[Patients with implanted pacemakers in the primary hospital and stay under the care of an outpatient cardiology clinic--differences in comparison with the reference center]. / Chory z rozrusznikiem serca wszczepionym w szpitalu rejonowym i pozostajacy pod opieka ambulatoryjna rejonowej poradni kardiologicznej--róznice w porównaniu z osrodkiem referencyjnym.

UNLABELLED: The aim of the study was to find an answer for a question whether a newly created primary centre ensures the same level of safety as a reference centre in terms of complications of pacemaker implantation and whether the outpatient care of patients with an implanted pacemaker is as competent as in a reference centre. MATERIAL AND METHODS. The analysis of documentation of the patients (274 pts, 135 men, mean age = 74 + 9 years) who underwent implantation of a permanent single (VVI, 222pts) or dual-chamber (DDD, 52pts) pacemaker at the department of cardiology of the primary centre compared to the reference centre (80 pts) at the department of cardiology. The following data was analyzed: gender, age, length of hospitalization, type of pacemaker, type of electrode, place of pacing, indications for permanent pacing, co-existing diseases, periprocedural complications, complications, technique of electrode implantation and the type of electrode fixation. RESULTS: Patients who underwent implantation of a pacemaker in the primary centre were hospitalized longer than those treated in the reference centre, p < 0.001. The technique of subclavian venipuncture used to implant the passive endocardial electrode was more common in the primary centre, p = 0.034. The number of complications after implantation of pacemaker was not significantly statistically. The technique of electrode implantation has a statistically significant effect on the number of complications (OR = 0.11, p < 0.04). Subclavian venipuncture was associated with a statistically significantly higher incidence of pneumothorax (p < 0.019). The type of pacemaker, electrodes or indication for implantation did not have a statistically significant influence on the complications. The patients with ischemic heart disease and myocardial infarction are the most exposed to the complications (OR = 3.73, p < 0.03). All check-ups at the primary centre were carried out by a physician who used suitable programmers. Most visits in the reference centre were carried out by a technician who used the "IMPULS-BIS" set. Pacemaker implantation costs were directly connected with the duration of hospitalization. CONCLUSIONS. High percentage of ventricular stimulation, stimulation of the apex of the right ventricle, the application of passive electrode, avoiding the use of cephalic vein indicates further the need deepen cooperation between centers. Outpatient care of patients with an implanted pacemaker in the primary centre was as competent as in the reference centre. Pacemaker implantation costs are directly connected with the duration of hospitalisation.

[Venous thrombosis as a clinical problem after pacemaker implantation--case report]. / Zakriepica zylna jako problem kliniczny po wszczepeniu rozusznika serca--opis przypadku.

Although transvenous pacing is a safe treatment modality for bradyarrhythmias, serious thrombotic and embolic complications are reported to occur in 0.6-3.5% of cases. We describe a case of pacemaker-associated thrombosis, with an axillary and subclavia veins thrombosis. The patient was treated with subcutaneous heparin which proved successful as the sole treatment.

[Quality of life after RF ablation of reentrant supraventricular tachycardias and ventricular ectopic beats in own observation]. / Jakosc zycia po ablacji pradem o wysokleJ czestotliwosci nawrotnych czestoskurczów nadkomorowych i ekstrasystolii komorowej w obserwacji wlasnej.

THE AIM OF THIS STUDY: To assess the quality of life (QoL) in patients who underwent RF reentrant supraventricular tachycardias and ventricular ectopic beats ablation. MATERIAL AND METHODS: The study group consisted of 70 patients, 21 male, mean age 39.5 +/- 8.3 y. with supraventricular tachycardias (AVNRT, AVRT) and ventricular ectopic beats (VEB) treated with RF catheter ablation. The indications for the procedure were: nodal reentry tachycardia (group A n=24), WPW syndrome (group B n=24) and ventricular ectopic beats (group C n=22). Quality of life was prospectively evaluated. All the patients completed self-administered questionnaire (SF-36), disease--specific symptoms scale (Manolisa) and exercise capacity (DASI) before and 6 months after ablation. Scores were compared with t-Student test. RESULTS: In all study population significant improvement in QOL was found after ablation. The improvement was significant in all eight subscales of SF-36 scale. The patients reported significant improvement as assessed by disease-specific symptoms scale and exercise capacity. Before ablation, role limitations (subscales 2 of SF-36) and exercise capacity were lower in WPW patients as compared to remaining patientss (63.5 vs. 31.3, p < 0.005 and 52.9 vs. 46.1, p < 0.05; group B vs. group A) and (52.9 vs. 39.9, p < 0.01; group B vs. group C). CONCLUSIONS: The treatment of reentrant supraventricular arrhythmias and ventricular ectopic beats with RF catheter ablation significantly improves quality of life. The improvement was higher in VEB patients and negative correlation between QoL and an amount of VEB was observed. Pathomechanism of supraventricular tachycardia influences parameters of QoL. Role limitations were higher in AVNRT group than AVRT group. SF-36, disease--specific symptoms (Manolisa) and DASI questionnaire are useful in the assessment of efficacy of treatment for supraventricular arrhythmias and ventricular ectopic beats.