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1.
Nursing ; 50(2): 24-29, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31904617

RESUMO

Historically, MRI was contraindicated in patients with cardiovascular implantable electronic devices because the devices' metallic components made this imaging study unsafe. Advances over the last decade have now made MRI safe for many of these patients. This article examines the risks of MRI technology for this patient population and reviews recent guidelines from the Heart Rhythm Society.


Assuntos
Desfibriladores Implantáveis , Imagem por Ressonância Magnética/normas , Marca-Passo Artificial , Segurança do Paciente/normas , Desfibriladores Implantáveis/efeitos adversos , Humanos , Imagem por Ressonância Magnética/efeitos adversos , Imagem por Ressonância Magnética/enfermagem , Marca-Passo Artificial/efeitos adversos
2.
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
3.
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
5.
Braz J Cardiovasc Surg ; 34(4): 458-463, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31454200

RESUMO

INTRODUCTION: Indications for cardiac devices have been increasing as well as the need for lead extractions as a result of infections, failed leads and device recalls. Powered laser sheaths, with a global trend towards the in-creasingly technological tools, meant to improve the procedure's outcome but have economic implications. OBJECTIVE: The aim of this study is to demonstrate the experience of a Bra-zilian center that uses simple manual traction in most lead removals per-formed annually, questioning the real need for expensive and technically challenging new devices. METHODS: This retrospective observational study included 35 patients who had a transvenous lead extraction in the period of a year between January 1998 and October 2014 at Hospital de Messejana Dr. Carlos Alberto Studart Gomes, in Fortaleza, CE, Brazil. Data were collected through a records review. They were evaluated based on age, type of device, dwelling time, indication for removal, technique used and immediate outcomes. RESULTS: The median dwelling time of the devices was 46.22 months. Infec-tion, lead fracture and device malfunction were the most common indica-tions. Simple traction was the method of choice, used in 88.9% of the pro-cedures. Manual traction presented high success rates, resulting in com-plete removal without complications in 90% of the cases. CONCLUSION: This article suggests that lead extraction by simple manual traction can still be performed effectively in countries with economic diffi-culties as a first attempt, leaving auxiliary tools for a second attempt in case of failure or contraindications to the simple manual traction technique.


Assuntos
Infecções Relacionadas a Cateter , Remoção de Dispositivo/instrumentação , Marca-Passo Artificial , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/microbiologia , Infecções Relacionadas a Cateter/microbiologia , Cateteres de Demora/efeitos adversos , Desfibriladores Implantáveis , Remoção de Dispositivo/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial/efeitos adversos , Marca-Passo Artificial/microbiologia , Estudos Retrospectivos , Adulto Jovem
6.
J Vet Cardiol ; 25: 7-13, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31437785

RESUMO

A six-year-old Brussels griffon was presented for cervical swelling three months after implantation of a transvenous pacemaker. Transthoracic echocardiography demonstrated a thrombus associated with the pacemaker lead, partially obstructing right atrial inflow. The laboratory findings were consistent with protein-losing nephropathy. Initial medical therapy consisted of rivaroxaban (0.68 mg/kg orally every 24 hours), clopidogrel (2.5 mg/kg orally every 24 hours), and enalapril (0.5 mg/kg orally every 12 hours). Resolution of cervical and thoracic edema was noted within two weeks of initiating therapy. Recheck echocardiography two months and one year later revealed decreasing thrombus size despite worsening proteinuria. To the authors' knowledge, this is the first documented use of rivaroxaban for successful medical treatment of cranial vena cava syndrome caused by intracardiac pacemaker lead thrombosis in a hypercoagulable patient.


