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Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Perioperative Sensor and Algorithm Programming in Patients with Implanted ICDs and Pacemakers for Cardiac

Alexander Niedermeier1, Laura Vitali-Serdoz2, Theodor Fischlein3

  • 1Faculty of Medicine, Friedrich-Alexander-University Erlangen-Nuernberg (FAU), 91054 Erlangen, Germany.

Sensors (Basel, Switzerland)
|December 28, 2021
PubMed
Summary

Perioperative management of cardiac resynchronization therapy (CRT) device carriers undergoing non-device surgery is safe. Comprehensive device interrogation before and after surgery is crucial, but prophylactic reprogramming is often unnecessary.

Keywords:
ICDcardiac resynchronization therapydefibrillator shockelectromagnetic interferenceheart failureimplantable cardioverter defibrillatorsensorssudden cardiac death

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Cardiac resynchronization therapy (CRT) devices, including ICDs and pacemakers, are complex and implanted in patients with advanced cardiac conditions.
  • Limited data exists on the perioperative management and outcomes for CRT patients undergoing non-device-related surgery.

Purpose of the Study:

  • To evaluate perioperative adverse (device-related) events (A(D)E) and lead parameter changes in CRT device carriers undergoing non-device surgery.
  • To assess the necessity of specific perioperative management strategies for these patients.

Main Methods:

  • Retrospective analysis of data from 198 CRT device carriers.
  • Evaluation of perioperative adverse events and lead parameters through device interrogation.
  • Comparison of outcomes based on device type and programming modes.

Main Results:

  • 39 adverse observations (12%) required intervention, primarily related to the left-ventricular lead.
  • No device-related adverse events occurred in non-cardiac surgery patients or pacemaker-dependent patients in asynchronous pacing mode.
  • Significant lead parameter changes occurred in 36% of patients post-operatively, requiring reprogramming in 16%.

Conclusions:

  • The left-ventricular pacing lead is the most vulnerable component, necessitating thorough pre- and post-operative device interrogation.
  • Prophylactic deactivation of activity sensors or reprogramming to asynchronous pacing is generally not required for non-cardiac interventions.
  • Most CRT pacemakers do not require surgery-related reprogramming, and ICD function suspension type does not impact patient outcomes.