32 patients were studied on model pacemakers implantation as DDD, DDDR pacing, VVIR pacing and AICD (Automatic Implantable Cardioverter defibrillator), in which 23 cases (71.8%) with complete A-V block, 8 cases (25.0%) with Sick Sinus Syndrome and 1 (3.2%) case with Ventricular tachycardia. The implantation technique for all these patients were successfull: VVIR 24 cases (75.0%), DDD + VDD 4 cases (12.5%), DDDR 3 cases (9.4%) and ACID 1 case (3.2%). After implantation, there were 30/32 cases (93.8%) have controled on follow-up, in which 29/32 pacemaker (90.6%) were programed. Not any patients was died. This success improved quality of life for patients in Vietnam whose were suffer from serious arrhythmia heart diseases
Arrhythmias, Cardiac ; Therapeutics ; Pacemaker, Artificial

Humans ; Cardiac Catheters ; Pacemaker, Artificial ; Arrhythmias, Cardiac

OBJECTIVETo assess the feasibility and safety of using the modified active fixation pacing leads model to pace the right ventricular outflow tract septum.

METHODSA total of 136 patients undergoing artificial heart pacemaker implantation with active fixation pacing leads were randomized into two groups to receive conventional right ventricular outflow tract pacing (CRVOTP) or modified right ventricular outflow tract pacing (MRVOTP). The electrode lead wire core was modeled in a double-curved three-dimensional shape in CRVOTP group and in a J-shaped bend in MRVOTP group before fixation at the right ventricular outflow tract septum.

RESULTSRight ventricular outflow tract septum pacing was achieved successfully in all the patients. None of patients experienced serious complications. No significant differences were found between the two groups in the number of times of electrode fixation, pacing thresholds, impedance, R wave height or QRS wave width during the operation, but MRVOTP was associated with a reduced time of X -ray exposure and operation (P<0.05) due to the convenience in electrode modeling and in passing the leads through the tricuspid annulus and the direct access to the right ventricular outflow tract septum. Postoperative follow-up of the patients showed no incidence of active fixation pacing lead dislocation and comparable pacing thresholds of the ventricular electrodes, impedance, R wave height and QRS wave width between the two groups.

CONCLUTIONSUsing the modified active fixation pacing leads model to pace the right ventricular outflow tract septum can reduce the time of X -ray exposure and operation with a low probability of lead damage.

Cardiac Pacing, Artificial ; Electrodes ; Heart Ventricles ; Humans ; Pacemaker, Artificial

Sinus node dysfunction occurs occasionally after heart transplantation and may be caused by surgical trauma, ischemia to the sinus node, rejection, drug therapy, and increasing donor age. However, the timing and indication of permanent pacemaker insertion due to sinus node dysfunction following heart transplantation is contentious. Here, we report a case of a permanent pacemaker insertion for syncope due to sinus arrest after heart transplantation, even with a bicaval technique, which has been known to associate with few incidences of sinus node dysfunction.
Adult ; *Heart Transplantation ; Humans ; Male ; *Pacemaker, Artificial ; Sinus Arrest, Cardiac

Objective: To reduce the length of hospital stay for patients undergoing pacemaker surgery. Patient and Methods: We prevented the leads from dislodging by anchoring a screw-in type pacing lead in the right atrium/ventricle through a cephalic vein that was cut down. We retrospectively compared the cost and duration of the hospital stay for the subpectoral technique (35 cases; January 2005-March 2006) and conventional technique (subcutaneous pocket and subclavian vein puncture) (18 cases; October 2003-December 2004) groups. Results: The mean (± SD) duration of hospital stay was 5.1 ± 2.1 days for the subpectoral technique group and 22.2 ± 15.2 days for the conventional technique group (P < 0.001), and the cost was 2,167,883 ± 147,549 yen in the subpectoral technique group and 2,528,053 ± 217,810 yen in the conventional technique group (P < 0.001). We noted no major complications such as bleeding, lead dislodgement, or wound infection. Conclusion: Our novel subpectoral technique helped reduce the length and cost of the hospital stay associated with pacemaker surgery.
Hospitals ; Length ; Artificial cardiac pacemaker ; Cost aspects ; Conferences

