Stokes W. Observations on some cases of permanently slow pulse. Dublin Quarterly Journal of Medical Science ; 2 — Reprinted in: Medical Classics ; 3 — Senning A. Cardiac pacing in retrospect. Am J Surg ; —9. Transcutaneous pacing: experience with the Zoll noninvasive temporary pacemaker. Am Heart J ; 1 Pt 1 :7— Furman S, Robinson G.
The use of an intracardiac pacemaker in the correction of total heart block. Surg Forum ; 9 —8. Lessons from the first patient with an implanted pacemaker: Pacing Clin Electrophysiol ; 26 1 Pt 1 — Early application of an implantable loop recorder allows effective specific therapy in patients with recurrent suspected neurally mediated syncope. Eur Heart J ; 27 — Rate responsive pacing using transthoracic impedance minute ventilation sensors: a multicenter study on calibration stability.
Pacing Clin Electrophysiol ; 25 — Selective vibration sensing: a new concept for activity-sensing rate-responsive pacing. Pacing Clin Electrophysiol ; 11 — Arthur W, Kaye GC. Clinical use of intracardiac impedance: current applications and future perspectives. Pacing Clin Electrophysiol ; 24 4 Pt 1 — Is the response to cardiac pacing controlled by central venous temperature physiological? Bratisl Lek Listy ; 98 — Biosensors and rate-responsive cardiac pacing.
Rev Esp Cardiol ; 43 suppl 2 : 58— Morton PG. Rate-responsive cardiac pacemakers. Kaplan-Meier analysis of freedom from extraction or death in patients with an Accufix J retention wire atrial permanent pacemaker lead: a potential management tool. Pacing Clin Electrophysiol ; 21 11 Pt 2 — Deharo JC, Djiane P. Pacemaker longevity. Replacement of the device.
Implantable Cardiac Devices Technology | David Korpas | Springer
Ann Cardiol Angeiol Paris ; 54 — How smart should pacemakers be? An implantable synchronous pacemaker for the long term correction of complete heart block. Am J Cardiol ; 11 —7.
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Comparison of resting hemodynamic indices and exercise performance during atrial synchronized and asynchronous ventricular pacing. Pacing Clin Electrophysiol ; 6 2 Pt 1 — Pacing Clin Electrophysiol ; 26 —4. Pacing Clin Electrophysiol ; 27 — Device-based therapies for atrial fibrillation. Curr Treat Options Cardiovasc Med ; 7 — Atrial fibrillation current and future treatments: radiofrequency ablation and novel pacing techniques.
Implantable Cardiac Devices in the Treatment of Arrhythmias and Congestive Heart Failure
Int J Clin Pract ; 56 —6. Pacing Clin Electrophysiol ; 24 — Janse MJ. A brief history of sudden cardiac death and its therapy. Pharmacol Ther ; — Enhanced specificity of a dual chamber ICD arrhythmia detection algorithm by rate stability criteria. Intracardiac QRS electrogram width-an arrhythmia detection feature for implantable cardioverter defibrillators: exercise induced variation as a base for device programming.
Pacing Clin Electrophysiol ; 21 — J Am Coll Cardiol ; 47 — Int J Cardiol ; 93 — Borggrefe M, Wolpert C. Amiodarone or ICD in patients with cardiac insufficiency. Internist Berl ; 47 — National Institute of Clinical Excellence. Cardiac resynchronization therapy in patients with chronic heart failure: pathophysiology and current experience. Am J Cardiovasc Drugs ; 2 — Eur Heart J ; 26 —8.
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Upgrade to biventricular pacing in patients with pacing-induced heart failure: can resynchronization do the trick? Europace ; 8 —7. Hemodynamic effects of alternative atrial pacing sites in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol ; 26 1 Pt 2 — Prakash A. Pacing for the prevention of atrial fibrillation.
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Although there are operational differences between manufacturers, the general flow of information is similar with all systems see Table 1. Data from the CIED are transmitted via radiofrequency waves to a home receiving station. The home receiver has indicators that the patient can use to confirm information transfer.
