scholarly journals Temporary transvenous endocardial pacing: method of endocardial electrode reposition in the right ventricular cavity of the heart

2016 ◽  
Vol 97 (3) ◽  
pp. 453-457
Author(s):  
A N Osmolovsky

Aim. To justify and develop method of endocardial electrode reposition in the right ventricular cavity of the heart in the spontaneous termination of temporary pacing in patients with recurrent myocardial infarction.Methods. A method of endocardial electrode reposition was used in 23 patients with myocardial infarction complicated by acute bradyarrhythmias. Written informed consent was obtained from all patients, and in the absence of contact with the patient, decision to insert temporary artificial pacemaker was made by medical consultation.Results. A method of endocardial electrode reposition that provides threading the electrode from the venous bed to the right ventricular cavity of the heart, cardiac stimulation by electrical impulses and creation the new contacts between electrode and right ventricular endocardium of the heart using the same electrode, both in the presence and in absence of the heart conduction and excitation function, was developed. At the same time, it excludes the electrode dislocation from the right ventricular cavity of the heart, provides the electrode fixation with endocardium, and at the same time allows to impose a stable artificial heart rhythm in the shortest time. During the spontaneous termination of the effective artificial pacemaker, endocardial electrodes reposition enabled to promptly regain the heart rhythm control in all 23 patients with acute bradyarrhythmia of infarction genesis.Conclusion. Effective and safe method of endocardial electrode reposition in the right ventricular cavity of the heart in the spontaneous termination of temporary pacing in patients with recurrent myocardial infarction was developed and introduced into clinical practice.

2020 ◽  
pp. 13-17
Author(s):  
Dmitrii Aleksandrovich Lopyn ◽  
Stanislav Valerevich Rybchynskyi ◽  
Dmitrii Evgenevich Volkov

Currently the electrophysiological treatment options have been considered to be the most effective for many patients with arrhythmogenic cardiomyopathies, as well as in those with arrhythmias on the background of heart failure. Currently, the dependence of efficiency of the pacemakers on the location of the electrodes has been proven. In order to study the effect of a myocardial dysynchrony on the effectiveness of pacing depending on the location of the right ventricular electrode, an investigation has been performed. This study comprised the patients with a complete atrioventricular block, preserved ejection fraction of the left ventricle (more than 50 %), with no history of myocardial infarction, who were implanted with the two−chamber pacemaker. It has been established that the best results were achieved with a stimulation of the middle and lower septal zone of the right ventricle, the worst ones were obtained with a stimulation of its apex. It has been found that the dynamics of the magnitude of segmental strains and a global longitudinal strain coincided with the dynamics of other parameters of the pacemaker effectiveness, which indicated the pathogenetic value of myocardial dysynchrony in the progression of heart failure after implantation of the pacemaker. Therefore it could be concluded that the studying of myocardial mobility by determining a longitudinal strain for assessing the functional state of the myocardium and the effectiveness of pacing is highly advisable. It is emphasized that the use of the latest strains−dependent techniques for cardiac performance evaluation in the patients with bradyarrhythmia have a great potential to predict the development of chronic heart failure and to choose the optimal method of physiological stimulation of the heart. Key words: right ventricular lead, cardiac stimulation, myocardial dyssynchrony.


2012 ◽  
Vol 94 (2) ◽  
pp. 643-646 ◽  
Author(s):  
Teruki Sato ◽  
Hiroyuki Watanabe ◽  
Megumi Okawa ◽  
Takako Iino ◽  
Kenji Iino ◽  
...  

2016 ◽  
Vol 97 (2) ◽  
pp. 177-181
Author(s):  
A N Osmolovsky ◽  
L V Babenkova

Aim. To assess the effectiveness of the original puncture transvenous temporary endocardial springy electrode use in patients with myocardial infarction complicated by bradyarrhythmias.Methods. The study included 126 patients with myocardial infarction complicated by acute bradyarrhythmias. The original endocardial electrode was used in 38 patients (main group). Temporary artificial heart rhythm control was performed using endocardial springy temporary puncture electrode in 88 cases of bradyarrhythmias (control group). Written informed consent was taken from all patients who underwent the procedure, and in the absence of contact with the patient decision to perform temporary cardiac pacing was made by a council of physicians.Results.. Spontaneous pacing interruption occurred in 13 patients of the main group and 32 control group patients at various times of the artificial pacing. Thanks to the used original electrode constructional features, fatal cases were prevented in 11 (84.6%) patients of the main group. In 9 of 32 patients of the control group with impaired pacemaker, cardiac pacing was restored by the electrode re-fixation to the heart right ventricular endocardium. In 23 patients of the control group artificial rhythm was restored by the method of endocardial electrode reposition. The number of patients with a spontaneous interruption of temporary artificial heart rhythm control had a strong correlation with the number of patients with the identified new changes in the electrocardiogram (ST segment elevation with acute recurrent myocardial infarction; r=0.84, pConclusion. In case of spontaneous interruption of temporary cardiac pacing caused by the loss of myocardial electrical conduction function in the area of the contact with the electrode, for effective and safe fatal cases prevention endocardial electrodes of the original design use is recommended.


