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[Arrhythmia associated with continuous cardiac pacing]

Ia V Volkolakov, Iu G Karpov, R Ia Latsis

    Kardiologiia
    |February 1, 1988
    PubMed

    Insights

    Permanent pacemaker use reveals high rates of rhythm competition with asynchronous stimulation, suggesting this method should be avoided. Myopotential inhibition is rare, but VVI pacing frequently causes escape-capture bigeminy.

    Area of Science:

    • Electrophysiology
    • Cardiology
    • Medical Devices

    Context:

    • Permanent pacemaker implantation is a common procedure for managing heart rhythm disorders.
    • Understanding pacemaker-associated arrhythmias is crucial for patient management and device optimization.
    • Previous research has focused on specific pacemaker settings and their effects on cardiac rhythm.

    Purpose:

    • To assess the incidence and diagnostic criteria of heart rhythm disorders in patients with permanent pacemakers.
    • To evaluate the clinical significance of asynchronous stimulation and myopotential inhibition.
    • To determine the frequency of specific arrhythmias like escape-capture bigeminy during VVI pacing.

    Summary:

    • A study of 1165 patients via single ECG and 49 via continuous monitoring found a 94.4% incidence of spontaneous and induced rhythm competition with asynchronous pacemaker stimulation, recommending its discontinuation.
    • Inhibition of unipolar pacemakers by myopotentials during physical activity was found to be uncommon and clinically insignificant.
    • VVI pacing was associated with escape-capture bigeminy in 45.2% of cases, highlighting a common pacemaker-induced arrhythmia.

    Impact:

    • Findings suggest abandoning asynchronous pacemaker stimulation due to high rates of rhythm competition.
    • The study clarifies the limited clinical relevance of myopotential inhibition in pacemaker patients.
    • Identifies VVI pacing as a frequent cause of escape-capture bigeminy, informing clinical practice and device programming.

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