ABSTRACT
Between March 1974, and November 1979, a total of 244 epicardial electrodes, 29 in the anterior surface and 215 in the right ventricular diaphragmatic surface (RVDS) were implanted using the 212 a left subcostal approach. In 174 consecutive patients (mean age 64 years) a preoperative epicardial electrophysiological study was made (mapping), with measurement of voltage, current, lead impedance and R wave sensing in different zones of right ventricle. A comparative study between two types of sutureless electrodes was realized. In 21 cases, thresholds chronic measurement was made 32 months after implantation. There were one surgical death (0.4%) with a morbidity of 7.4%. The follow-up is 20 months mean. The mapped group has significantly lower thresholds and better sensing than the unmapped group (p 0.001). Chronic thresholds were obtained at pacemaker replacement in 21 cases (average 32 months postimplant) and were much lower in the mapped group. These are in line with the acute studies.
Subject(s)
Cardiac Pacing, Artificial , Heart/physiopathology , Pacemaker, Artificial , Aged , Cardiac Pacing, Artificial/methods , Electrodes, Implanted , Electrophysiology , Evaluation Studies as Topic , Heart Diseases/physiopathology , Heart Diseases/therapy , Heart Ventricles/physiopathology , Humans , Middle Aged , Postoperative ComplicationsABSTRACT
Desde marzo de 1974 a noviembre de 1979, hemos implantado un total de 244 electrodos epicardicos, 29 en la cara anterior y 215 en la cara diafragmatica del ventriculo derecho usando en 212 ocasiones un abordaje subcostal extrapleural. En 174 casos consecutivos hemos practicado un estudio electrofisiologico preoperatorio con medicion de voltaje corriente, resistencia y amplitud de la onda R, en diferentes zonas del ventriculo derecho realizando un estudio comparativo entre dos tipos de electrodos epicardicos. En 21 casos se realizo medicion de los umbrales cronicos a 32 meses de media de la primoimplantacion. Hubo una muerte quirurgica (0.4%) con una morbilidad del 7.4%. La media de seguimiento es de 20 meses. En el grupo de pacientes con mapeo, los umbrales fueron significativamente menores que en el grupo no mapeado (p 0.001). En cuanto a los umbrales cronicos, estos se incrementan en ambos grupos de pacientes, siendo mucho menor en el mapeado, hecho que esta en relacion con los hallazgos agudos
