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1.
Health Qual Life Outcomes ; 17(1): 152, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604454

RESUMO

BACKGROUND: Little is known about health-related quality of life (HRQoL) in pediatric patients with cardiac rhythm devices. This study aims to compare self- and proxy-reported HRQoL in patients with pacemaker (PM) and implantable cardioverter-defibrillator (ICD) to that in sex- and age-matched healthy controls and to examine predictors for generic and disease-specific HRQoL. METHODS: The study included 72 PM and ICD patients (39% females) and 72 sex- and age-matched healthy controls from 3 to 18 years of age. HRQoL data was obtained by the PedsQL 4.0 Generic Core Scales and Pediatric Cardiac Quality of Life Inventory. Medical data was collected retrospectively from medical records. RESULTS: Patients had significantly lower self- and proxy-reported generic overall HRQoL and lower physical health than healthy controls, and ICD patients also had lower psychosocial health. On multivariate analyses, generic overall HRQoL and physical health was significantly predicted by current cardiac medication (ß = -.39, p = .02 for overall HRQoL, respectively ß = -.44, p = .006 for physical health). Disease-specific overall HRQoL was only marginally predicted by child age, device type, and the presence of a structural congenital heart disease (p < .10). CONCLUSIONS: This study shows that PM and ICD patients have lower HRQoL than healthy controls and that patients who need cardiac medication are seen by their parents at great risk for lower generic overall HRQoL. Our study also indicates a trend towards higher risk for low disease-specific HRQoL in younger patients, ICD patients, and patients with a structural congenital heart disease. Special attention should be given to these patients as they may benefit from a timely clinical evaluation in order to provide supportive interventions.


Assuntos
Desfibriladores Implantáveis/psicologia , Marca-Passo Artificial/psicologia , Qualidade de Vida , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Cardiopatias Congênitas/psicologia , Humanos , Masculino , Procurador , Estudos Retrospectivos
2.
Kyobu Geka ; 72(11): 928-930, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31588111

RESUMO

We report a case of surgical treatment of iatrogenic right ventricular perforation. An 86-year-old woman with sick sinus syndrome was treated by insertion of transvenous electrode catheters. She was transferred to our hospital due to chest pain 9 days after the insertion. We found the ventricular electrode catheter had perforated the right ventricle by computed tomography (CT). This perforated lesion was repaired under beating heart using 2-0 monofilament mattress sutures reinforced by felt pledgets. The perforation may have occurred because the apex portion of the right ventricle was fragile. Iatrogenic cardiac trauma is rare, and prompt recognition and treatment are essential.


Assuntos
Traumatismos Cardíacos , Marca-Passo Artificial , Idoso de 80 Anos ou mais , Cateteres , Dor no Peito , Feminino , Ventrículos do Coração , Humanos
3.
S D Med ; 72(9): 393-395, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31581374

RESUMO

Glossopharyngeal neuralgia is an underreported condition characterized by discomfort elicited through involvement of the ninthcranial nerve. Triggering phenomena and associated vagal nerve involvement creates the potential for an unexpected clinical presentation. In this case report, we present a 60-year-old male who described a shock-like pain throughout his neck and jaw. The patient initially responded to carbamazepine but the clinical course was complicated by cardiac pauses with syncope requiring pacemaker implantation. Failure of pharmacologic treatment led to surgical intervention.


Assuntos
Analgésicos não Entorpecentes , Carbamazepina , Doenças do Nervo Glossofaríngeo , Neuralgia , Analgésicos não Entorpecentes/uso terapêutico , Carbamazepina/uso terapêutico , Nervo Glossofaríngeo , Doenças do Nervo Glossofaríngeo/diagnóstico , Doenças do Nervo Glossofaríngeo/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial , Síncope
9.
Int. j. cardiovasc. sci. (Impr.) ; 32(5): 492-504, Sept-Oct. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1040093