Assuntos
Doenças do Cão/tratamento farmacológico , Ecocardiografia/veterinária , Marca-Passo Artificial/veterinária , Rivaroxabana/uso terapêutico , Síndrome da Veia Cava Superior/veterinária , Animais , Doenças do Cão/etiologia , Cães , Feminino , Marca-Passo Artificial/efeitos adversos , Síndrome da Veia Cava Superior/tratamento farmacológico , Síndrome da Veia Cava Superior/etiologia
7.
Eur J Med Res ; 24(1): 23, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331388

RESUMO

BACKGROUND: Data concerning the effect of chronic right ventricular pacing in patients with normal left ventricular ejection fraction (LVEF%) are contradictory. The aim of this study is to evaluate the prevalence of pacing-induced cardiomyopathy (PICM) at midterm follow-up after permanent pacemaker implantation (PPM). METHODS: A series of 170 patients were submitted to PPM within our facility. Inclusion criteria were the absence of structural heart disease and a preserved LVEF% (> 45%) at the time of PPM. A midterm clinical and echocardiographic follow-up was performed, and data were collected and analyzed retrospectively. PICM was defined as follow-up LVEF ≤ 45%, dyskinesia during RV pacing, and the absence of other known causes of cardiomyopathy. RESULTS: At a median echocardiographic follow-up of 24.5 months (IQR 10.0-43.0 months), the overall mean LVEF% decreased from a preimplantation value of 66.7% (± 8.6%) to 63.2% (± 10.6%) (p < 0.0001). PICM occurred in 11 patients (6.5%). Patients developing PICM had a significantly lower preimplantation LVEF% (58.4 ± 8.0% vs. 67.3 ± 8.4%; p = 0.005), a trend for higher right ventricular pacing time rate (0.7 ± 0.3 vs. 0.5 ± 0.4; p = 0.1), a significantly lower rate of PPM indication for sick sinus syndrome (SSS) (18.2% vs. 61.0%; p = 0.009), and significantly higher rate of second-grade cardiac conduction block (36.4% vs. 11.3%; p = 0.03). At multivariate logistic regression, only preimplantation LVEF% (OR = 0.88; CI 0.80-0.96; p = 0.006) and the presence of SSS (OR = 0.1; CI 0.03-0.9; p = 0.04) were independently related (inverse relationship) to follow-up PICM. CONCLUSIONS: In this selected PPM patient cohort with preserved LVEF%, the rate of PICM at midterm follow-up is relatively low, but its occurrence seems to be related to baseline LVEF% and PPM indication category.


Assuntos
Cardiomiopatias/etiologia , Ventrículos do Coração/patologia , Marca-Passo Artificial/efeitos adversos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Análise Multivariada
8.
Dermatol Surg ; 45(10): 1228-1236, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31318829

RESUMO

BACKGROUND: In dermatologic and procedural surgery settings, there are commonly encountered devices in patients. Safe surgical planning requires familiarity with these devices. OBJECTIVE: To review the current implanted devices in patients and recommendations for surgical planning around these devices. METHODS AND MATERIALS: A comprehensive review using PubMed and published device recommendations was performed, searching for those most relevant to dermatologic surgery. RESULTS: Devices such as pacemakers and implantable cardiac defibrillators, deep brain stimulators, cochlear implants, and various nerve stimulators are potential devices that may be encountered in patients and specific recommendations exist for each of these devices. CONCLUSION: Dermatologic surgeons' knowledge of implanted devices in patients is paramout to safe surgical procedures.


Assuntos
Procedimentos Cirúrgicos Dermatológicos/métodos , Planejamento de Assistência ao Paciente , Neoplasias Cutâneas/cirurgia , Implantes Cocleares/efeitos adversos , Estimulação Encefálica Profunda/instrumentação , Desfibriladores Implantáveis/efeitos adversos , Humanos , Neuroestimuladores Implantáveis/efeitos adversos , Marca-Passo Artificial/efeitos adversos , Estimulação do Nervo Vago/instrumentação
11.
Kardiol Pol ; 77(5): 561-567, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31066721

