scholarly journals Relationship of NT-ProBNP and pacemaker parameters in patients with sick sinus syndrome?

2021 ◽  
Vol 35 ◽  
pp. 243-247
Author(s):  
Pham Nhu Hung ◽  
Truong Quang Viet
Keyword(s):  
Sick Sinus Syndrome ◽  
Pacing Threshold ◽  
Ventricular Lead ◽  
Relationship Of

Objectives: NT-ProBNP could influence the pacemaker parameters in patients with sick sisnus syndrome? Methods and Results: 93 patients with sick sinus syndrome were implanted 2 chambers pacemaker with mean aged 61,19±14,95 years old and 37,6% of male. The pacemaker parameters of ventricular lead include: Pacing thresholds were measured 0.75 ± 0.17 V, sensing amplitudes were measured 9,93 ± 4.01 mV, and lead impedances were measured 710,06 ± 130,86 ᾨ. The pacemaker parameters of atrial lead include: Pacing thresholds were measured 1,06 ± 0,29 V, sensing amplitudes were measured 2,58 ± 1,23 mV, and lead impedances were measured 509,13 ± 69,22 ᾨ. There is not significantly relationships of NT-ProBNP and pacemaker parameters of ventricular lead, atrial lead impedance, atrial lead sensing amplitudes (p>0,05). However, there is significantly relationship of NT-ProBNP and atrial lead pacing threshold (r=0,34; p=0,003). Conclusion: There is significantly relationship of NT proBNP and atrial lead pacing threshold in patients with sick sinus syndrome who were implanted the pacemaker.

scholarly journals Left bundle branch pacing: efficacy and safety compared to right ventricular outflow tract pacing

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Riano Ondiviela ◽  
M Cabrera Ramos ◽  
JR Ruiz Arroyo ◽  
J Ramos Maqueda
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Ejection ◽  
Pacing Threshold ◽  
Ventricular Ejection Fraction ◽  
Ventricular Lead ◽  
Qrs Duration

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients with preserved left ventricular ejection fraction (LVEF) and atrioventricular block (AVB) who are anticipated for high-burden of right ventricular (RV) pacing possess a risk to develop pacing-induced cardiomyopathy and adverse clinical outcomes. Left bundle branch pacing (LBBP) has recently emerged as a mode of conduction system pacing in the quest for physiological pacing. Purpose The aim of our study was to assess LBBP feasibility and safety compared to right ventricular outflow tract pacing (RVOTP). Methods Single centre randomized clinical trial to investigate acute success, feasibility and safety of LBBP versus RVOTP. May to October 2020. Patients with pacemaker indication and preserved LVEF were randomized 1:1 and followed up 3 months. Success was defined in LBBP group as a paced ECG < 120ms or with a 20% length reduction from the basal ECG. Results 120 patients were randomized, 60 in each group, 61% males. The mean age was 77,9 ± 9 years and third-degree AVB was the main pacing indication. The procedure was successful in 95% of the cases in both groups (p = 1). The paced QRS interval was narrower in the LBBP group compared to the RVOT group (99 ± 2 ms vs 113,6 ± 11,7 ms, p < 0,001). Lower fluoroscopy times were achieved in LBBP group (3.1 ± 2.1 min vs 4.3 ± 3.4, p = 0,035) and also longer procedure times in LBBP group (68,9 ± 36,9 min vs 44,3 ± 18,7 min, p < 0,001). No complications were achieved and no difference in ventricular lead dislocation was found between both groups (1.6% vs 1.6%)(p = 1). Conclusions LBBP is feasible, safe and provides a narrower paced QRS compared to RVOTP. LBBP required lower fluoroscopy times but longer procedure times compared to RVOTP. LBBP (n = 60) RVOTP (n = 60) p Age (mean ± SD) 76,7 ± 9 79,7 ± 8 0,067 Male gender 62 (37) 60 (36) 1 Successful procedure 95 (57) 95 (57) 1 Basal left bundle branch block 15 (9) 13 (8) Basal QRS duration (mean ± SD) 112,6 ± 29,6 109,9 ± 25,8 0,59 Pacing QRS duration (min)(mean ± SD) 99 ± 2 139,6 ± 11,7 < 0,001 Procedure time (min) (mean ± SD) 68,9 ± 36,9 44,3 ± 18,7 < 0,001 Fuoroscopy time (min)(mean ± SD) 3.1 ± 2.1 4.3 ± 3.4 0,035 R wave (mV)(mean ± SD) 9,9 ± 5,7 9,9 ± 5 0,98 Right ventricle pacing threshold (V)(mean ± SD) 0,67 ± 0,3 0,58 ± 0,24 0,08 Ventricular lead dislocation 1.6 (1) 1.6 (1) 1

scholarly journals Interpret The Synergistic Mechanism of Shenfu Decoction in Treating Sick Sinus Syndrome From the Perspective of Systematic Pharmacology

