scholarly journals Epidemiological Record of Permanent Artificial Cardiac Pacemaker Implant at a Reference Center

2016 ◽  
Vol 32 (4) ◽  
pp. 257-261
Author(s):  
Larissa Freitas Nunes Goldoni ◽  
Rafaela Louise Sales ◽  
Kárila Scarduelli Luciano ◽  
Alessandra Kraus ◽  
Rafael de March Ronsoni
Keyword(s):  
Length Of Stay ◽  
Clinical Characteristics ◽  
Cardiovascular Surgery ◽  
Pacemaker Implantation ◽  
Cardiac Pacemaker ◽  
Reference Center ◽  
Temporary Pacemaker ◽  
Study Population ◽  
Artificial Cardiac Pacemaker ◽  
Pacemaker Insertion

Objective: To identify the profile of patients who implanted pacemakers and their complications in a tertiary cardiology center in the state of Santa Catarina. Methods: Unicentric, observational and prospective study with 81 patients submitted to pacemaker implantation by the Cardiovascular Surgery Service. Results: Provisional pacemaker was necessary in 42 cases (51.8%) and the average time of temporary pacemaker insertion was 2.2 days. Death occurred in 3 patients (3.7%), however only 1 case (1.2%) was associated with the implant. Conclusion: The clinical characteristics and indications of the implant in the study population were similar to those found in the literature, however the number of complications was high and the length of stay of the provisional pacemaker is beyond that recommended.

scholarly journals Investigating the Manifestation of Coronary Artery Disease and Determining the Role of Effective Factors in the Need for Pacemaker Insertion in These Patients

2019 ◽  
Vol 7 (13) ◽  
pp. 2108-2113
Author(s):  
Mohammad Tayyebi ◽  
Mitra Danesh Sani ◽  
Hamid Reza Mashreghi Moghadam ◽  
Arash Gholoobi ◽  
Negar Morovatdar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Pacemaker Implantation ◽  
Cardiac Pacemaker ◽  
Factors Affecting ◽  
History Of ◽  
Artery Disease ◽  
Pacemaker Insertion

BACKGROUND: Many patients who are candidates for a pacemaker are also at the same time risk factors for coronary artery disease such as high blood pressure, hypertension, diabetes, and hyperlipidemia, and therefore the probability of having coronary artery disease is significant. Effective diagnostic measures can be taken to prove the factors affecting the incidence of CAD in patients undergoing pacemakers at high-risk, including angiography. Therefore, it can prevent complications during and after pacemaker implantation, which leads to an increase in the quality of treatment in patients requiring pacemaker implantation. AIM: Therefore, the purpose of this study was to determine the predictive factors of significant coronary artery disease in patients with pacemaker implantation to identify patients in need of coronary angiography at the time of pacemaker implantation. METHODS: This retrospective study was carried out to examine the patients' files that were placed at the heart of Imam Reza Hospital during the period between March 2017 and September 2017. Demographic data, risk factors, echocardiography findings, and angiography, were collected and then recorded using a checklist. Statistical analysis was performed using SPSS software version 22 and Chi-square, and Mann-Whitney tests were used for determining significates variables. RESULTS: A group of 102 patients who had undergone a permanent cardiac pacemaker insertion due to an atrioventricular (AV) Block were included in the study, and also coronary anatomy was determined coronary angiography. Based on the results, 13.7% of patients with cardiac pacemaker had obstructive coronary artery disease (stenosis > 70%). Factors affecting coronary artery stenosis on angiography include gender, chest pain, history of myocardial infarction, angioplasty, diabetes, smoking, history of aspirin intake, calcium blocker and Plavix, high hematocrit, ST elevation and ST depression in the ECG, and severe mitral regurgitation. CONCLUSION: It seems that in most patients requiring permanent pacemaker insertion because of the atrioventricular (AV) Block, angiography does not change the patient's fate, and so can be ignored. However, in patients who have several risk factors from the listed above, coronary angiography is recommended during admission.

