahn@uwo.ca
Source
Heart Rhythm. 2009 Sep;6(9):1276-9
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Aged
Anticoagulants - therapeutic use
Atrial Fibrillation - surgery
Canada
Cardiac Pacing, Artificial
Cardiac Surgical Procedures
Chronic Disease
Health Care Surveys
Hemorrhage - prevention & control
Humans
Perioperative Care
Questionnaires
Risk assessment
Risk factors
Thromboembolism - prevention & control
Time Factors
Abstract
In patients undergoing cardiac rhythm device surgery, it is common practice to discontinue oral anticoagulation and to perform heparin bridging in order to reduce the risk of bleeding and minimize the risk of thromboembolic events.
The purpose of this study was to determine the perioperative anticoagulation strategies currently in use.
A survey presented four clinical scenarios of patients on oral anticoagulation undergoing cardiac rhythm device surgery. The scenarios represented a gradient of perceived thromboembolic risk based on the presence of atrial fibrillation, a mechanical heart valve, previous stroke, and the remainder of the CHADS(2) risk factors (congestive heart failure, hypertension, age >75 years, diabetes, previous stroke or transient ischemic attack). Respondents were offered six options that included discontinuing oral anticoagulation without heparin, three different heparin bridging protocols, and ongoing oral anticoagulation with reduced or therapeutic dose warfarin.
Based on responses from 38 (61%) of 62 electrophysiologists surveyed across Canada, 83% of respondents held warfarin without bridging in a low-risk, 78-year-old patient with atrial fibrillation (CHADS(2) score 1). In three higher-risk patient scenarios, 67% to 100% of respondents chose heparin bridging or ongoing warfarin; 38% to 72% of respondents chose heparin bridging, with 23% to 36% choosing variable use of ongoing warfarin. In all three cases where respondents indicated that they would bridge, each of the three heparin regimens was chosen by at least 20% of respondents.
There is a wide range of approaches to perioperative management in patients on oral anticoagulation undergoing cardiac rhythm device surgery. Clinical equipoise is evident and supports the need for comparative studies.
Notes
Comment In: Heart Rhythm. 2009 Sep;6(9):1280-119656737
PubMed ID
19716082 View in PubMed
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Arrhythmic complications after electrical cardioversion of acute atrial fibrillation: the FinCV study.

https://arctichealth.org/en/permalink/ahliterature113783
Source
Europace. 2013 Oct;15(10):1432-5
Publication Type
Article
Date
Oct-2013
Author
Toni Grönberg
Ilpo Nuotio
Marko Nikkinen
Antti Ylitalo
Tuija Vasankari
Juha E K Hartikainen
K E Juhani Airaksinen
Author Affiliation
Heart Center, Turku University Hospital, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland.
Source
Europace. 2013 Oct;15(10):1432-5
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Acute Disease
Age Factors
Aged
Atrial Fibrillation - diagnosis - epidemiology - therapy
Bradycardia - diagnosis - epidemiology - physiopathology - therapy
Cardiac Pacing, Artificial
Chi-Square Distribution
Electric Countershock - adverse effects
Female
Finland - epidemiology
Heart Arrest - diagnosis - epidemiology - physiopathology - therapy
Heart rate
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Retrospective Studies
Risk factors
Sex Factors
Sinoatrial Node - physiopathology
Time Factors
Treatment Outcome
Abstract
To determine the incidence and risk factors of arrhythmic complications after electrical cardioversion of acute atrial fibrillation (AF).
Our retrospective multicentre study collected data from 7660 cardioversions of acute (5 s) occurred immediately after 51 cardioversions leading to a short resuscitation in seven cases and two patients needed extrinsic pacing after the cardioversion. In nine cases, asystole was followed by bradycardia. Bradycardic ventricular rate (
Notes
Comment In: Europace. 2013 Oct;15(10):1387-824014802
PubMed ID
23687124 View in PubMed
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Atrial fibrillation in the pacemaker clinic.

https://arctichealth.org/en/permalink/ahliterature185661
Source
Can J Cardiol. 2003 Apr;19(5):492-4
Publication Type
Article
Date
Apr-2003
Author
Catherine S McLellan
Hoshiar Abdollah
F James Brennan
Christopher S Simpson
Author Affiliation
Queen's University, Kingston, Ontario.
Source
Can J Cardiol. 2003 Apr;19(5):492-4
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Ambulatory Care Facilities
Anticoagulants - therapeutic use
Atrial Fibrillation - diagnosis - drug therapy - epidemiology - etiology - physiopathology
Cardiac Pacing, Artificial
Electrocardiography
Female
Humans
Male
Ontario - epidemiology
Predictive value of tests
Risk factors
Sensitivity and specificity
Single-Blind Method
Warfarin - therapeutic use
Abstract
Electrocardiographic (ECG) recognition of the underlying rhythm in patients with ventricular pacing can be difficult. Atrial fibrillation (AF) in particular may go unreported.
To compare the underlying atrial rhythm determined in the pacemaker clinic with the 12-lead ECG interpretation of the atrial rhythm in those who were continuously paced in the ventricle. It was intended to determine whether long term anticoagulation therapy was related to whether AF was diagnosed before or after pacemaker implantation.
Pacemaker clinic patients were enrolled if they had a 100% paced ventricular rhythm. The underlying rhythm was determined using pacemaker programming manoeuvres. A 12-lead ECG was recorded on all patients within 10 min of their pacemaker assessment and interpreted by one of the several geographic full-time cardiologists at the centre. All cardiologists were blinded to the results of pacemaker assessment and to the clinical history.
Fifty-six patients were enrolled. At the pacemaker clinic, 37 were determined to be in AF and three were in atrial flutter (AFL). Of these 40 patients with AF/AFL, 28 were correctly identified as such on the 12-lead ECG interpretation. Twelve of the 40 were interpreted only as having an 'electronic ventricular pacemaker' (EVP). Sixteen of the 40 patients (40.0%) with AF or AFL were not taking warfarin. Twenty-two of 25 patients with an AF/AFL diagnosis before pacemaker implantation were taking warfarin, compared with two of 15 patients with AF/AFL diagnosis after pacemaker implantation (P
PubMed ID
12717483 View in PubMed
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Atrial fibrillation--new aspects on mechanism and treatment.