2020 ◽  
Author(s):  
Yihua Li ◽  
Zhiyun Luo ◽  
Yupeng Chen ◽  
Kexin Wang ◽  
Yi Li ◽  
...  
Keyword(s):  
Molecular Docking ◽  
Signaling Pathway ◽  
Sick Sinus Syndrome ◽  
Target Function ◽  
Pharmacokinetic Parameters ◽  
Active Components ◽  
Therapeutic Mechanisms ◽  
Relationship Of ◽  
Functional Components ◽  
Synergistic Relationship

Abstract Introduction: Sick sinus syndrome (SSS) is a common cardiovascular disease without available oral drugs for a long-term routine treatment, which can be treated by Shenfu Decoction (SFD) according to Traditional Chinese Medicine (TCM) clinical applications. The purpose of this research is to decode the therapeutic mechanisms of SFD in treating SSS as well as interpret the synergistic relationship of herbs in SFD through the method of systematic pharmacology.Methods: We established a novel systematic pharmacological model, which integrate pharmacokinetic parameters, pharmacological data and network topology analysis, to effectively screen the key components of SFD. Based on the key components, gene ontology, pathway enrichment and molecular docking were used to clarify and validate the therapeutic mechanisms of SFD in treating SSS and the synergistic relationship of herbs in SFD. Results: Through our proposed mathematical model, we retrieved 55 components which were defined as synergistic functional components group (SFCG) from 209 potential active components of SFD screened by ADME parameters. Pathway analysis of SFCG targets indicated that RS and FZ could synergistically target to neuroactive ligand-receptor reaction, cAMP signaling pathway, calcium signaling pathway, PI3K-Akt signaling pathway, Rap1 signaling pathway and other pathways to treat SSS. Additionally, molecular docking analysis showed that the average affinity of SFCG and targets involved in the key pathways reached -6.36 kcal/mmol, validating the synergistic effect of RS and FZ in treating SSS.Conclusions: The therapeutic effect of SFD on SSS may be due to its functions of regulating ion channel function, signal transduction and energy metabolism. Besides, we found that the synergistic relationship between RS and FZ can be described at the levels of target, function and pathway.

Experimental studies on sick sinus syndrome: Relationship of extent of right atrial lesions to subsidiary pacemaker shift and its function

1983 ◽  
Vol 105 (4) ◽  
pp. 593-602 ◽  
Author(s):  
Shinichi Ishikawa ◽  
Ken Sawada ◽  
Yoshihumi Tanahashi ◽  
Jitsuki Tsuzuki ◽  
Masao Hattori ◽  
...  
Keyword(s):  
Sick Sinus Syndrome ◽  
Experimental Studies ◽  
Right Atrial ◽  
Pacemaker Shift ◽  
Relationship Of

scholarly journals Long-Term Technical Performance of the Osypka QT-5® Ventricular Pacemaker Lead

2021 ◽  
Vol 10 (4) ◽  
pp. 639 ◽  
Author(s):  
Georg Semmler ◽  
Fabian Barbieri ◽  
Karin Thudt ◽  
Paul Vock ◽  
Deddo Mörtl ◽  
...  
Keyword(s):  
High Rate ◽  
Pacing Threshold ◽  
Technical Performance ◽  
Cardiac Implantable Electronic Devices ◽  
Kaplan Meier ◽  
Ventricular Lead ◽  
Long Term Follow Up ◽  
Technical Issues

