.Cardiac Pacing and ICDs Fourth Edition..Cardiac Pacing and ICDsFourth Edition Kenneth A. pdf

[...]... provided unquestioning support and encouragement for all our academic and scholarly activities Kenneth A Ellenbogen, M.D x Indications for Permanent and Temporary Cardiac Pacing Pugazhendhi Vijayaraman, Robert W Peters, and Kenneth A Ellenbogen 1 ANATOMY To understand the principles and concepts involved in cardiac pacing more completely, a brief review of the anatomy and physiology of the specialized... ventricular pacing This finding suggests remodeling of ventricular function or anatomy by chronic pacing From top to bottom: I, II, III, V1 and V6 are standard ECG leads 23 CARDIAC PACING AND ICDS tomatic improvement (quality of life and functional class) was not necessarily accompanied by improvement in objective indices such as treadmill exercise time and peak oxygen consumption.22 Similarly, in the Pacing. .. dynamic and affected by preload, afterload, and other factors Difficulty with diastolic relaxation (and ventricular filling) of the thickened and noncompliant ventricular musculature is present in both forms of this disorder and may be an important determinant of the clinical presentation Pacing is thought to exert a beneficial effect by inducing paradoxical septal motion and ventricular dyssynchrony and. .. physiology, and implantation and follow-up of these new devices Additionally, several recent clinical trials of ICDs has led to a marked increase in defibrillator implantation It is important that cardiologists and other healthcare providers become familiar with the results of these clinical trials These exciting new developments have been the stimulus for Dr Mark A Wood and I to prepare the fourth edition. .. patients with left 13 CARDIAC PACING AND ICDS bundle branch block and first-degree AV block, the site of block could be located either in the His-Purkinje system or in the AV node The term “trifascicular block” should be reserved for alternating right and left bundle branch block or for block of either bundle in the setting of a prolonged HV interval The indications for pacing in the setting of chronic... complaining of weakness and presyncopal episodes A 12-lead electrocardiogram revealed complete AV block and a slow junctional escape rhythm with narrow QRS complexes He received a permanent dual-chamber pacemaker, which completely relieved his symptoms 6 INDICATIONS FOR PERMANENT AND TEMPORARY CARDIAC PACING The indications for permanent pacing with AV block follow Class I 1 Third-degree and advanced second-degree... filling and reducing the outflow tract gradient 22 INDICATIONS FOR PERMANENT AND TEMPORARY CARDIAC PACING This is generally achieved with dual-chamber pacing with a short PR interval (i.e., usually 50 to 125 milliseconds) to produce maximal ventricular preexcitation.The acute hemodynamic effects of dual-chamber pacing may be quite dramatic, with a major reduction in left ventricular cavity obliteration and. .. effects of dual-chamber pacing in this condition do not dissipate immediately once the pacing has been terminated.21 The mechanism of the beneficial effects of pacing is incompletely understood and the population who would most reliably benefit has not been fully elucidated In a recent multicenter trial (the M-PATHY study) using a randomized, double-blind crossover design, Maron and colleagues found that... failure, and bundle branch block, especially left bundle branch block and QRS interval greater than 120 milliseconds, defibrillators with biventricular pacing have been shown to improve symptoms from heart failure and reduce mortality.9 Barold has pointed out that the standard definition of trifascicular block is often too loosely applied.10 Thus, in patients with right bundle branch block and either... important one and should be based on solid clinical evidence A joint committee of the American College of Cardiology and the American Heart Association was formed in the 1980s to provide uniform criteria for pacemaker implantation.These guidelines were first published in 1984 and most recently revised in 2002.2,3 It must be realized, however, that medicine is a constantly changing science, and absolute and relative .