https://arctichealth.org/en/permalink/ahliterature54716
Source
J Intern Med. 1996 Jan;239(1):3-15
Publication Type
Article
Date
Jan-1996
Author
S B Olsson
Author Affiliation
Department of Cardiology, University Hospital, Lund, Sweden.
Source
J Intern Med. 1996 Jan;239(1):3-15
Date
Jan-1996
Language
English
Publication Type
Article
Keywords
Animals
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - complications - drug therapy - physiopathology - therapy
Cardiac Pacing, Artificial
Clinical Trials
Electric Countershock
Electrophysiology
Humans
Research Support, Non-U.S. Gov't
Abstract
During recent years, the exploration of different aspects of atrial fibrillation (AF) has become increasingly interesting. Thus, knowledge about basic underlying mechanisms, consequences and different modes of treatment has rapidly expanded. At a meeting in Lund, Sweden, in 1993, scientists within different fields of AF research gathered for the exchange of information. This paper is a short summary of some topics discussed at the Lund meeting and some suggestions as to how further research in this field may help to improve our understanding of this arrhythmia and the treatment of patients suffering from it. Underlying pathoelectrophysiological mechanisms in AF have been explored in experimental models in animals and by direct recordings of different atrial myocardial electrophysiological variables both in the catheter laboratory and during open heart surgery in man. Some findings illustrate possible generalized atrial myocardial mechanisms, whilst other findings clearly indicate the possibility of localized pathoelectrophysiological mechanisms. The generally accepted hypothesis that AF is perpetuated by multiple re-entry mechanisms is, thus, both verified and modified by recent studies. In addition to subjective symptoms and well identified thromboembolic consequences, accumulating evidence tells us that AF may precipitate a myocardial dysfunction which may be misinterpreted as an underlying factor initiating the arrhythmia. Today's treatment of AF includes several newer antiarrhythmic drugs, different ablation techniques, the application of different electrical devices as well as different surgical methods. New, improved and simplified methods are expected. Atrial fibrillation is the single most important supraventricular arrhythmia needing substantial further exploration of mechanisms, consequences and treatment. The Lund symposium contributed to this process by defining the state of knowledge in 1993 and outlining the need for the years to come.
PubMed ID
8551197 View in PubMed
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Atrial vs. dual-chamber cardiac pacing in sinus node disease: a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature93198
Source
Europace. 2008 Jul;10(7):825-31
Publication Type
Article
Date
Jul-2008
Author
Fored C Michael
Granath Fredrik
Gadler Fredrik
Blomqvist Paul
Rynder Jenny
Linde Cecilia
Ekbom Anders
Rosenqvist Mårten
Author Affiliation
Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Site Solna M9:01, SE-171 76 Stockholm, Sweden. Michael.Fored@ki.se
Source
Europace. 2008 Jul;10(7):825-31
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Arrhythmia, Sinus - mortality - physiopathology - therapy
Atrial Fibrillation - epidemiology - physiopathology
Atrial Flutter - epidemiology - physiopathology
Atrioventricular Node - physiopathology
Cardiac Pacing, Artificial - adverse effects - methods
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pacemaker, Artificial
Registries
Risk factors
Sinoatrial Node - physiopathology
Sweden
Treatment Outcome
Abstract
AIMS: In patients with sinus node disease, dual-chamber pacing (DDD) possibly results in adverse effects on the ventricular function. We have compared the incidence of cardiovascular morbidity and mortality in patients with sinus node disease and with atrioventricular (AV) synchronous pacemakers, DDD vs. atrial pacing (AAI). METHODS AND RESULTS: A nation-wide population-based cohort of 8777 patients with AAI- or DDD-mode pacemakers was followed during 12 years. The cohort was linked to national healthcare and census registers. Patients with DDD pacing and without any pre-implant admission for atrial fibrillation or flutter had an increased risk of post-implant fibrillation or flutter, in relation to corresponding AAA patients [hazard ratio (HR) = 1.30; 95% confidence interval (CI) 1.10-1.52]. A slight increase in the risk of any cardiovascular disease (HR = 1.07; CI, 1.00-1.15), and all-cause mortality (HR = 1.12; CI, 1.00-1.25), was seen among DDD patients, in relation to AAI patients, but there was no significant difference in the risk of ischaemic or unspecified stroke (HR = 1.14; CI, 0.94-1.37). Among DDD patients, the all-cause mortality did not differ from the general population [standardized mortality ratio (SMR) = 1.04; CI, 0.98-1.11]. Patients with AAI, however, had a decreased all-cause mortality risk (SMR = 0.89; CI, 0.82-0.97). CONCLUSION: Our results support AAI as the preferred mode of pacing in patients with sinus node disease, and a normal AV node function.
PubMed ID
18467299 View in PubMed
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100 records – page 1 of 10.