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Related Experiment Videos

Pacemaker-induced change in prosthetic valvular sounds.

D F Brown, G Prescott

    Chest
    |April 1, 1976
    PubMed
    Summary

    Pacemakers can alter the sounds of prosthetic heart valves. These changes are often physiological, not signs of valve malfunction, in patients with pacemakers and artificial valves.

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    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Medical Acoustics

    Background:

    • Prosthetic heart valves can produce distinct sounds detectable via phonocardiography.
    • Permanent pacemakers significantly alter cardiac electrical activation and mechanical function.
    • Interactions between pacemakers and prosthetic valves require careful auscultatory assessment.

    Observation:

    • Two patients with prosthetic valves (mitral, tricuspid) and permanent pacemakers exhibited variable valvular sound intensity and timing.
    • Changes in pacing mode (nodal to ventricular) affected the separation of valvular opening sounds.
    • Ventricular pacing onset increased the intensity of a quiet prosthetic mitral valve closing sound.

    Findings:

    • Simultaneous phonocardiogram, electrocardiogram, and pulse tracings, along with prosthesis visualization, elucidated the mechanism of sound changes.
    • Pacemaker-induced alterations in ventricular activation influence prosthetic valve dynamics and audible sounds.
    • Observed auscultatory changes in patients with pacemakers and prosthetic valves are often physiologically explained.

    Implications:

    • Auscultatory findings in patients with prosthetic valves and pacemakers may not indicate malfunction.
    • Clinicians should consider pacemaker function when interpreting prosthetic valve sounds.
    • This understanding aids in accurate diagnosis and management of patients with cardiac implantable electronic devices and prosthetic valves.

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