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Rate responsive pacing with a minute ventilation sensing pacemaker during pregnancy and delivery
Pacing and Clinical Electrophysiology : PACE
|February 1, 1990
Summary
A minute ventilation sensing pacemaker effectively managed a pregnant woman with complete atrioventricular block. The device demonstrated accurate rate adjustments during exercise and pregnancy, ensuring maternal and fetal well-being.
Area of Science:
- Cardiology
- Biomedical Engineering
- Obstetrics
Background:
- Complete atrioventricular (AV) block poses significant risks during pregnancy.
- Rate-responsive pacemakers are crucial for managing bradyarrhythmias, but their efficacy in pregnancy requires evaluation.
Observation:
- A minute ventilation sensing rate-responsive pacemaker was implanted in a 29-week pregnant patient with symptomatic complete AV block.
- Echocardiographic and electrocardiographic (ECG) guidance ensured accurate pacemaker placement.
- The patient underwent a submaximal treadmill exercise test and experienced normal daily activities.
Findings:
- The pacemaker demonstrated satisfactory rate responses during exercise and daily life.
- Pacing rate showed a strong correlation with tidal volume (r = 0.94, P < 0.01) and respiratory rate (r = 0.93, P < 0.05) during cesarean section and postpartum.
- Successful pregnancy management and delivery were achieved.
Implications:
- Minute ventilation sensing pacemakers are a viable and effective option for pregnant women with AV block.
- This technology ensures adequate cardiac output during physiological changes of pregnancy and delivery.
- Further research can explore long-term outcomes and broader applications in obstetric cardiology.