ABSTRACT
The LD-PACE II was designed for use in cardiomyoplasty, aortomyoplasty, and skeletal muscle ventricles. All parameters specified as programmable can be changed in a noninvasive manner (using a programming interface wand connected to a computer using the Windows 95/98 environment). Two new functions may be very useful clinically, based on experimental research. 1. Work-rest regimen. The LD-PACE II is able to deliver alternating periods of muscle contractions and rest. Work and rest periods may be programmed independently between 1 and 120 minutes in increments of 1 minute. The work-rest regimen may be useful clinically if muscle contractions are needed for cardiac assist postoperatively. 2. Night/day regimen. This feature allows for a change in the ratio of muscle contractions according to a patient's activity level. During the day the cardiosynchronization ratio may be set from 1:1 to 1:4, and during the night it may be set for 1:8 to 1:16. This allows the muscle to have a long rest period, prevents overuse, and prolongs battery life. These two new features make this cardiomyostimulator very attractive for cardiomyoplasty in particular. The addition of the work-rest and night-day regimens allow the muscle to rest for periods during the day to prevent overuse, subsequent damage, and potential atrophy.
Subject(s)
Cardiomyoplasty/instrumentation , Heart-Assist Devices , Heart/physiology , Pacemaker, Artificial , Humans , Myocardial Contraction , Prosthesis DesignABSTRACT
Ten patients of the authors' practice who have survived to be 100 years of age or more have had an implanted pacemaker for an average of 11.4 years. As the life expectancy of the country (Uruguay) is 75 years, their survival is considered to be unusual, confirming the statistical conclusion that patient survival with an implanted pacemaker may be expected to be as good or better than those who do not require a pacemaker implant.
Subject(s)
Longevity , Pacemaker, Artificial , Aged , Aged, 80 and over , Atrial Fibrillation/therapy , Disease , Equipment Failure , Female , Follow-Up Studies , Heart Block/therapy , Humans , Life Expectancy , Male , Sick Sinus Syndrome/therapy , Survival Rate , UruguayABSTRACT
Chronic heart failure continues unsolved as ever despite recent advances in cardiac surgery and pharmacological new armamentarium and remains a significant cause of death, regardless of etiology. Cardiomyoplasty (CMP), a new form of biomechanical ventricular support, has given new life to the field of mechanical circulatory support, providing a "bridge" to transplantation and serving as a possible alternative to surgical treatment. The geographic distribution of world experience in 401 patients shows that 80% were centralized in Europe (50%) and South America (30%). This review of the data analysis, documented improved changes in patients clinical status, further clarifies and appropriate patients population indications for DCMP as well as that more than 80% survival probability for NYHA class II & III and an early procedure related mortality of 8 to 10%.
Subject(s)
Cardiomyoplasty , Cardiomyopathy, Dilated/surgery , Chagas Cardiomyopathy/surgery , Clinical Trials, Phase I as Topic , Clinical Trials, Phase II as Topic , Contraindications , Evaluation Studies as Topic , Follow-Up Studies , Heart Aneurysm/surgery , Heart Failure/classification , Heart Failure/surgery , Humans , Multicenter Studies as Topic , Myocardial Ischemia/surgery , Patient Selection , Quality of Life , Time FactorsABSTRACT
Pese a que se emplea la cardioestimulacion permanente, el pronostico del bloqueo auriculo ventricular completo y de tantos otros trastornos del ritmo ha sufrido una notoria modificacion. La utilizacion de esta tecnica electronica, no obstante, no esta exenta de complicaciones (no siempre imputables al funcionamiento electronico) que son origen de diversas arritmias cardiacas. A continuacion, haremos un estudio de estas arritmias, destacando que no estan incluidas en el mismo las que estan relacionadas con los marcapasos auricular y secuencial, dado que no utilizamos tales tipos de estimulacion
Subject(s)
Humans , Pacemaker, Artificial , Arrhythmias, Cardiac , Electric StimulationABSTRACT
En base a nuestra experiencia de 14 anos en la disciplina de tratar trastornos lentos del ritmo con estimuladores cardiacos, intentamos poner al dia las indicaciones actuales de implantacion de marcapasos, refiriendonos especialmente a los trastornos lentos del ritmo. El estudio electrofisiologico del corazon nos han permitido comprender la fisiopatologia de los trastornos de conduccion asi como su comportamiento clinico y pronostico vital de tal manera que nos ha sido muy util en los ultimos cuatro anos para definir conductas en cuanto a tratamiento de dichos trastornos. Hemos analizado fundamentalmente las alteraciones del automatismo sinusal como asi la conduccion del impulso sinusal a todo el tejido de conduccion cardiaca
Subject(s)
Humans , Pacemaker, Artificial , Heart BlockABSTRACT
The writers describe a self-anchoring monopolar electrode for use in implantable pacemakers, intended to prevent migration. The device was implanted in 63 patients observed for 36 months, and results are considered very favorable.
Subject(s)
Electrodes, Implanted , Pacemaker, Artificial , Aged , Female , Humans , Male , Middle AgedABSTRACT
The intramyocardial PO2 was studied in 7 patients after cardiac surgery, by means of a long-term electrode implanted subepicardically in the free wall of the left or the right ventricle, utilizing the polarographic method. Inhalation of 100% O2 or 5% CO2 +95% O2 provoked maximal increases in the myocardial PO2. In most cases intense exercise, and the Valsalva manoeuvre caused a decrease in the PO2. Intravenous propranolol slightly increased the PO2 in one case. Other drugs used in coronary patients caused inconstant effects. Sleeping decreased the heart PO2 in one case. This technique appears to be a useful tool for studying the human intramyocardial PO2 during a period of several weeks.