P1791Conduction abnormalities following aortic valve intervention in patients with transthyretin cardiac amyloidosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Zikry Deitch ◽  
D Haberman ◽  
S Lifshitz ◽  
S Tshori ◽  
Y Fabricant ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Cardiac Amyloidosis ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Conduction Disorders ◽  
Conduction Abnormalities ◽  
High Prevalence ◽  
Study Population ◽  
Pacemaker Insertion

Abstract Introduction Aortic Stenosis (AS) is the most common valvular heart disease in the Western world. Transcatheter aortic valve implantation (TAVI) is an alternative to surgical valve replacement in medium and high-risk patients. One of the most common complications after TAVI is conduction system disturbances including bundle branch block, complete heart block and need for permanent pacemaker implantation. Transthyretin cardiac amyloidosis (TTR–CA) is an increasingly recognized cause of heart failure that almost exclusively affects older adults. Diagnosis of TTR-CA in patients undergoing valvular intervention is relevant to understand their clinical outcomes and to discuss specific management. Objectives Occult amyloid may account for the frequent need for pacemakers among TAVR patients. We aimed to assess the correlation between intervention induced conduction abnormalities and the need for a pacemaker insertion and the presence of TTR-CA. Methods The study population included patients who had aortic valve intervention between 2011–2018. The patients underwent Tc99m-PYP scan using SPECT technology which has been shown to be valid for the diagnosis of TTR-CA. We examined the rate of conduction disorders and the need for a permanent pacemaker from patient files at the time of hospitalization and during a 24-month follow-up. Results The study population included 86 patients, mean age 78±6 years, 55% women. Twenty-nine (33%) of the participants were diagnosed as positive (VAS 2 and 3) for transthyretin cardiac amyloidosis. There were no differences in baseline characteristics with regard to age, gender, risk factors, hemoglobin and renal function between patients positive and negative for TTR CA. Conduction disorders were seen in 35 (40%) patients. Patients with TTR CA had a statistically higher prevalence of conduction disorders. Forty-two percent of TTR CA positive patients underwent peri-procedural permanent pacemaker implantation compared to 28% peri-procedural pacemaker implantations in the negative group (p=0.043). Development of a new left bundle branch block during the follow-up period was observed in 14.1% of all patients. There was a statistically significant higher rate in the positive group compared to TTR CA negative group (39.1% vs 10.9% p=0.03). Conclusions We observed a high prevalence of occult TTR-CA in older adults with aortic stenosis who underwent TAVI. We also found a high prevalence of conduction abnormalities following TAVI in patients with TTR CA. These findings suggest a need for more careful observation for possible conduction abnormalities and requirement for pacemaker insertion in these patients. Acknowledgement/Funding None

scholarly journals Clinical Profile of Patients Undergoing Temporary Transvenous Pacing in a Tertiary Cardiac Care Centre in Nepal

2020 ◽  
Vol 42 (2) ◽  
pp. 37-41
Author(s):  
Manju Sharma ◽  
Sunil C Jha ◽  
Arun Sayami ◽  
Ratna M Gajurel ◽  
Chandra M Poudel ◽  
...  
Keyword(s):  
Care Center ◽  
Femoral Vein ◽  
Tertiary Care ◽  
Pacemaker Implantation ◽  
Venous Access ◽  
Safe Procedure ◽  
Temporary Pacing ◽  
Temporary Pacemaker ◽  
Life Threatening ◽  
Pacemaker Insertion

Introduction Temporary transvenous pacemaker insertion is an emergency lifesaving procedure for patients with hemodynamically unstable and life-threatening bradyarrythmias. The aim of this study was to analyze demographics, indications, route of insertion and complications in patients undergoing temporary transvenous pacemaker implantation. MethodsThis was a retrospective observational study conducted at a tertiary-care center in Nepal. The hospital records of patients who had undergone temporary transvenous pacemaker implantation between July 2015 and June 2019 were reviewed. ResultsA total of 343 patients with mean age of 65.52±16.09 years received temporary transvenous pacing. Out of these 205 (59.8%) were males. Greater proportion of patients were between the age group of 70-80 years (n=76, 22.2%). Hypertension (n=97, 28.3%) was the most common comorbidity noted. The most common indication for temporary pacing was symptomatic complete heart block 165 (59.6%). Total of 288 (84%) patients received permanent pacemakers while 55(16%) had reversible cause so TPI was removed. Right Femoral vein was the most common (99%) venous access site. Among the 343 patients, complications were observed in 29 (8.4%) of cases during and after the temporary transvenous pacemaker insertion. The overall mortality stood low at 2% (n=7). ConclusionTemporary transvenous pacemaker insertion is required in elderly population presenting with bradyarrythmias and occasionally in acute myocardial infarction presenting with bradyarrythmias as complication. Temporary pacemaker insertion was overall a safe procedure with infrequent serious complications; however, strategies to avoid and alleviate such complications (RV perforation) should be sought and implemented.

scholarly journals Measurement of total hemoglobin reduces red cell transfusion in hospitalized patients undergoing cardiac surgery: a retrospective database analysis