Background: Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature. Methods: All patients undergoing implantation of the Osypka QT-5® ventricular lead at the University Clinic St. Pölten between 1 January 2006 and 31 December 2012 were retrospectively analyzed (n = 211). Clinical data including pacemaker follow-up examinations and the need for lead revisions were assessed. Kaplan–Meier analysis to estimate the rate of lead dysfunction during long-term follow-up was conducted. Results: Patients were followed for a median of 5.2 years (interquartile range (IQR) 2.0–8.7). R-wave sensing properties at implantation, compared to last follow-up, remained basically unchanged: 9.9 mV (IQR 6.8–13.4) and 9.6 mV (IQR 5.6–12.0), respectively). Ventricular pacing threshold significantly increased between implantation (0.5 V at 0.4 ms; IQR 0.5–0.8) and the first follow-up visit (1.0 V at 0.4 ms; IQR 0.8–1.3; p < 0.001) and this increase persisted throughout to the last check-up (0.9 V at 0.4 ms; IQR 0.8–1.2). Impedance significantly declined from 1142 Ω (IQR 955–1285) at implantation to 814 Ω (IQR 701–949; p < 0.001) at the first check-up, followed by a further decrease to 450 Ω (IQR 289–652; p < 0.001) at the last check-up. Overall, the Osypka QT-5® ventricular lead was replaced in 36 patients (17.1%). Conclusions: This report shows an unexpected high rate of technical issues of the Osypka QT-5® ventricular lead during long-term follow-up.

scholarly journals Implantation of DDD Pacemaker in a Patient With Dextrocardia and Sick Sinus Syndrome: A Case Report

2021 ◽  
Author(s):  
Junqian Luo ◽  
Zihao Zhou ◽  
Kaicong Chen ◽  
Junyao Lin ◽  
Chaogeng Cai ◽  
...  
Keyword(s):  
Main Part ◽  
Sick Sinus Syndrome ◽  
Holter Monitoring ◽  
Mirror Image ◽  
Pacing Threshold ◽  
Case Presentation ◽  
X Ray ◽  
Active Fixation ◽  
The Right ◽  
Electrocardiogram Ecg

Abstract Background: Dextrocardia is a congenital abnormal position of the heart in which the main part of the heart is in the right chest and the long axis of the heart points to the lower right, cases with combination of dextrocardia and sick sinus syndrome are rare.Case presentation: A 65-year-old female patient was admitted with palpitations and dizziness for 1 week. Mirror-image Dextrocardia and sick sinus syndrome was diagnosed by electrocardiogram (ECG), echocardiography, Holter monitoring, and X-ray. The rarity of the case and the specificity of anatomy brought great challenges to our interventional treatments. Finally, we successfully implanted a DDD pacemaker into the patient.Conclusion: For dextrocardia, using active fixation leads in both atrial and ventricular leads is easier to find the position with optimal sensing and pacing threshold, which also have a lower and more stable pacing threshold and can reduce the incidence of falling off at the same time. During operation, combine the multiple positions under fluoroscopy to confirm the leads position, which can improve the success rate of implantation.

Robotic-Assisted or Minithoracotomy Incision for Left Ventricular Lead Placement a Single-Surgeon, Single-Center Experience

2012 ◽  
Vol 7 (3) ◽  
pp. 208-212 ◽  
Author(s):  
Castigliano Murthy Bhamidipati ◽  
Igor W. Mboumi ◽  
Keri A. Seymour ◽  
Roberta Rolland ◽  
Karikehalli Dilip ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Patient Characteristics ◽  
Left Ventricular ◽  
Tactile Feedback ◽  
Pacing Threshold ◽  
Robotic Assisted ◽  
Single Center Experience ◽  
Epicardial Lead ◽  
Lead Placement ◽  
Ventricular Lead

