CLINICAL PROFILES OF PATIENTS UNDERGOING PACEMAKER IMPLANTATION

Background and Objective: The implantation of a permanent cardiac pacemaker for the treatment of bradyarrhythmia is one of the most popular cardiac interventions. The goal of this study is to look at the clinical profiles of individuals who have permanent pacemakers implanted Material and Methods: The study was conducted using observational methods. The study included patients who received a permanent pacemaker for bradyarrhythmias between November 2019 and November 2021. A thorough review of the demographic profile and indications was performed. Results: The vast majority of the 312 patients were older, with the majority being between the ages of 56 and 88 years old (75 % ). Pacemakers were implanted in more men than in women. Complete heart block was the most common ECG finding and the most common presenting symptom was syncope. The most prevalent sign of pacing was acquired A-V block, and the most common pacemaker mode was single chamber (VVI/VVIR). Conclusion: Acquired A-V block and SSS were found to be the most common reasons for pacemaker implantation in our study. Higher implantation rates were linked to advanced age and male gender.

CONDUCTION DISORDERS AND PERMANENT CARDIAC PACEMAKER AFTER TRANSCATHETER AORTIC IMPLANTATION - AN UPDATE OVERVIEW

Aortic valve substitution is a standard technique with tolerable risk; nevertheless, the high mortality may be contraindicated. To reduce morbidity and mortality minimally invasive transcatheter aortic valve implantation (TAVI) may be an alternative approach. Although considered secure, after the method complications can occur, presenting as new-onset persistent left bundle branch block and demanding pacemaker implant. To establish how frequent this probability is, a systematic review from PUBMED (philters used were "15 years" and "free full texts") was achieved applying the terms "TAVI", "pacing" and "complications". For supporting literature, the other sources (SCIELO, Google Scholar and MEDLINE) were used and consulted for supporting literature. Catheter aortic prosthesis implantation is an effective modality for patients with high surgical risk and severe aortic stenosis. The review results suggest that the need for a pacemaker after endovascular treatment is neither inevitable nor easily predicted by known risk factors. Even though TAVI is considered a safe technique of selection, the implant position is near to functionally significant septal cardiac structures. Conduction disorders are frequent and need prudent checking after the procedure. Forthcoming studies must be necessary to validate the proposed algorithm and define the role of EP studies, ambulatory continuous electrocardiogram (Holter 24 hours) monitoring and preventive pacemaker in the management of conduction disturbances in patients undergoing transcatheter aortic valve replacement

A pacemaker-assisted microvascular decompression for a patient with left primary facial spasm and arrhythmia: a case report

Background Primary facial spasm accompanied by arrhythmia is a rare clinical phenomenon and has not been reported before. We describe this phenomenon and discuss its mechanism and treatment. Case presentation We herein present a rare case of a patient with left primary facial spasm and a third-degree atrioventricular block (III degree AVB), who was implanted with a temporary cardiac pacemaker to receive microvascular decompression (MVD) because of refusal of a permanent cardiac pacemaker. The symptoms of facial spasm disappeared after MVD. The temporary cardiac pacemaker was removed on the second day after surgery. Her ECG still showed the third-degree atrioventricular block after a follow-up period of 5 months. Conclusions We are the first to report a patient with facial spasm and arrhythmia who was implanted with a temporary cardiac pacemaker to receive MVD. This case report demonstrated that the concomitant presence of a III degree AVB maybe not a contraindication for MVD, and the etiology of this facial spasm was the actual vascular compression of the facial nerve entry zone that was not related to the atrioventricular block.

One case of severe obesity with preserved ejection fraction heart failure treated by permanent cardiac pacemaker

A 54 year old male, with multiple diseases(such as severe obesity, severe edema, atrial fibrillation, high atrioventricular block, global enlargement (lA55mm LV 62mm RA 69*55mm RV 46mm)), was diagnosed as heart failure with preserved ejection fraction (HFpEF). After treatment with drugs and implanting permanent cardiac pacemaker, the patient’s edema completely disappeared, weight loss of 42kg, heart failure symptoms disappeared left ventricular shrinkage (LV 59mm).

