The Canadian journal of cardiology
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Biventricular pacing improves left ventricular dysynchrony, leading to improvement in congestive heart failure symptoms. The extent of placebo effect, the predictors of response and the long term benefits are unknown. ⋯ Biventricular pacing improves quality of life and NYHA class in patients with advanced heart failure and intraventricular conduction delay. The attenuated benefit seen over time may be related to initial placebo effect or simple dual- chamber pacing, or the natural history of the underlying disease. Identification of patients most likely to respond to biventricular pacing was not possible.
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Case Reports
Audible implantable cardioverter defibrillator alarms detect intermittent conductor discontinuity.
The lead conductor integrity of implantable cardioverter defibrillator devices is inferred from impedance measurements; however, intermittent discontinuity can be difficult to detect or confirm. Newer devices can perform daily lead impedance self-testing, and some even have audible alarms that promptly warn patients of anomalies. In the present case, the audible alarms were solely responsible for the timely identification of an intermittent, otherwise clinically nonreproducible, form of potentially fatal implantable cardioverter defibrillator system failure.