Clinical testing of implanted pacemakers

Sowton, Edgar; Gray, Kenneth N.

doi:10.1136/thx.26.2.145

Cited by 10 publications

(2 citation statements)

References 13 publications

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“…(Gram-negative bacteria in 17, Gram-positive bacteria in 12, and a fungus in 1). The second commonest cause was pneumonia (11 episodes), followed by blood transfusion (6) and urinary tract infection (5). One of the two perioral infections started as a pustule growing Staphylococcus aureus, while the other started as a typical herpes simplex vesicle.…”

Section: Methodsmentioning

confidence: 99%

Ten-year survey of treatment with implanted cardiac pacemaker.

Sowton¹,

Hendrix²,

Roy³

1974

BMJ

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Since the first implant of an artificial cardiac pacemaker in a patient by Senning in 1958 the reliability of apparatus has increased considerably and the indications for long-term pacing have greatly extended. In this paper Aetiology Thirty-two patients (8-6%) had associated ischaemic heart disease as judged by cardiac infarction, angina, or E.C.G. evidence before the onset of heart block though this was not proved to be the cause of the block. Thirty patients (8%) probably had high block in the atrioventricular node, diagnosed on the basis of a narrow QRS complex, a rapid ventricular rate which increased with effort, and a normal sized heart on x-ray examination. It is impossible to determine how many of these had congenital block because the age at presentation varied from 12-52 years. There were 24 patients (6-5%) in whom the block was attributed to miscellaneous causes such as calcific aortic stenosis, myocarditis, Chagas's disease, Reiter's syndrome, or cardiomyopathy. The remaining 77% were diagnosed as having degenerative fibrosis of the conducting system. These aetiological factors applied about equally to both sexes except that 23 of the 32 patients with ischaemic heart disease were male.Indications for Pacing Pacemakers were implanted because of syncopal episodes in 290 patients (78%) and because of dizzyness or near-syncope in a further 30 (8%). Thus 86% were paced for a Stokes-Adams attack, either major or minor. Twenty-four patients were paced because of heart failure and bradycardia without syncope, three because complete heart block persisted one month after cardiac infarction, and two because they needed long-term pacing after cardiac surgery.Twenty patients were paced because of intermittent episodes of supraventricular tachycardia (flutter, fibrillation, paroxysmal atrial tachycardia, etc.) alternating with severe bradycardia. Various supraventricular natural pacemakers arose and junctional rhythms were common. Other patients who were paced for tachycardia alone are being reported separately and were not included in the present report.Of the patients with syncopal episodes 16 also had heart failure. Of a totalof40 patients withheart failure 18had ischaemic heart disease. All the patients with narrow QRS complexes were paced because of syncope.It proved impossible to determine the time of onset of heart block in most patients, but the delay between the first StokesAdams attack and the start of pacing in 309 patients ranged from 13 years to one day (mean 18 months). In 18 patients

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Section: Methodsmentioning

confidence: 99%

Ten-year survey of treatment with implanted cardiac pacemaker.

Sowton¹,

Hendrix²,

Roy³

1974

BMJ

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“…Display of pacemaker pulse waveform proved useful to identify faults or impending failure, such as lead failure, fractured wire, and changes in the electrical property of electrode–tissue interface. 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

A simple, wide bandwidth, biopotential amplifier to record pacemaker pulse waveform

Bifulco

Romano

Cesarelli

2016

MDER

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Reliable detection of pacemaker pulses is getting more and more important in electrocardiography (ECG) diagnosis. Many studies recommend ECG amplifiers with higher bandwidth to prevent errors. In the past, few pilot studies showed that analysis of pacemaker pulses waveform can enhance diagnosis (eg, lead failure and fractured wire), but they were carried out with inadequate instrumentations for clinical practice. Typically, pacemaker pulses last hundreds of microseconds, edges of pulses elapse in few microseconds, and amplitude may exhibit large variations from few millivolts to volts. Pulse waveforms change often and depend on pacemaker type and programming. A simple, biopotential amplifier made of a few off-the-shelf components is proposed. The circuit fulfills specifications for biopotential amplifiers and offers a large bandwidth (~1 MHz). Therefore, it is able to accurately record time course of pacemaker pulses and allows highly accurate pulse detection and timing. Signals can be easily displayed and acquired by means of a standard, battery-powered oscilloscope. Pacemaker pulse vectorcardiography can be obtained by using two or more, wideband channels. Some exemplificative waveforms recorded during patient’s periodic medical examination are reported. The proposed circuit offers simultaneous conventional ECG signal as an additional output.

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Electroactive Nanomaterials for the Prevention and Treatment of Heart Failure: From Materials and Mechanisms to Applications

Kong,

Guo,

Teng

et al. 2024

Small

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Heart failure (HF) represents a cardiovascular disease that significantly threatens global well‐being and quality of life. Electroactive nanomaterials, characterized by their distinctive physical and chemical properties, emerge as promising candidates for HF prevention and management. This review comprehensively examines electroactive nanomaterials and their applications in HF intervention. It presents the definition, classification, and intrinsic characteristics of conductive, piezoelectric, and triboelectric nanomaterials, emphasizing their mechanical robustness, electrical conductivity, and piezoelectric coefficients. The review elucidates their applications and mechanisms: 1) early detection and diagnosis, employing nanomaterial‐based sensors for real‐time cardiac health monitoring; 2) cardiac tissue repair and regeneration, providing mechanical, chemical, and electrical stimuli for tissue restoration; 3) localized administration of bioactive biomolecules, genes, or pharmacotherapeutic agents, using nanomaterials as advanced drug delivery systems; and 4) electrical stimulation therapies, leveraging their properties for innovative pacemaker and neurostimulation technologies. Challenges in clinical translation, such as biocompatibility, stability, and scalability, are discussed, along with future prospects and potential innovations, including multifunctional and stimuli‐responsive nanomaterials for precise HF therapies. This review encapsulates current research and future directions concerning the use of electroactive nanomaterials in HF prevention and management, highlighting their potential to innovating in cardiovascular medicine.

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Clinical testing of implanted pacemakers

Cited by 10 publications

References 13 publications

Ten-year survey of treatment with implanted cardiac pacemaker.

Ten-year survey of treatment with implanted cardiac pacemaker.

A simple, wide bandwidth, biopotential amplifier to record pacemaker pulse waveform

Electroactive Nanomaterials for the Prevention and Treatment of Heart Failure: From Materials and Mechanisms to Applications

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