 English version |
Home - Edito Nos Praticiens Notre Service Espace Patients Espace Professionnels Revue de Presse |
Service de Cardiologie de la Clinique de la Dhuys | 1 rue Pierre et Marie Curie 93170 Bagnolet | Tel : 01 48 97 50 04 Espace Professionnels FAQ - Derniere publication - Recrutement - Posez nous vos questions |
| Home > Espace professionnel > Derniere publication |
 |
| Derniere Publication |
|
REDUCING UNNECESSARY RIGHT VENTRICULAR PACING USING THE IRS ALGORITHM
T. Zerah*, H, Sitbon*, P. Granger** From *Clinique de la Dhuys, Bagnolet; **Centre Cardiologique d Evecquemont, France Purpose: The deleterious effect of unnecessary ventricular pacing has conducted most of manufacturers to develop an algorithm to promote spontaneous AV conduction. We analyzed the IRS Plus algorithm (BIOTRONIK), which automatically enlarge the AV delay, in patients receiving double chamber pacemaker. Methods: 53 patients (52% Male; Mean age: 78±10 y.o.) without permanent AV block were included for first double chamber implantation indication. Pacing indications were 38% of AV block (AVB), 24% of sinus node disease (SND = SSS + sinus bradycardia), 34% of brady/tachy syndrome (BTS), and 4% of carotid sinus syndrome (CSS). At discharge, the PR conduction was measured and the pacing mode was individualized. Patients were followed for an additional follow-up at one month and AV sequences counters were collected. Results: On the described population, mean of PR intervals was measured at 162±80ms. With the IRS Plus activated, the cumulative percentage of ventricular pacing (%Vp) was 19±27% (median:6%) for all types of indications. 50% of patients had less than 5%Vp. Repartition of %Vp between pacing indications was: SND: 7±19%Vp (median 1%Vp); BTS: 27±32Vp (median 13%Vp) ; AVB: 22±27% (median 12%Vp). No adverse event was attributed to IRS algorithm. Conclusions: IRS Plus algorithm avoids unnecessary ventricular pacing in patients implanted with a double chamber pacemaker. Patients with SND experienced greater reduction in %Vp.  |
 |
|
CARDIAC RESYNCHRONIZATION: FEASIBILITY OF A SIMPLIFIED PROCEDURE?
T.Zerah, G.Zerah, H.Sitbon, Clinique de la DHUYS, France 9th international work shop on cardiac arrythmias, Venise 2005 Multisite pacing procedures are X-ray and time consuming and difficult. Our aim was to determine whether a simple procedure is effective, safe and faster. A coronary sinus (CS) angiography is performed prior to implantation. Even with thin or twisted target vein, we tried to catheterize directly CS and target vein using different stylets type and curves. The lead choice (OTW or standard) was discussed before each procedure. In case of failure, the standard procedure (sheath ± angioplasty guide wire) was tried. Results: 27 pts were evaluated from 05-04 to 12-04. The target vein size was thin with 7 pts, medium with 11 pts and large with 9 pts. An OTW lead was chosen for 8 pts. 2 pts failed to be implanted with both techniques and 2 pts were implanted using the standard procedure. The direct SC lead positioning was successful in 25/27. LV threshold: 1.23±0.8V, LV wave amplitude: 15.2±7mV , LV impedance: 820±330Ohms, and procedure time: 70±30min. 3 early lead dislodgments had required a repositioning. Conclusion: In a majority of cases (85%), this simplified procedure is safe and faster than standard procedures even when the target vein seems to be small. |
 |
| © www.pacemaker-online.net (2006) |
www.dhuys.com PLAN D'ACCÈS PARTENAIRES ET LIENS VOS REACTIONS SUR CE SITE |