Effect of Chest Wall Stimulation on Cardiac Pacemaker Function

Samet, Philip; Sz, Abbas; Fj, Hildner; Rp, Javier; Befeler, Benjamin; Cd, Schoenfeld

doi:10.1097/00000441-197011000-00006

Cited by 10 publications

(3 citation statements)

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“…5, November-December, 1982) pacemaker dependence, underlying heart rhythm, spontaneous heart rhythm, chest wall stimulation, sick sinus syndrome, atrioventricular block During long-term follow-up a substantial number of paced patients show spontaneous cardiac activity faster than the basic rate of their pulse generators. However, in approximately 40 percent of patients' requiring permanent cardiac pacemakers because of symptomatic bradyarrhythmias, continuous pacemaker-induced rhythm obscures the intrinsic cardiac activity at consecutive follow-up examinations.Overdrive suppression of QRS-inhibited pacemakers by chest wall stimulation>" permits pacing to be stopped briefly and safely, [2][3][4][5]7,8,11 This easily applicable and non-invasive technique enables the clinician or investigator to evaluate the underlying cardiac rhythm.…”

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confidence: 99%

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The Underlying Heart Rhythm in Patients with an Artificial Cardiac Pacemaker

Staessen¹,

Ector²,

Geest³

1982

Pacing Clinical Electrophis

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One-hundred forty-two patients with atrioventricular block (AVB) and 61 patients with sick sinus syndrome (SSS) were followed for an average of 50 months after permanent pacemaker insertion. Their underlying heart rhythms (UHR) were evaluated repeatedly by chest wall stimulation (CWS). A deficient UHR was defined as ventricular asystole lasting 4 seconds or longer. The underlying conduction disturbance increased in 14% of AVB patients, decreased in 14%, and remained constant in 68%. The occurrence of Adams-Stokes attacks before pacemaker implantation was associated with a higher incidence of deficient UHR both in AVB and SSS; a deficient UHR was seen more frequently in AVB than in SSS. Among AVB patients (1) atrial fibrillation, flutter or tachycardia and (2) sinus rhythm with incomplete AVB, especially Mobitz 1, when present before pacemaker implantation, were associated with a significantly lower incidence of deficient UHR during subsequent pacing in comparison with other AVB patients. CWS is a non-invasive method which allows the evaluation of UHR and which can contribute to the early recognition of pacemaker-dependent patients.

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mentioning

confidence: 99%

“…Overdrive suppression of QRS-inhibited pacemakers by chest wall stimulation>" permits pacing to be stopped briefly and safely, [2][3][4][5]7,8,11 This easily applicable and non-invasive technique enables the clinician or investigator to evaluate the underlying cardiac rhythm.…”

mentioning

confidence: 99%

The Underlying Heart Rhythm in Patients with an Artificial Cardiac Pacemaker

Staessen¹,

Ector²,

Geest³

1982

Pacing Clinical Electrophis

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“…Overdrive suppression of QRS inhibited pacemakers permits pacing to be stopped briefly and safely to reveal this rhythm (Barold et al, 1970;Samet et al, 1970). The pulse generator may be inhibited by overdrive impulses from an external pacemaker, by passing a magnet over it (Thormann and Schwarz, 1975;Voukydis et al, 1975), or by the use of an electronic programmer or rate controller (Latif and Ewy, 1977).…”

mentioning

confidence: 99%

Overdrive suppression of implanted pacemakers in patients with AV block.

Grendahl¹,

M²,

Kjekshus³

1978

Heart

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Patients being permanently paced for symptomatic AV block were studied by overdrive suppression of the QRS-inhibited pacemaker, in order to observe the underlying heart rhythm. The chest wall stimulation method was used. In complete AV block the escape rhythm recovery time proved highly reproducible on repeated testing on the same day, and in many patients remained so over months or years. Occasionally, a doubling of the escape rhythm recovery time was seen, suggesting initial exit block of the escape focus. Resetting of the escape rhythm usually followed an exponential curve until stabilisation after about 3 minutes. An early escape rhythm with a recovery time of less than 4 seconds was found on every occasion in 21 of 58 patients with complete AV block, and inconstantly in 23 more; in 14 it was never observed. Accidental pacing failure was seen in 15 patients. The overdrive suppression test was helpful in selecting pacemaker dependent patients.

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