ABSTRACT
The authors have presented the case of a young woman, who was observed because of repetitive loss of consciousness. The unbalance of the vegetative nervous system (parasympathetic overactivity) was responsible for the syncopic events, which could be prevented by the implantation of pacemaker successfully. The reoccurrence of loss of conciousness after 10 years could be attributed partly to the presence of dysfunction of pacemaker (undersensing+inhibition of myopotential), partly to a passing off the stress situation, with previous status of fever, and the consequent orthostatic hypotension caused by actually inadequat use of nitratvasodilator.
Subject(s)
Pacemaker, Artificial , Syncope/etiology , Adult , Equipment Failure , Female , Humans , Hypotension/etiology , Pacemaker, Artificial/adverse effects , Parasympathetic Nervous System/physiopathology , Recurrence , Syncope/physiopathology , Syncope/therapy , Vagus Nerve/physiopathologyABSTRACT
One hundred eighteen surgical complications of 209 patients underwent 249 physiological and rate responsive pacemaker implantations are discussed. In 27.9% of total complications represented the dislodgement of atrial leads occurred particularly in the early period of the observation time which decreased significantly later in the second period of the survey. This high complication rate of bifocal pacemakers was found due to a high incidence of the generator preerosion beside the dislodgment of the atrial electrodes. Complication rate could be reduced by the improvement of surgical technics, and with the implantations of new types of leads and smaller generators, however the number of complications remained higher compared to the pacemaker systems with one lead. The implantation procedure of ventricular rate responsive pacemakers is simple, and significant improvement in working capacity could be observed by the restoration of the chronotropic capacity during exercise. Physiological and atrial rate responsive pacemakers provide many advantages in the hemodynamic state even at rest which exceed all disadvantage of the expected complications, which might occur.