RESUMO

BACKGROUND: The rate of cardiac device-related infective endocarditis (CDRIE) is increasing worldwide, but no detailed data are available for Poland. AIMS: We aimed to evaluate clinical, diagnostic, and therapeutic data of patients hospitalized due to CDRIE in 22 Polish referential cardiology centers from May 1, 2016 to May 1, 2017. METHODS: Participating cardiology departments were asked to fill in a questionnaire that included data on the number of hospitalized patients, number and types of implanted cardiac electrotherapy devices, and number of infective endocarditis cases. We also collected clinical data and data regarding the management of patients with CDRIE. RESULTS: Overall, 99 621 hospitalizations were reported. Infective endocarditis unrelated to cardiac device was the cause of 596 admissions (0.6%), and CDRIE, of 195 (0.2%). Pacemaker was implanted in 91 patients with CDRIE (47%); cardioverter­defibrillator, in 51 (26%); cardiac resynchronization therapy­defibrillator, in 48 (25%); and cardiac resynchronization therapy­pacemaker, in 5 (2.5%). The most common symptoms were malaise (62%), fever/chills (61%), cough (21%), chest pain (19.5%), and inflammation of the device pocket (5.6%). Cultures were positive in 77.5% of patients. The cardiac device was removed in 91% of patients. The percutaneous approach was most common for cardiac device removal. All patients received antibiotic therapy, and 3 patients underwent a heart valve procedure. Transesophageal echocardiography was performed in 80% of patients. The most common complication was heart failure (25% of patients). CONCLUSIONS: The clinical profile, pathogen types, and management strategies in Polish patients with CDRIE are consistent with similar data from other European countries. Transesophageal echocardiography was performed less frequently than recommended. The removal rate in the Polish population is consistent with the general rates observed for interventional treatment in patients with CDRIE.


Assuntos
Desfibriladores Implantáveis/efeitos adversos , Remoção de Dispositivo/estatística & dados numéricos , Endocardite/etiologia , Marca-Passo Artificial/efeitos adversos , Sistema de Registros , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Serviço Hospitalar de Cardiologia , Desfibriladores Implantáveis/estatística & dados numéricos , Ecocardiografia Transesofagiana/estatística & dados numéricos , Endocardite/diagnóstico por imagem , Endocardite/epidemiologia , Endocardite/cirurgia , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/epidemiologia , Endocardite Bacteriana/etiologia , Endocardite Bacteriana/cirurgia , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial/estatística & dados numéricos , Polônia/epidemiologia , Infecções Relacionadas à Prótese/tratamento farmacológico , Infecções Relacionadas à Prótese/epidemiologia , Infecções Relacionadas à Prótese/cirurgia
13.
JACC Cardiovasc Imaging ; 12(4): 622-636, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30947905

RESUMO

With the expanding use of cardiac implantable electronic device (CIEDs) in an ever-aging population, the looming problem of CIED-associated interference with the tricuspid valve is significant. The first pacemaker was implanted in 1958 for severe symptomatic bradycardia. The concept of a device to avert sudden cardiac death (i.e., the defibrillator) was first published in 1970 by Mirowski and Mower. The first reports of CIED-mediated tricuspid valve apparatus interference surfaced in the late 1900s, but it was not until recently that concentrated efforts have been made to better define the scope of CIED-mediated interference with the tricuspid valve apparatus. Because stopping implantation of these devices is not an option, better understanding of their mechanical complications could potentially lead to improvements in device design or epicardial device implantation, as an alternative, in select patients. This review covers existing evidence for CIED-mediated tricuspid regurgitation, discusses potential mechanisms of CIED-mediated interference of the tricuspid valve apparatus, provides an overview of how to diagnose CIED-mediated interference on echocardiography, and discusses management strategies for patients who have CIED-mediated severe tricuspid regurgitation.


Assuntos
Desfibriladores Implantáveis/efeitos adversos , Hemodinâmica , Marca-Passo Artificial/efeitos adversos , Insuficiência da Valva Tricúspide/etiologia , Valva Tricúspide/fisiopatologia , Cateterismo Cardíaco , Remoção de Dispositivo , Diuréticos/uso terapêutico , Ecocardiografia , Implante de Prótese de Valva Cardíaca , Humanos , Desenho de Prótese , Fatores de Risco , Índice de Gravidade de Doença , Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/diagnóstico por imagem , Insuficiência da Valva Tricúspide/fisiopatologia , Insuficiência da Valva Tricúspide/terapia
14.
BMJ Case Rep ; 12(4)2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30948415

