Pacing and clinical electrophysiology : PACE
-
Pacing Clin Electrophysiol · Oct 1999
Percutaneous cephalic vein approach for permanent pacemaker implantation.
Implantation of permanent pacemaker leads into the cephalic vein within the deltopectoral groove is enhanced by introduction of a flexible guidewire into the brachial vein at the antecubital fossa, which is then advanced to the subclavian vein. The cephalic vein within the deltopectoral groove is easily found by incision with the guidewire as a marker. A pacing lead or leads can be inserted along the guidewire or by using a sheath advanced over the guidewire. The procedure was performed on 32 patients and the pacing leads of 28 procedures (DDD 15, VDD 9 and WI 4) were inserted using the cephalic vein without complications.
-
Pacing Clin Electrophysiol · Oct 1999
Case ReportsSpurious redetection of sinus rhythm by an implantable cardioverter defibrillator during spontaneous ventricular fibrillation.
Implantable cardioverter defibrillator undersensing leading to delayed or aborted therapy delivery has been reported with induced arrhythmias and following failed defibrillator shocks. We describe a case in which spurious redetection of sinus rhythm during a spontaneous episode of ventricular fibrillation resulted in aborted device therapy.
-
Pacing Clin Electrophysiol · Oct 1999
External exponential biphasic versus monophasic shock waveform: efficacy in ventricular fibrillation of longer duration.
Ventricular fibrillation (VF) duration may be a factor in determining the defibrillation energy for successful defibrillation. Exponential biphasic waveforms have been shown to defibrillate with less energy than do monophasic waveforms when used for external defibrillation. However, it is unknown whether this advantage persists with longer VF duration. ⋯ The E50 (J) for M, B1, and B2 were 131 +/- 41, 57 +/- 18,* and 60 +/- 26* with 10 seconds of VF duration, respectively, and 114 +/- 62, 77 +/- 45,* and 72 +/- 53* with 1 minute of VF duration, respectively (*P < 0.05 vs M). There was no significant difference in the E50 between 10 seconds and 1 minute of VF durations for each waveform. We conclude that (1) the E50 does not significantly increase with lengthening VF durations up to 1 minute regardless of the shock waveform, and (2) external exponential biphasic shocks are more effective than monophasic waveforms even with longer VF durations.