2018 ◽  
Vol 07 (08) ◽  
pp. 476-481
Author(s):  
Amanollah Heidari ◽  
Mohammad Nourizadeh ◽  
Mohammad Hossein Najafi ◽  
Sara Nourizadeh ◽  
Najmeh Assadinia

Kardiologiia ◽  
2019 ◽  
Vol 59 (6) ◽  
pp. 86-90
Author(s):  
M. N. Baranova ◽  
M. Yu. Ogarkov ◽  
A. E. Skripchenko ◽  
F. N. Chavdar ◽  
A. Yu. Yankin ◽  
...  

Arrhythmogenic dysplasia of the right ventricle is a rare pathology of the myocardium, the diagnosis of which is difficult. Isolated myocardial infarction of the right ventricle occurs and is diagnosed extremely rarely. In this article we describe a case of arrhythmogenic right ventricular dysplasia, complicated by transmural infarction of the anterolateral wall of the right ventricle, myocardial rupture, and cardiac tamponade.


2014 ◽  
Vol 45 (3) ◽  
pp. 680-690 ◽  
Author(s):  
Stefan Buchner ◽  
Michael Eglseer ◽  
Kurt Debl ◽  
Andrea Hetzenecker ◽  
Andreas Luchner ◽  
...  

Structural and functional integrity of the right heart is important in the prognosis after acute myocardial infarction (AMI). The objective of this study was to assess the impact of sleep disordered breathing (SDB) on structure and function of the right heart early after AMI.54 patients underwent cardiovascular magnetic resonance 3–5 days and 12 weeks after AMI, and were stratified according to the presence of SDB, defined as an apnoea–hypopnoea index of ≥15 events·h−1.12 weeks after AMI, end-diastolic volume of the right ventricle had increased significantly in patients with SDB (n=27)versusthose without (n=25) (mean±sd14±23%versus0±17%, p=0.020). Multivariable linear regression analysis accounting for age, sex, body mass index, smoking, left ventricular mass and left ventricular end-systolic volume showed that the apnoea–hypopnoea index was significantly associated with right ventricular end-diastolic volume (B-coefficient 0.315 (95% CI 0.013–0.617); p=0.041). From baseline to 12 weeks, right atrial diastolic area increased more in patients with SDB (2.9±3.7 cm2versus1.0±2.4 cm2, p=0.038; when adjusted for left ventricular end systolic volume, p=0.166).SDB diagnosed shortly after AMI predicts an increase of right ventricular end-diastolic volume and possibly right atrial area within the following 12 weeks. Thus, SDB may contribute to enlargement of the right heart after AMI.


1991 ◽  
Vol 1 (2) ◽  
pp. 105-113 ◽  
Author(s):  
Robert H. Anderson ◽  
Christine Anderson ◽  
James R. Zuberbuhler

SummaryAtresia of the outflow tract of the right ventricle in the presence of an intact ventricular septum poses major problems for surgical management. In the light of known problems, 43 autopsied hearts with this congenital abnormality were evaluated to note the arrangement of the myocardium and the cavity of the right ventricle, the state of the tricuspid valve, the precise substrate for pulmonary atresia, and the presence offistulous communications between the ventricular cavity and the coronary arteries. The specimens could be divided into two groups. The first group (38 hearts) had hypoplasia of the cavity of the right ventricle with mural hypertrophy while the second group (5 hearts) had a dilated right ventricular cavity with thinning of the wall. The larger group could be divided into two subgroups on the basis of the substrate for pulmonary atresia. Twenty hearts had muscular atresia of the right ventricular outflow tract and 18 had a potentially patent outflow tract blocked by an imperforate pulmonary valve. A comparison of these two subgroups revealed that mural hypertrophy and cavitary hypoplasia were more severe in hearts with muscular atresia. The tricuspid valve was hypoplastic and its leaflets were not dysplastic in this group but the leaflets were dysplastic in hearts with valvar pulmonary atresia. Fistulous communications between the ventricular cavity and the coronary arteries were only seen in the cases with muscular atresia. In this series, recognition of muscular pulmonary atresia would have identified those patients with the worst surgical prognosis.


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