Objective Left ventricular (LV) resynchronization with epicardial lead placement after failed coronary sinus cannulation can be achieved with minimally invasive robotic-assisted (RA) or minithoracotomy (MT) incisions. We evaluated early outcomes and costs after RA and MT epicardial LV lead implantation at our academic center. Methods From 2005 to 2010, 24 patients underwent minimally invasive RA or MT epicardial LV lead placement for resynchronization. Patient characteristics, electrophysiologic features, outcomes, and costs were analyzed. Results Ten patients underwent RA and 14 underwent MT minimally invasive LV lead placement, with no 30-day mortality in either group. Younger patients underwent RA epicardial lead placement (63.8 ± 15.4 vs 75.6 ± 10.0 years; P = 0.03). In addition, although both groups had comparable body surface areas, RA patients had significantly higher body mass index versus MT patients (44.4 ± 17.5 vs 26.9 ± 7.1 kg/m2, respectively; P = 0.003). Premorbid risk and cardiovascular profiles were similar across groups. Importantly, pacing threshold, impedance, and postoperative QRS interval were equivalent between groups. Significantly, both operating room and mechanical ventilation durations were higher with RA epicardial placement (P < 0.001). Despite equivalent outcomes, incision-to-closure interval was 48 minutes shorter with MT (P = 0.002). Absolute differences in direct costs between groups were negligible. Despite these differences, resource utilization and lengths of stay were equivalent. Conclusions Epicardial LV lead placement is efficacious with either approach. Early outcomes and mortality are equivalent. Greater tactile feedback during operation and equivalent short-term outcomes suggest that MT minimally invasive LV lead placement is the more favorable approach for epicardial resynchronization.

scholarly journals 616 Endocardial lead placement guided by high resolution voltage mapping in a patient with recurrent failure of transvenous pacing system

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Paolo Vitillo ◽  
Francesca Esposito ◽  
Francesco Rotondi ◽  
Felice Nappi ◽  
Francesco Urraro ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Progressive Increase ◽  
The Other ◽  
Electrical Parameters ◽  
Pacing Threshold ◽  
Lead Placement ◽  
Voltage Mapping ◽  
Ventricular Lead ◽  
Mapping Catheter

Abstract Methods and results A 58 years-old man was admitted to our intensive care unit for syncope due to inconstant capture of epicardial ventricular lead. His cardiovascular history began 20 years before when he underwent single chamber pacemaker implantation with insertion of a passive fixation ventricular lead for symptomatic complete atrio ventricular block (AVB). Electrical parameters were good at implantation. However, during follow-up a gradual and progressive increase of pacing threshold occurred, with no changes in impedance values, finally leading to complete loss of ventricular capture. Hence, 2 years later, the lead was extracted and a new transvenous ventricular lead was placed in septal position. All electrical parameters were optimal at the end of the procedure. However, in the following months threshold values gradually increased as previously observed. The referring clinicians decided to surgically extract both the device and transvenous lead and to implant an epicardial ventricular lead connected to an abdominal generator. The pacemaker worked properly for about 17 years until he was transferred to our institution with evidence of inconstant lead capture at maximum pacing outputs. A temporary transvenous pacemaker was immediately inserted. Clinical examination, laboratory exams, and echocardiography were normal. Cardiac magnetic resonance (MRI) was not feasible due to the epicardial lead. Thus, in order to obtain cardiac substrate characterization, we decided to perform high density multielectrode voltage mapping of the right ventricular endocardium with HD Grid multielectrode mapping catheter (HD Grid mapping catheter sensor enabled, Abbott Technologies, Minneapolis, MN). Electroanatomic voltage map allows distinction of areas of healthy myocardium (&gt;1.5 mV) from scar tissue (&lt;0.5 mV). Unexpectedly, voltage mapping highlighted no scar zones, showing a globally normal endomyocardial surface. Therefore, a new endocavitary pacemaker was inserted in right prepectoral region and an active fixation right ventricular lead was placed on mid-ventricular septum. A backup pacing lead was placed in a more apical position in an area of endocardial healthy myocardium. Post-procedural sensing, impedance and capture threshold were optimal (0.3 V × 0.4 ms for mid-septal lead and 0.3 × 0.4 ms for the other one). At 1 month follow-up mid-septal lead’s threshold was slightly increased (1.0 V × 0.4 ms) and further increase was observed at 3-month outpatient visit (1.75 V × 0.4 ms). Capture threshold of the other lead and other parameters were stable. The patient received remote monitoring for home surveillance of the implanted system. Home monitoring shows a trend toward a progressive increase of pacing threshold of the mid-septal lead and stable value of the other electrode. Conclusions The present report suggests an innovative use of high-density mapping with HD Grid catheter to characterize endocardial right ventricular myocardium in a patient with contraindication to cardiac MRI and recurrent failure of previous implanted pacing systems for unknown reason and to guide effective lead placement in areas of normal endocardial voltage. Combined use of telemedicine and high-resolution mapping technique allowed us to avoid unnecessary high risk reintervention for novel epicardial lead placement.

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