RESUMO

A 54-year-old woman was referred to our centre for the third recurrence of colchicine-intolerant, corticosteroid dependent iatrogenic post-traumatic pericarditis after pacemaker placement 3 months prior to the first episode. The initial episode and each recurrence were associated with a pericardial effusion requiring drainage. Evaluation for pericardial infection, malignancy, autoimmune disease and pacemaker lead perforation was negative. After fourth recurrence and fifth pericardial drainage in 3 months, a trial of anakinra (interleukin-1 inhibitor), in addition to swift symptom resolution successfully prevented subsequent symptomatic and echocardiographic recurrence. Corticosteroids were tapered and eventually discontinued. At 4-month follow-up, the patient continues to be on daily anakinra 100 mg subcutaneous (SQ) daily without adverse effects.


Assuntos
Antirreumáticos/administração & dosagem , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Proteína Antagonista do Receptor de Interleucina 1/administração & dosagem , Marca-Passo Artificial/efeitos adversos , Pericardite/tratamento farmacológico , Corticosteroides/uso terapêutico , Colchicina/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Pessoa de Meia-Idade , Pericardite/etiologia , Recidiva
15.
Heart Surg Forum ; 22(2): E131-E133, 2019 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-31013223

RESUMO

BACKGROUND: Pacemaker lead-related thrombosis is a rare but severe complication in patients with pacing lead implantation in the right ventricle. We present a case with recurrent syncope after single-chamber implantable cardioverter defibrillator (ICD) implantation. Pacing lead-related thrombosis was observed during open-heart surgery. This induced intermittent pacemaker dysfunction and recurrent syncope. CASE PRESENTATION: A 67-year-old male patient presented with frequent episodes of syncope and a history of dilated cardiomyopathy and paroxysmal ventricular tachycardia. Normal coronary angiography was found, and therefore a single-chamber ICD was implanted into the right ventricle to prevent cardiac events in 2013. However, he was referred to our hospital because of recurrent syncope 3 to 4 years after ICD implantation. A comprehensive investigation was performed to find out the etiology for the recurrent syncope. Pacing lead thrombosis was finally observed during open-heart surgery, which can introduce intermittent pacemaker dysfunction. After the thrombus was removed and the lead was separated from the posterior leaflet of the tricuspid valve, the ICD functioned normally after reprogramming. Oral anticoagulant was prescribed after discharging. During the 1-year follow-up period, this patient was free of syncope. CONCLUSIONS: This case illustrated that pacemaker lead-associated thrombosis should be considered when the cardiac implantable electronic device fails to prevent patients from having cardiac events. Oral anticoagulant might be important for preventing thrombosis among patients with ICD implantation into the right ventricle.


Assuntos
Trombose Coronária/etiologia , Trombose Coronária/cirurgia , Eletrodos Implantados/efeitos adversos , Marca-Passo Artificial/efeitos adversos , Síncope/etiologia , Idoso , Eletrocardiografia , Ventrículos do Coração , Humanos , Masculino , Falha de Prótese , Recidiva
16.
J Card Surg ; 34(6): 424-427, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31017328

RESUMO

BACKGROUND AND AIM OF THE STUDY: Cardiac implantable electronic device (CIED) implantation is associated with an increase in CIED infection. For pacemaker-dependent patients, temporary pacemaker leads are implanted until infection remission, which allows new CIED implantation. We compared the outcome of pacemaker-dependent patients with infected CIED based on whether a combined single procedure of epicardial pacemaker implantation with system extraction or a temporary transjugular pacemaker implantation with interval system implantation was performed. METHODS: This retrospective study included pacemaker-dependent patients with CIED infection who were divided into two groups: the Tempo and Epi groups. The Tempo group received temporary transvenous pacemaker connected to an external pulse generator. After infection remission, a new permanent pacemaker was implanted, and the temporary pacemaker leads were removed. The Epi group received implantable epicardial right-ventricular pacemaker through infrasternal inferior pericardiotomy, and a permanent pulse generator was implanted through the same incision between the subcutaneous tissue and abdominal fascia. RESULTS: Sixty-six patients were included. Forty-two patients with epicardial pacemakers were discharged after 9.5 ± 8.8 days without infection of the newly implanted epicardial pacemaker. Patients with temporary transjugular pacemaker lead were discharged 23 ± 15 days after receiving permanent pacemakers. No serious complications were recorded in the Epi group. CONCLUSIONS: CIED infections in pacemaker-dependent patients can be treated through epicardial pacemaker implantation that allows early patient mobility and reduces hospital stay with no risk of epicardial pacemaker infection. Epicardial pacemakers can be used as a bridge until permanent intravenous CIED is implanted or as a replacement for permeant intravenous CIED.