Perfusion ◽  
2017 ◽  
Vol 33 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Christopher Craver ◽  
Kathy W. Belk ◽  
Gerard J. Myers
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Cardiovascular Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Discharge Data ◽  
Total Hemoglobin ◽  
Study Population ◽  
Red Cell Transfusion ◽  
Rbc Transfusion

Introduction: Historically, perioperative hemoglobin monitoring has relied on calculated saturation, using blood gas devices that measure plasma hematocrit (Hct). Co-oximetry, which measures total hemoglobin (tHb), yields a more comprehensive assessment of hemodilution. The purpose of this study was to examine the association of tHb measurement by co-oximetry and Hct, using conductivity with red blood cell (RBC) transfusion, length of stay (LOS) and inpatient costs in patients having major cardiac surgery. Methods: A retrospective study was conducted on patients who underwent coronary artery bypass graft (CABG) and/or valve replacement (VR) procedures from January 2014 to June 2016, using MedAssets discharge data. The patient population was sub-divided by the measurement modality (tHb and Hct), using detailed billing records and Current Procedural Terminology coding. Cost was calculated using hospital-specific cost-to-charge ratios. Multivariable logistic regression was performed to identify significant drivers of RBC transfusion and resource utilization. Results: The study population included 18,169 cardiovascular surgery patients. Hct-monitored patients accounted for 66% of the population and were more likely to have dual CABG and VR procedures (10.4% vs 8.9%, p=0.0069). After controlling for patient and hospital characteristics, as well as patient comorbidities, Hct-monitored patients had significantly higher RBC transfusion risk (OR=1.26, CI 1.15-1.38, p<0.0001), longer LOS (IRR=1.08, p<0.0001) and higher costs (IRR=1.15, p<0.0001) than tHb-monitored patients. RBC transfusions were a significant driver of LOS (IRR=1.25, p<0.0001) and cost (IRR=1.22, p<0.0001). Conclusions: tHb monitoring during cardiovascular surgery could offer a significant reduction in RBC transfusion, length of stay and hospital cost compared to Hct monitoring.

scholarly journals Assessment of Cardiopulmonary Bypass Duration Improves Novel Biomarker Detection for Predicting Postoperative Acute Kidney Injury after Cardiovascular Surgery

2021 ◽  
Vol 10 (13) ◽  
pp. 2741
Author(s):  
Tao Han Lee ◽  
Cheng-Chia Lee ◽  
Jia-Jin Chen ◽  
Pei-Chun Fan ◽  
Yi-Ran Tu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiopulmonary Bypass ◽  
Fatty Acid Binding Protein ◽  
Cardiovascular Surgery ◽  
Kidney Injury ◽  
Fatty Acid Binding ◽  
Discriminatory Ability ◽  
Postoperative Risk ◽  
Study Population ◽  
Postoperative Aki

Urinary liver-type fatty acid binding protein (L-FABP) is a novel biomarker with promising performance in detecting kidney injury. Previous studies reported that L-FABP showed moderate discrimination in patients that underwent cardiac surgery, and other studies revealed that longer duration of cardiopulmonary bypass (CPB) was associated with a higher risk of postoperative acute kidney injury (AKI). This study aims to examine assessing CPB duration first, then examining L-FABP can improve the discriminatory ability of L-FABP in postoperative AKI. A total of 144 patients who received cardiovascular surgery were enrolled. Urinary L-FABP levels were examined at 4 to 6 and 16 to 18 h postoperatively. In the whole study population, the AUROC of urinary L-FABP in predicting postoperative AKI within 7 days was 0.720 at 16 to 18 h postoperatively. By assessing patients according to CPB duration, the urinary L-FABP at 16 to 18 h showed more favorable discriminating ability with AUROC of 0.742. Urinary L-FABP exhibited good performance in discriminating the onset of AKI within 7 days after cardiovascular surgery. Assessing postoperative risk of AKI through CPB duration first and then using urinary L-FABP examination can provide more accurate and satisfactory performance in predicting postoperative AKI.

scholarly journals Analysis of risk scores and duration of hospital stay in prognosis of STEMI patients after pPCI

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
SR Thangasami ◽  
JS Prajapati ◽  
GL Dubey ◽  
VR Pandey ◽  
PM Shaniswara ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Early Discharge ◽  
Risk Scores ◽  
Timi Score ◽  
Study Population ◽  
Event Rates ◽  
Grace Score

