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Review
. 2005 Sep;91(9):1229-34.
doi: 10.1136/hrt.2004.054528.

Follow up and optimisation of cardiac pacing

Paul R Roberts  1
Affiliations
Review

Follow up and optimisation of cardiac pacing

Paul R Roberts. Heart. 2005 Sep.
No abstract available

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Figures

Figure 1
Figure 1
Pacemaker complications observed at follow up. (A) Microdisplacement of atrial lead in patient with sick sinus syndrome leading to intermittent failure to accurately atrial sense. This results in atrial pacing “spikes” wandering through the QRS complex. This patient required lead repositioning. (B) Incorrect ventricular sensitivity setting resulting in failure to sense intrinsic ventricular electrograms. This leads to failure of next impulse to capture (arrow) as falling within refractory period of previous complex. Adjustment of ventricular sensitivity corrected this problem. (C) Recurrence of patient’s symptoms four months after pacemaker was implanted. Histogram demonstrates a sudden rise in ventricular lead impedance and a chest x ray confirmed subclavian lead crush.
Figure 2
Figure 2
This ECG was recorded at a patient’s first follow up visit following implantation. While the patient was asymptomatic the ECG demonstrates that the first pacing pulse (black arrow) stimulates the ventricle and the second pulse (grey arrow) falls within the QRS complex. A plain chest x ray confirmed that the atrial lead had displaced into the right ventricle.
Figure 3
Figure 3
This patient reported recurrent syncope four months after a routine pulse generator change. A repeat chest film demonstrated a clear fracture (arrow) in the pacing lead compared to the film taken before the generator change (top). This required replacement of the ventricular lead.
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References

    1. Fraser JD, Gillis AM, Irwin ME, et al. Guidelines for pacemaker follow-up in Canada: a consensus statement of the Canadian working group on cardiac pacing. Can J Cardiol 2000;16:355–63. ▸ National Canadian guidelines on pacemaker follow up providing comprehensive details on minimum requirements. - PubMed
    1. Hayes DL, Naccarelli GV, Furman S, et al. NASPE training requirements for cardiac implantable electronic devices: selection, implantation and follow-up. Pace Clin Electrophysiol 2003;26:1556–62. - PubMed
    1. Erdinler I, Akyol A, Okmen E, et al. Long term follow-up of pacemakers with and autocapture pacing system. Jpn Heart J 2003;43:631–41. - PubMed
    1. Nowak B. Pacemaker stored electrograms: teaching us what is really going on in our patients. Pacing Clin Electrophysiol 2002;25:838–49. ▸ A comprehensive review of stored electrograms and their clinical interpretation. - PubMed
    1. Huikuri H. Effect of stored electrograms on management in the paced patient. Am J Cardiol 2000;86 (suppl) :101K–3K. ▸ Review article concentrating on evaluation of symptomatic and asymptomatic arrhythmias recorded in pacemakers. - PubMed