Assuntos
Desfibriladores Implantáveis , Remoção de Dispositivo/métodos , Marca-Passo Artificial , Implantação de Prótese/métodos , Infecções Relacionadas à Prótese/cirurgia , Idoso , Desfibriladores Implantáveis/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial/efeitos adversos , Pericardiectomia/métodos , Estudos Retrospectivos , Resultado do Tratamento
17.
PLoS One ; 14(4): e0215589, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31034499

RESUMO

INTRODUCTION: Cardiac implantable electronic device (CIED) trans venous lead extraction (TLE) is technically challenging. Whether the use of a laser sheath reduces complications and improves outcomes is still in debate. We therefore aimed at comparing our experience with and without laser in a large referral center. METHODS: Information of all patients undergoing TLE was collected prospectively. We retrospectively compared procedural outcomes prior to the introduction of the laser sheath lead extraction technique to use of laser sheath. RESULTS: During the years 2007-2017, there were 850 attempted lead removals in 407 pts. Of them, 339 (83%) were extracted due to infection, device upgrade/lead malfunction in 42 (10%) cases, and other (7%). Complete removal (radiological success) of all leads was achieved in (88%). Partial removal was achieved in another 6% of the patients. Comparison of cases prior to and after laser technique introduction, showed that with laser, a significantly smaller proportion of cases required conversion to femoral approach [31/275 (6%) laser vs. 40/132 (15%) non-laser; p<0.001]. However, success rates of removal [259/275 (94%) vs. 124/132 (94%) respectively; p = 0.83] and total complication rates [35 (13%) vs. 19 (14%) respectively; p = 0.86] did not differ prior to and after laser use. In multivariate analysis, laser-assisted extraction was an independent predictor for no need for femoral extraction (OR = 0.39; 95% CI 0.23-0.69; p = 0.01). CONCLUSION: Introduction of laser lead removal resulted in decreased need to convert to femoral approach, albeit without improving success rates or preventing major complications.


Assuntos
Remoção de Dispositivo/métodos , Eletrodos Implantados , Marca-Passo Artificial , Idoso , Idoso de 80 Anos ou mais , Remoção de Dispositivo/efeitos adversos , Remoção de Dispositivo/instrumentação , Eletrodos Implantados/efeitos adversos , Falha de Equipamento , Feminino , Veia Femoral , Humanos , Lasers , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial/efeitos adversos , Estudos Prospectivos , Veia Subclávia/lesões , Resultado do Tratamento
18.
Ann Thorac Surg ; 108(3): 700-707, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31034827

RESUMO

BACKGROUND: Damage to the cardiac conduction system requiring permanent pacemaker implantation is a complication of aortic valve replacement (AVR) that may importantly affect quality of life. We investigated the prevalence of and preprocedure risk factors for new permanent pacemakers after surgical (SAVR) and transcatheter AVR (TAVR) at a single institution. METHODS: Preoperative variables and baseline electrocardiograms were reviewed for 5807 patients undergoing elective SAVR, with or without coronary artery bypass grafting, and 1292 undergoing TAVR, with or without percutaneous coronary intervention, from 2006 to 2017 at Cleveland Clinic. Patients with previous permanent pacemakers were excluded. Risk factors for permanent pacemaker implantation were identified using multivariable logistic regression analysis. RESULTS: New permanent pacemakers were implanted in 151 (2.6%) after SAVR and in 125 (9.7%) after TAVR (whole group SAVR vs TAVR, P <.0001). Risk factors for pacemaker implantation after TAVR included preoperative conduction disturbances and type of prosthesis (SAPIEN, 9.5%; SAPIEN XT, 4.8%; SAPIEN 3, 10% [Edwards Lifesciences, Irvine, CA]; CoreValve, 30% [Medtronic, Minneapolis, MN]; and other TAVR, 10%). There were no reliable risk factors for pacemaker implantation after SAVR. Bicuspid valves, mechanical vs bioprosthetic valves, higher Society of Thoracic Surgeons risk score, and concomitant coronary artery bypass grafting were not associated with elevated risk. CONCLUSIONS: At a high-volume institution in the current era, establishing a baseline for pacemaker implantation after AVR is necessary. Preoperative conduction disturbances and transcatheter valve type affect its prevalence. These data provide a benchmark that should be taken into account when considering TAVR in low-risk patients.