RESUMO

Transcatheter aortic valve implantation (TAVI) has become a therapeutic option for high-risk or non-operable patients with severe symptomatic aortic stenosis. Atrioventricular conduction disturbances requiring permanent pacemaker (PPM) are a common and clinically important complication. Objectives: To evaluate the incidence of conduction disorders (CDs) after TAVI and the need for subsequent PPM implantation. To identify the predictors of postoperative PPM implantation. Methods: Retrospective study. All patients who underwent TAVI in a public hospital from December/2011 to June/2016 were included. Multivariate analysis was conducted to establish the predictor of permanent pacemaker implantation. Survival curves were constructed by the Kaplan-Meyer method. Statistically significant variables were those with p value < 0.05. Results: 64 patients with AS underwent TAVI. Eleven patients were excluded. TAVI induced a new CD in 40 (77%) of the remaining 53 patients. The most common new CDs were 3rd degree AV block (32%) and left bundle branch block (30%). Sixteen patients (30,2%) underwent PPM implantation during the index hospitalization. On univariate analysis the risk factors for PPM implantation were CoreValve® use (OR: 1,76; P = 0,005), larger prosthesis implantation (P = 0,015), presence of a QRS ≥ 120 ms (OR: 5,62; P = 0,012), and 1st degree AV block (OR: 13; P = 0.008). On multivariate analysis the presence of 1st degree AV block predicted the need for PPM. Conclusion: TAVI induced CDs requiring PPM in 30% of the patients. The presence of 1st degree AV block predicted the need for PPM


Assuntos
Humanos , Masculino , Feminino , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/terapia , Marca-Passo Artificial , Bloqueio de Ramo , Substituição da Valva Aórtica Transcateter/métodos , Valva Aórtica , Volume Sistólico , Ecocardiografia/métodos , Análise Estatística , Análise Multivariada , Estudos Retrospectivos , Fatores de Risco , Bloqueio Atrioventricular
12.
Zhonghua Xin Xue Guan Bing Za Zhi ; 47(9): 737-741, 2019 Sep 24.
Artigo em Chinês | MEDLINE | ID: mdl-31550846

RESUMO

Objective: To explore the feasibility and safety of a newly developed simple and rapid axillary vein puncture technique based on the surface landmarks for pacemaker implantation. Methods: From January to November 2018, we enrolled 110 patients who underwent pacemaker implantation in Beijing Anzhen Hospital. Basic clinical characteristics, such as gender, age, major diagnosis, type of pacemaker, and His-purkinje system pacing, were collected. The success rate of this axillary vein puncture technique, complications, and technical parameters of present puncture method were analyzed. Results: There were 58 (52.7%) male patients in this cohort and the average aged was (70.26±10.45) years old. This "blind" axillary vein puncture method was successful in 105 out of 110 patients (95.5%). The relevant puncture-related parameters included: the distance between points "a and b" was (3.89±0.40) cm, the first angle α was (25.84±5.54)° and the second angle ß was (66.18±10.26)°. There were no puncture-related complications, such as hematoma, pneumothorax and hemothorax. Conclusion: The new "blind" axillary vein puncture approach is a simple, effective and safe technique for pacemaker implantation, which is easy to learn and practice and suitable for promotion.


Assuntos
Veia Axilar , Marca-Passo Artificial , Implantação de Prótese , Punções/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Flebografia
14.
Cancer Radiother ; 23(6-7): 708-715, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31477442

RESUMO

Stereotactic radiation therapy of brain metastases is a treatment recognized as effective, well tolerated, applicable for therapeutic indications codified and validated by national and international guidelines. However, the effectiveness of this irradiation, the evolution of patient care and the technical improvements enabling its implementation make it possible to consider it in more complex situations: proximity of brain metastases to organs at risk; large, cystic, haemorrhagic or multiple brain metastases, combination with targeted therapies and immunotherapy, stereotactic radiotherapy in patients with a pacemaker. This article aims to put forward the arguments available to date in the literature and those resulting from clinical practice to provide decision support for the radiation oncologists.


Assuntos
Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Irradiação Craniana/métodos , Órgãos em Risco , Radiocirurgia/métodos , Neoplasias Encefálicas/patologia , Tronco Encefálico , Hemorragia Cerebral/complicações , Terapia Combinada/métodos , Contraindicações de Procedimentos , Humanos , Imunoterapia , Imagem por Ressonância Magnética/efeitos adversos , Terapia de Alvo Molecular , Nervo Óptico , Marca-Passo Artificial , Carga Tumoral
15.
Pan Afr Med J ; 33: 107, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31489085

RESUMO

Twiddler's syndrome is a rare but potentially lethal complication of pacemaker implantation. It is usually diagnosed within 1 year after implantation. It is characterized by device malfunction caused by pacemaker lead displacement due to twisting of the box on part of the patient. Twiddler's syndrome has been described by in 1968 as a complication of pacemaker implantation. It has also been reported after defibrillator implantation and cardiac resynchronization therapy. We here report the case of a 89-year old female patient admitted with Twiddler's syndrome leading to pacemaker malfunction secondary to pacemaker lead displacement. She underwent lead repositioning and received appropriate advice.


