Permanent Ventricular Pacing for Symptomatic Bradycardia Patients at Maharat Nakhon Ratchasima Hospital: One-Year Experience
Article Sidebar
Main Article Content
Abstract
Background: Permanent pacemaker implantation was the main therapy for bradyarrhythmic patients with associated symptoms related to bradycardia. The relative ease and low risk of implantation make them an attractive choice for the treatment of symptomatic bradycardia.
Objective: To report the experience of implantation of cardiac permanent pacemaker at the Cardiovascular Disease Center, Maharat Nakhon Ratchasima Hospital.
Materials and methods: We performed permanent pacemaker implantation during June, 2001 and May, 2002 in 31 symptomatic bradycardia patients with ventricular pacing mode (VVI) at cardiac catheterization laboratory. The permanent pacemaker was implanted by inserting the pacing lead via subclavian vein by venipuncture and pulse generator was implanted subcutaneously at the left pectoral region.
Results: Thirty-one symptomatic bradycardia patients were implanted with ventricular pacing permanent pacemaker, most patients were females (12 males, 19 females) with mean age of 62.87±14.45 years. Most patients had symptoms of fatigue and up to 50% had syncope at presentation. Electrocardiograms (ECGs) were recorded in all patients. Most patients had third degree atrio-ventricular (AV) block (77.4%) and the remaining ECGs were sinus node dysfunction (20%). Cardiac pacemaker implantation were successfully performed in all patients with no immediate complication. Lead parameter at implantation were as follows: threshold 0.3-0.7 V, (mean 0.5 V), lead impedance 520-1,470 Ohms (mean 827 Ohms), and R wave 3.8-27.3 mV (mean 11 mV). There were two complications during follow up, one patient with infected pacemaker 3 months after implantation and the other one with lead displacement 1 week after implantation. Both of them were successfully treated.
Conclusion: Pacemaker implantation is intended to free the patient from health-related limitations. It is the main treatment of symptomatic bradycardia and can be performed easily with minimal complication.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Zoll PM. Resuscitation of the heart in ventricular standstill by external electrical stimulation. N Engl J Med 1952; 247:768.
Furman S, Schweidel JB. An intracardiac pacemaker for for Strokes-Adams seizures. N Engl J Med 1959,261:943.
Gregoratos G, Cheitlin MD,Conil A, etal. ACC/AHA guidelines for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation). Am Coll Cardiol 1998;31:1175-209.
Alboni P, Menozzi C, Brignole M, et al. Efts of permanent paceemaker and oral theophylline in sick simus syndrome: The THEOPACE study: a randomized controlled trial. Circulation 1997;9:260-6.
Lamas GA, Pashos CL, Normand SLT, et al. Permanent pacemaker selection and subsequent survival in elderly Medicare pacemaker recipients. Cinculation 1995;91:1063-9.
Myerburg RJ,Kloosterman EM, Castellanos A.Recognition, clinical assessment and management of arrhythmias and conduction disturbances. In: Fuster V, Alexander RW, O'Rourke RA, editors. Hurst's the heart. 10th ed. New York: McGraw-Hill; 2001. p.797-874.
Dhingra RC, Denes P, Wu D, etal. The significant second degree atrioventricular block and bundle branch block: observations regarding site and type of block. Circulation 1976;49:638.
Stamato NJ, O'Toole MF,Enger EL. Permanent pacemaker implantation in the cardiac catheterization labolatory versus the operating room: An analysis of hospital charges and complications. PACE 1992;15:2236-9.
Yamamura KH, Kloostrman EM, Alba J, et al. Analysis of charges and complications of permanent pacemaker implantation in the cardiac caltheterization laboratory versus operating room. PACE 1999;22:1820-4.
Phibbs B, Marriott HJL. Complication of permanent transvenous pacing. N Engl J Med 1985;312:1428.
Mueller X,Sadeghi H,Kappenberger L. Complications after single versus dual chamber pacemakerimplantation. Pacing Clin Electrophysiol 1990;13:711.
Smith TW, Chen I,Epstein LM, Implantable devices for the treatment of cardiac arrbythmia. In: Baim DS, Grossman W,editors. Grossman's cardiac catheterization, angiography, and intervention. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 498-546.