Temporary cardiac pacing is an essential technique in the diagnosis and treatment of arrhythmias. Due to its urgency, complexity, and uncertainty, it is necessary to develop an evidence-based emergency operation norms. Currently, there is no specific consensus guidelines at home or abroad. The Emergency Branch of Chinese Medical Association organized relevant experts to draft the Chinese emergency expert consensus on bedside temporary cardiac pacing (2023) to guide the operation and application of bedside cardiac pacing. The formulation of the consensus adopts the consensus meeting method and the evidentiary basis and recommendation grading of the Oxford Center for Evidence-based Medicine in the United States. A total of 13 recommendations were extracted from the discussion on the methods of bedside temporary cardiac pacing, the puncture site of transvenous temporary cardiac pacing, the selection of leads, the placement and placement of leads, pacemaker parameter settings, indications, complications and postoperative management. The recommended consensus includes the choice between transcutaneous and transvenous pacing, preferred venous access for temporary transvenous pacing, the target and best guidance method for implantation of bedside pacing electrodes, recommended default pacemaker settings, recommended indications for sinoatrial node dysfunction, atrioventricular block, acute myocardial infarction, cardiac arrest, ventricular and supraventricular arrhythmias. They also recommended ultrasound guidance and a shortened temporary pacing support time to reduce complications of temporary transvenous cardiac pacing, recommended bedrest, and anticoagulation after temporary transvenous pacing. Bedside temporary cardiac pacing is generally safe and effective. Accurate assessment, correct selection of the pacing mode, and timely performance of bedside temporary cardiac pacing can further improve the survival rate and prognosis of related emergency patients.
Humans ; Cardiac Pacing, Artificial/methods* ; Pacemaker, Artificial ; Arrhythmias, Cardiac/therapy* ; Myocardial Infarction/therapy* ; Electrodes

Cardiac Pacing, Artificial ; adverse effects ; Diaphragm ; Female ; Humans ; Muscular Diseases ; etiology ; Pacemaker, Artificial ; Young Adult

The unipolar/bipolar pacing mode of pacemaker is related to its circuit impedance, which affects the battery life. In this study, the in vitro experiment scheme of pacemaker circuit impedance test was constructed. The human blood environment was simulated by NaCl solution, and the experimental environment temperature was controlled by water bath. The results of in vitro experiments showed that under the experimental conditions similar to clinical human parameters, the difference between the circuit impedance of bipolar mode and unipolar mode is 120~200 Ω. The results of the in vitro experiment confirmed that the circuit impedance of bipolar circuit was larger than that of unipolar mode, which was found in clinical practice. The results of this study have reference value to the optimization of pacing mode and the reduction of pacemaker power consumption.
Cardiac Pacing, Artificial/methods* ; Electric Impedance ; Humans ; Pacemaker, Artificial ; Prostheses and Implants

Humans ; Bradycardia/therapy* ; Tricuspid Valve Insufficiency ; Pacemaker, Artificial/adverse effects* ; Cardiac Pacing, Artificial

OBJECTIVETo analyse the reasons for pacing lead abandonment during pacemaker replacement.

METHODClinical data of patients underwent permanent pacemaker replacement between Jan 1st, 1976 to Dec 31st 2006 in Fuwai Hospital were obtained and the reasons for pacing leads abandonment were analyzed.

RESULTSPacemaker was replaced in 1023 patients during this period and 235 pacing leads were abandoned, 131 leads (55.7%) were abandoned for leads malfunction, including leads body fracture (35, 14.9%), isolation defects (10, 4.3%), dislocations (10, 4.3%) and excessively high threshold values (76, 32.3%). Other reasons for leads abandonment were infection (50, 21.3%), incompatibility between the leads and new generator (30, 12.8%), need to degrade the pacing system (13, 5.5%) and other rare reasons (11, 4.7%).

CONCLUSIONThe most often reason for leads abandonment during pacemaker replacement is lead malfunction, including lead body fracture, isolation defect, dislocation and excessively high threshold value of the leads.

Cardiac Catheterization ; instrumentation ; methods ; Cardiac Pacing, Artificial ; methods ; Equipment Failure ; Equipment Safety ; Female ; Heart Failure ; therapy ; Humans ; Male ; Pacemaker, Artificial