Assuntos
Falha de Equipamento , Marca-Passo Artificial/efeitos adversos , Idoso de 80 Anos ou mais , Feminino , Humanos , Síndrome
16.
Kyobu Geka ; 72(9): 712-715, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31506415

RESUMO

A 5-year-old girl has a history of epicardial VVI-pacemaker implantation due to congenital heart block at the age of 2 months. Five years later, she developed heart failure at the same time of battery depletion. The chest X-ray indicated the loop formation of the epicardial leads and the echocardiogram demonstrated paradoxical movement of ventricles. The 3-dimensional computed tomography finally revealed strangulation of biventricular apex caused by loop of the leads. She underwent reoperation. Cardiac strangulation was relieved by total removal of the loop and repositioning of right atrial and ventricular electrodes in a gentle curve of the leads. She was discharged and doing well. Cardiac strangulation is a rare, but it can be lethal. Therefore epicardial pacemaker leads should not be positioned around the ventricle with excessive redundancy.


Assuntos
Insuficiência Cardíaca , Marca-Passo Artificial , Pré-Escolar , Feminino , Átrios do Coração , Bloqueio Cardíaco , Insuficiência Cardíaca/etiologia , Ventrículos do Coração , Humanos , Marca-Passo Artificial/efeitos adversos
17.
Lakartidningen ; 1162019 Aug 13.
Artigo em Sueco | MEDLINE | ID: mdl-31408188

RESUMO

Atrial high rate episodes (AHRE) are frequently detected in patients with pacemakers or implantable cardioverter defibrillators. AHRE episodes ≥5 minutes are associated with increased risk of ischemic stroke. There is no clear temporal relationship between AHRE and ischemic stroke, therefore atrial arrhythmia could be suspected to at least in part be a risk marker and not solely a direct cause of stroke. No results have been published on the effect of anticoagulation in patients with AHRE, but several studies are in progress. The European Heart Rhythm Association (EHRA) recommends anticoagulation for patients with AHRE ≥5.5 hours per day and a CHA2DS2-VASc score of ≥2 (≥3 in females). Anticoagulation may be considered for CHA2DS2-VASc scores of 1 (2 in females). In patients with several risk factors anticoagulation should be considered also in cases with shorter duration of AHRE.


Assuntos
Fibrilação Atrial/complicações , Desfibriladores Implantáveis , Marca-Passo Artificial , Acidente Vascular Cerebral/etiologia , Taquicardia/complicações , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/tratamento farmacológico , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto , Fatores de Risco , Acidente Vascular Cerebral/prevenção & controle , Taquicardia/diagnóstico , Taquicardia/tratamento farmacológico
18.
Med Clin North Am ; 103(5): 767-774, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378323

RESUMO

This article represents an overview of the basic concepts of cardiac electrophysiology. This relatively new field became a subspecialty of cardiology in the mid-1990s due to the rapid development of equipment that allowed the study and cure of cardiac arrhythmias percutaneously. Simultaneously, technology provided the field with percutaneous cardiac implantable electronic devices designed to protect patients from life-threatening bradyarrhythmias and tachyarrhythmias. Recently, the field has focused on the ablative treatment of atrial fibrillation, the most common arrhythmia facing an aging population, and the diagnosis and management of many inherited arrhythmias through advances in understanding of their genetic cause.


Assuntos
Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Eletrocardiografia , Fenômenos Eletrofisiológicos , Humanos , Marca-Passo Artificial , Ablação por Radiofrequência
19.
Med Clin North Am ; 103(5): 897-912, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378333

RESUMO

In this article, the authors review the different types of sinus node and atrioventricular node diseases that lead to bradyarrhythmias with their associated symptoms, the diagnostic investigations needed to assess the degree of disease, and the therapeutic management, including the indications for permanent pacing.


Assuntos
Bradicardia/terapia , Estimulação Cardíaca Artificial/métodos , Humanos , Marca-Passo Artificial
20.
Med Clin North Am ; 103(5): 931-943, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378335

RESUMO

Cardiac implantable electronic devices (CIEDs) provide lifesaving therapy for the treatment of bradyarrhythmias, ventricular tachyarrhythmias, and advanced systolic heart failure. Advances in CIED therapy have expanded the number of patients receiving permanent pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices. These devices improve quality of life and, in many cases, reduce mortality. However, limitations remain in the management of patients who require CIED therapy. This article provides a broad overview of CIED therapy in the management of the cardiac patient.


Assuntos
Bradicardia/terapia , Terapia de Ressincronização Cardíaca/métodos , Insuficiência Cardíaca Sistólica/terapia , Taquicardia Ventricular/terapia , Dispositivos de Terapia de Ressincronização Cardíaca , Desfibriladores Implantáveis , Humanos , Marca-Passo Artificial , Qualidade de Vida
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