Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · May 1999
Case ReportsArteriovenous fistula after injury of the left internal mammary artery during extraction of pacemaker leads with a laser sheath.
The left internal mammary artery was severed and an arteriovenous fistula created during extraction of pacemaker leads with a laser sheath.
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Pacing Clin Electrophysiol · Mar 1999
The impact of the millennium problem on implantable pacemakers and defibrillators.
The unpredictable behavior of computer systems on January 1, 2000, known as the millennium problem or millennium 'bug,' also affects medical establishments and, due to the large use of computers in all kind of applications, cardiological clinics in particular. This review discusses the effect of the millennium computer problem on the implantation procedures and follow-up registries of implantable pacemakers and defibrillators. ⋯ Pacemaker databases and the logistics linked to the implantation and follow-up of patients and their pacemaker may and probably will be affected by the millennium transition. Using the FDA database on biomedical equipment, the actual status of all biomedical devices can be assessed.
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Pacing Clin Electrophysiol · Jan 1999
Multicenter Study Clinical Trial Controlled Clinical TrialSteroid eluting high impedance pacing leads decrease short and long-term current drain: results from a multicenter clinical trial. CapSure Z investigators.
Pacemaker lead technology has changed considerably over the past decades. The widespread use of low polarization highly porous electrodes and steroid elution electrodes has resulted in low chronic pacing thresholds, as well as a decrease in the incidence of exit block. Efforts to develop pacing leads with high impedance might theoretically lead to lower lead current drain, which is a component of battery capacity. ⋯ High impedance leads are associated with lower lead current drain than standard pacing leads in the atrium and ventricle for up to 1 year. No clinically important differences in sensing characteristics was noted with the high impedance leads in the atrium or ventricle compared to standard pacing leads. High impedance leads may result in increased pulse generator longevity.
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Three cases of twiddler's syndrome in patients with an abdominally implanted cardioverter defibrillator (ICD) and an endocardial lead system are reported. The condition was detected when an increase in pacing threshold or lead impedance was noted at routine follow-up. ⋯ Elderly female patients with some degree of obesity appear most susceptible. Minimizing pocket size and suturing of the device to the fascia should decrease the chance of developing this problem.
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Pacing Clin Electrophysiol · Dec 1998
Case ReportsCombined use of a true-bipolar sensing implantable cardioverter defibrillator in a patient having a prior implantable spinal cord stimulator for intractable pain.
Reported is a case involving a patient with a previously implanted spinal cord stimulator (SCS) who presented for an implantable cardioverter defibrillator (ICD). The SCS device was located in the left lower abdominal quadrant with a stimulation electrode array placed on the dorsal aspect of the spinal cord at the T-11 thoracic level. Interaction testing demonstrated that the biopolar sensing transvenous ICD system (Medtronic 7221 Cx PCD) did not detect the stimulator's output at burst rates ranging from 20-130 pulses/s, even with the ICD set to its maximum sensitivity of 0.15 m V and the stimulator programmed to the highest patient tolerated output combinations of 5 V, 0.45 ms in the bipolar configuration and 3 V, 0.45 ms in the unipolar (i.e., case-electrode) configuration.