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Related Experiment Videos

Problems of artificial pacemaker therapy.

M Murase, M Tanaka, E Takeuchi

    Japanese Circulation Journal
    |March 1, 1985
    PubMed
    Summary
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    Artificial pacemaker implantation shows a 63% 15-year survival rate. Physiological pacing offers superior hemodynamic and clinical benefits over ventricular pacing, though atrial lead complications require attention.

    Area of Science:

    • Cardiology
    • Biomedical Engineering

    Background:

    • Sick sinus syndrome (SSS) affects pacemaker patient outcomes.
    • Thromboembolism is a concern post-pacemaker implantation.
    • Physiological pacing aims to improve upon traditional ventricular pacing.

    Purpose of the Study:

    • To evaluate the long-term survival and complication rates of artificial pacemaker implantation.
    • To compare the efficacy of physiological pacing versus ventricular pacing.
    • To identify and address complications associated with physiological pacing.

    Main Methods:

    • Retrospective analysis of 467 patients with artificial pacemaker implantation.
    • Comparison of physiological pacing (n=100) with ventricular pacing.
    • Assessment of postoperative survival, thromboembolism, physical activity, and hemodynamic parameters.

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    Main Results:

    • 15-year postoperative survival rate was 63%.
    • Type III SSS patients had a 72% freedom from thromboembolism.
    • Physiological pacing demonstrated superior hemodynamic effects and clinical outcomes compared to ventricular pacing.
    • Atrial sensing failure (7 cases) and over-sensing (2 cases) were observed, linked to unipolar leads and low atrial potentials.

    Conclusions:

    • Artificial pacemakers offer significant long-term survival.
    • Physiological pacing is hemodynamically and clinically superior to ventricular pacing.
    • Bipolar atrial leads and adaptive A-V delay are recommended to minimize sensing complications and optimize pacing function.