Assuntos
Estimulação Cardíaca Artificial/métodos , Marca-Passo Artificial/efeitos adversos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Centros Médicos Acadêmicos , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Benchmarking , Estimulação Cardíaca Artificial/efeitos adversos , Estudos de Coortes , Feminino , Hospitais com Alto Volume de Atendimentos , Humanos , Assistência de Longa Duração , Masculino , Marca-Passo Artificial/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/terapia , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
19.
Monaldi Arch Chest Dis ; 89(1)2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30968668

RESUMO

Superior vena cava [SVC] syndrome due to pacemaker leads is a distinct diagnostic rarity. It is diagnosed clinically based on constellation of signs and symptoms supported by imaging evidence of SVC obstruction. A 70-year-old male, an ex-smoker, presented with facial and upper limb swelling along with exertional dyspnea. He had undergone transvenous dual chamber rate modulated [DDDR] pacemaker implantation four years back for symptomatic sinus node dysfunction. Imaging demonstrated a hypodense-filling defect in the SVC causing 70-80% luminal narrowing along with presence of collaterals. Patient was managed on anticoagulants and planned for SVC stenting with epicardial pacing which failed. Patient refused to undergo further any further treatment and was subsequently lost to follow-up. To the best of our knowledge, this is the first detailed description of SVC syndrome due to pacemaker leads from India, which was managed medically.


Assuntos
Anticoagulantes/administração & dosagem , Marca-Passo Artificial/efeitos adversos , Síndrome da Veia Cava Superior/etiologia , Idoso , Dispneia/etiologia , Falha de Equipamento , Humanos , Índia , Masculino , Síndrome da Veia Cava Superior/diagnóstico por imagem , Síndrome da Veia Cava Superior/terapia
20.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936325

RESUMO

Runaway pacemaker is phenomenon in which pacemaker induces ventricular tachycardia as a result of some malfunction in the device. This entity is not very common in clinical practice. Normally, the pacemaker perceives the inherent cardiac impulse and hence averting the delivery of pacemaker stimulus in susceptible period of cardiac cycle. This is a case of a pacemaker-induced tachycardia (named as runaway pacemaker) in a patient with a history of Single Chamber Ventricular (VVI) pacemaker. A 75-year-old man was admitted with 3 days history of fluttering in the chest, shortness of breath, central chest and epigastric pain which radiated to the back. His medical history includes pacemaker implantation in 1996 with lead complication following which he was managed with VVI pacemaker, and the last procedure was generator change 4 years ago with no complication. Examination revealed ventricular tachycardia with ECG showing paced rhythm with ventricular pacing at the rate of 200-150/min. His pacemaker-induced ventricular tachycardia was immediately aborted after putting magnet on the device which restored his baseline rhythm with heart rate of 60/min. Pacemaker was explanted urgently with replacement of new pulse generator. The patient was discharged home with VVI pacemaker showing excellent parameters.


Assuntos
Arritmias Cardíacas/terapia , Sistema de Condução Cardíaco/cirurgia , Marca-Passo Artificial/efeitos adversos , Implantação de Prótese , Taquicardia Ventricular/etiologia , Idoso , Fontes de Energia Bioelétrica , Remoção de Dispositivo , Eletrocardiografia , Desenho de Equipamento , Falha de Equipamento , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Masculino , Taquicardia Ventricular/fisiopatologia , Taquicardia Ventricular/cirurgia , Resultado do Tratamento
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