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Advances in the immediate management of ST elevation myocardial infarction (STEMI) have led to a dramatic decline in mortality and reduction in hospital length of stay (LOS). We analysed the prognostic value of selected risk models in STEMI treated with primary percutaneous coronary intervention (PPCI) and to identify additional parameters to strengthen risk scores in categorizing patients for safe early discharge and to identify parameters prolonging hospital stay. Purpose To assess parameters and risk scores to categorize patients for safe early discharge following STEMI and to assess the composite of death, MI, unstable angina (UA), stroke, unplanned hospitalization at the end of 30 days, 6 months and at 1year follow up. Methods The study included 222 patients, who were diagnosed as STEMI, treated with successful pPCI. The risk scores like TIMI score, GRACE score, ZWOLLE score, CADILLAC score were calculated for all patients from the baseline clinical data collected on admission. Routine blood investigations along with Brain natri-uretic peptide (BNP) were done for all patients. The entire cohort was divided into three groups on the basis of length of stay: ≤3 days (n = 150), 4–5 days (n = 47), and &gt;5 days (n = 25). All-cause mortality and major cardiovascular events (MACEs) were assessed up to 1 year. Results The mean age group (yrs) of the study population was 53.92 ± 12.9. Patients in LOS &lt;3 days had a mean age (yrs) of 52.41 ± 11.74, patients in LOS 4-5 days group had 54.19 ±13.59 and patient with LOS &gt;5 days had 62.52 ± 15.32. The most important parameters that predicted hospital stay in our study are BNP levels OR: 1.003, 95% CI: 1.002-1.004, P &lt; 0.001, GRACE score OR: 1.02 ,95% CI: 1.01-1.03, P &lt; 0.001, TIMI score OR: 1.35, 95% CI: 1.18-1.55, P = 0.007, ZWOLLE score OR: 1.26, 95% CI: 1.16-1.37, P &lt; 0.001, CADILLAC score OR: 1.24, 95% CI; 1.15-1.3: P &lt; 0.001. 32 (14.4%) patients expired in the study population. 36% patients of LOS &gt;5 days expired in 1year follow up with maximum mortality in the first 6 months. 56% of the patients in LOS &gt; 5 days had an adverse cardiac event in 1 year follow up. Patients in LOS &gt;5 days had increased event rates in 30 days,6 months and in 1 year follow up. Patients with LOS 4-5 days (30%) had increased event rates than patients in LOS &lt; 3 days (19%).Unadjusted Kaplan Meir survival curves for 1 year mortality among hospital survivors showed a significant increase in mortality at 6 months in length of stay&gt; 5 days group. (P value &lt; 0.001). CONCLUSION Long hospital stay after PCI among patients with STEMI was associated with increased long-term all-cause mortality. Addition of BNP to this risk scores can better predict the course of hospital stay and adverse clinical outcomes in follow up. Long hospital stay may be used as a marker to identify patients at higher risk for long-term mortality. Abstract Figure. Kaplan meir survival curve

scholarly journals Case Report: Complete heart block as a manifestation of cardiac metastasis of oral cancer

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1243
Author(s):  
Andrianto Andrianto ◽  
Eka Prasetya Budi Mulia ◽  
Denny Suwanto ◽  
Dita Aulia Rachmi ◽  
Mohammad Yogiarto
Keyword(s):  
Pericardial Effusion ◽  
Heart Block ◽  
Complete Heart Block ◽  
Tongue Cancer ◽  
Pacemaker Implantation ◽  
Metastatic Tumor ◽  
Variable Number ◽  
Permanent Pacemaker ◽  
Cardiac Metastasis ◽  
Temporary Pacemaker

Metastatic tumors of the heart presenting with complete heart block (CHB) is an extremely uncommon case. There are no available guidelines in managing CHB in terminal cancer. Permanent pacemaker implantation in such cases is a challenge in terms of clinical utility and palliative care. We report a case of a 24-year-old man suffering from tongue cancer presenting with CHB. An intracardiac mass and moderate pericardial effusion were present, presumed as the metastatic tumor of tongue cancer. We implanted a temporary pacemaker for his symptomatic heart block and cardiogenic shock, and pericardiocentesis for his massive pericardial effusion. We decided that a permanent pacemaker would not be implanted based on the low survival rate and significant comorbidities. Multiple studies report a variable number of cardiac metastasis incidence ranging from 2.3% to 18.3%. It is rare for such malignancies to present with CHB. The decision to implant a permanent pacemaker is highly specific based on the risks and benefits of each patient. It needs to be tailored to the patient’s functional status, comorbid diseases, prognosis, and response to conservative management.

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