The encrypted information is collected and transmitted from the receiver via an analogue or mobile phone line to an Internet-based server that decodes and stores it. The information is then sent to the physician by fax, short message service SMS or email. The physician can also access it by logging into a secure database. Scheduled or unscheduled transmissions are available for review. Almost any parameter obtained from a standard device interrogation can be evaluated, including programmed pacing mode, lead parameters, automatic threshold tests, activity logs, automatic alert events, patient-triggered events, all memorised episodes, configurable alerts, heart failure management parameters and more.
Although the collected data are basically the same, collection and management require manufacturer-specific equipment. For safety reasons, although the CIED can be interrogated remotely, programming cannot be done without an in-clinic visit using a special programmer. Remote monitoring could improve outcomes by more timely identification of new or worsening medical conditions such as arrhythmia or heart failure and the detection of device-related problems. Identification of atrial arrhythmias by CIEDs may provide important prognostic information. In the recently published ASSERT trial Asymptomatic atrial fibrillation and stroke evaluation in pacemaker patients and the atrial fibrillation reduction atrial pacing trial , 2, patients with an ICD or a PM and without a history of atrial fibrillation were followed for 2.
Other investigators have reported the use of remote monitoring for evaluating efficacy of antiarrhythmic therapy for atrial fibrillation. Recent advisories and recalls have made timely access to device data critical to clinical practice. In response, the manufacturer developed specialised algorithms that, when coupled with remote monitoring, led to more timely identification of lead failures.
In an early analysis of data from 40 patients who had an implanted Medtronic Sprint Fidelis lead, remote monitoring triggered events notifications and led to unscheduled visits within one to three days of the event in four patients, three of whom had confirmed lead fractures. Lead performance can be evaluated by analysing stored data for evidence of noise and over-sensing and by measuring temporal changes in impedance.
Manufacturers have developed algorithms and specialised monitors both stand-alone and incorporated into CIEDs used for heart rhythm therapy to facilitate the management of heart failure see Figure 2.
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The information gathered from the device or algorithm is incorporated to clinical data to assist the physician in managing complex patients. A meta-analysis of randomised controlled and cohort trials of remote monitoring in heart failure patients showed that remote monitoring was associated with a significantly lower number of deaths and hospitalisations. Several recently published prospective multicentre trials have established the benefits of remote monitoring see Table 2.
Remote monitoring was associated with earlier identification of a clinically actionable event 5. Importantly, in the conventional follow-up group, TTM only detected three out of events, while, in the remote monitoring group, out of events were identified. In the Clinical evaluation of remote notification to reduce time to clinical decision CONNECT study, 1, patients undergoing ICD or CRT-D device implantation were randomised either to follow-up using wireless automatic remote monitoring or to conventional in-clinic follow-up.
Remote monitoring was not associated with a decrease in healthcare use parameters, such as hospitalisation or accident and emergency department visits, but did increase the number of unscheduled clinic visits. The curves between the two groups began diverging at approximately five months and, importantly, continued to diverge after the initial separation, suggesting that the potential benefits of remote monitoring may be even higher with longer follow-up. Furthermore, median time from onset of clinically significant events to physician evaluation of patients with first episodes of atrial fibrillation, ventricular tachycardia and ventricular fibrillation was lower in remotely monitored patients than in the conventional group 1 day versus Surprisingly, the promptness of arrhythmia detection did not translate into a reduction in adverse events rate or overall mortality.
Recently, two studies from France were presented at the European Society of Cardiology meeting that highlighted the potential benefits of remote monitoring. At one year after implant, there was no difference between the groups in the rate of major cardiovascular events a combined endpoint that included death, cardiovascular hospitalisation and ineffective or inappropriate ICD therapy.
However, patients who were remotely monitored had fewer inappropriate ICD therapies 4. The second study, the ECOST Benefits of implantable cardioverter defibrillator follow-up using remote monitoring trial, enrolled patients, lasted for 27 months and randomised patients to remote monitoring with daily data transmission or conventional clinic visits.
In the remote monitoring group, fewer inappropriate shocks and a decrease in the number of charged shocks significantly prolonged battery life. Another benefit of remote monitoring has been the development of large databases containing a significant number of device evaluations.
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Buy Softcover. FAQ Policy. Show all. It provides very useful explanations of the device technology, making it an ideal reference. Pacing Modes Korpas, David Pages