Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Jun 2004
Selective site pacing: defining and reaching the selected site.
Selective site right ventricular pacing has been suggested as an approach to reduce the incidence of ventricular dysfunction and hopefully influence the morbidity resulting from traditional right ventricular apical pacing. Pacing from the right ventricular apex allows a stable ventricular rate, and together with atrial pacing and sensing, helps maintain atrioventricular synchrony but does not allow physiological activation of the left ventricle. ⋯ This lack of definition consensus may have contributed to the apparent conflict of data, particularly in the right ventricle. There is an urgent need for a standardization of terms and identifying measures for selective pacing sites.
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Pacing Clin Electrophysiol · Apr 2004
Randomized Controlled Trial Clinical TrialPhysician management of pacemaker and implantable cardioverter defibrillator advisories.
This study was designed to determine how physicians manage pacemaker (PM) and implantable cardioverter defibrillator (ICD) recalls and safety alerts (collectively "advisories") and to determine which factors influence physicians' clinical decisions. Although PM and ICD advisories affected over 500,000 patients in the past decade, physician clinical management of advisory devices has not been well studied. Advisories continue to occur frequently and are increasing in number and rate. ⋯ Physician consensus exists regarding the management of some PM and ICD advisories and can be used to guide clinical practice. Substantial differences of opinion, however, are present regarding the management of many other advisories. Evidence based guidelines incorporating the indication for device implantation and the likelihood of device malfunction would greatly facilitate clinical management of PM and ICD advisory devices.
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Pacing Clin Electrophysiol · Apr 2004
Case ReportsDual antegrade response tachycardia induced cardiomyopathy.
We report a rare case of tachycardia induced cardiomyopathy resulting from nearly incessant dual antegrade response tachycardia. Criteria necessary for sustaining dual antegrade responses are discussed, including: (1) sufficient antegrade dissociation of the AV node; (2) absence of retrograde conduction over each AV nodal pathway following antegrade conduction over its counterpart; (3) difference between fast and slow pathway conduction times exceeding His-Purkinje refractoriness; and (4) critical timing of sinus impulses relative to preceding AV nodal conduction. Both the arrhythmia and cardiomyopathy were successfully treated by slow pathway ablation.
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Pacing Clin Electrophysiol · Apr 2004
Case ReportsPeripartum cardiomyopathy presenting with repetitive monomorphic ventricular tachycardia.
A 30-year-old asymptomatic pregnant woman at 38 weeks' gestation was noticed to have repetitive monomorphic ventricular tachycardia. A dilated left ventricle with moderately reduced systolic function was found on echocardiographic examination. To the best of our knowledge, a case of peripartum cardiomyopathy presenting with repetitive monomorphic ventricular tachycardia has not been previously reported.