Abstract 14683: Central Nervous System Mediated Cardiac Bradyarrhythmia With Asystole That Required Permanent Pacemaker in a Young Woman With Anti- NMDAR Encephalitis

Background: We report a young woman who presented with acute psychosis and autonomic dysfunction who was diagnosed with Anti-N-Methyl-D-Aspartate Receptor Encephalitis (anti-NMDARE). Her life-threatening autonomic instability was controlled only after the placement of a permanent cardiac pacemaker. Case Presentation: A 29-year-old woman presented with abnormal movements and depersonalization. Vital signs showed BP 132/94 mmHg, HR 110 beats/min, RR 26 cycles/min, temperature of 101 F and spO2 of 80 % on RA. She was emergently intubated. Laboratory evaluation showed elevated CRP 6.98 mg/dL and CK 3329 U/L. Brain MRI revealed an abnormality in the right amygdala and hippocampus. Infectious workup was negative; however, a high titer of CSF NMDAR antibody was present. CT abdomen and pelvis revealed a 1.1 cm cyst within the left ovary. With a diagnosis of anti-NMDARE, she was treated with plasmapheresis, methylprednisolone, and immunoglobulin G therapy and underwent bilateral salpingo-oophorectomy with pathology confirming a teratoma. Despite these treatments, she continued to display autonomic dysfunction. Telemetry showed tachycardia-bradycardia with asystole that remained refractory to treatment and required placement of a permanent pacemaker (PPM). She showed clinical improvement after PPM and treatment ( Figure ). Conclusion: This is a rare case of severe bradyarrhythmia in anti NMDARE that necessitated placement of a permanent cardiac pacemaker. Neural-mapping studies show that the amygdala and hippocampus strongly modulate autonomic control. Disruption of cortical circuitry related to autonomic tone likely lead to arrhythmias in our case. Class I indications for pacemakers in the ICU include asystole, symptomatic bradycardia with hypotension and/or unresponsive to atropine. Early recognition, cardiorespiratory support, multistep pharmacological care and sometimes early electrophysiological support in anti-NMDARE are paramount.

Correlation between Deep Venous Thrombosis and Inflammation in Patients after Implantation of Permanent Pacemaker

Background: The correlation between postoperative deep venous thrombosis (DVT) and inflammation in patients with permanent cardiac pacemaker implantation was analyzed. Methods: A total of 130 cases undergoing permanent pacemaker implantation in the 305 Hospital of Chinese PLA and Fuwai Hospital from May 2014 to February 2017 were selected. Of the 130 cases, 60 patients complicated with DVT were selected as the observation group, and the remaining 70 cases without complications of DVT were selected as the control group. The relationship and influence of various factors were explored. Results: The number of patients smoking and the number of subjects with DVT history in the observation group were higher than those in the control group. In the observation group, plasminogen activator inhibitor (PAI)-1: Ag, PAI-1: Ac, thrombin-activated fibrinolysis inhibitor (TAFI): Ag, and TAFI: Ac levels were higher than those in control group (P<0.05). The levels of inflammatory factors of the peripheral blood of the observation group were significantly higher than those of the control group (P<0.05). In the correlation analysis of serum inflammatory factors and coagulation factors, CRP, IL-6, IL-10 were positively correlated with PAI-1: Ag level. Age, BMI, smoking history, number of implanted electrodes, DVT history, duration of immobilization and inflammatory factor levels had independent predictive value on postoperative complicated DVT. Conclusion: The serum inflammatory factors are closely associated with postoperative DVT in patients implanted with permanent cardiac pacemaker, and the serum inflammatory factors are a good reference for the evaluation of DVT.

Anxiety in patients with permanent cardiac pacemaker aged > 60 years old

Introduction: A cardiac pacemaker is a small implanted device to control abnormal heart rhythms. According to estimates, 3 million individuals worldwide live with an implanted permanent pacemaker (PPM) while about 600 thousand pacemakers are implanted, annually.Purpose: to explore anxiety of pacemaker recipients as well as all the associated demographic and self-reported characteristics.Material and Method: 100 outpatients with PPM were enrolled in the study. Collection of data was performed by the completion of the “Self-rating Anxiety Scale Zung (SAS)” which included patients' characteristics. Results: From the 100 participants 65% were men, 66% were >70 years old, 60% married, 50,5% of primary education and 90% lived in Attica. In terms of anxiety, 50% of recipients scored less than 48 on SAS scale (wide of range: 20-80) indicating mild to low levels of anxiety. Regarding associated factors, anxiety was found to be statistically significantly associated with gender (p=<0,001), understanding of provided information (p=<0,001), understanding of precautions in electromagnetic fields (p=0,021), desire for more frequent and long term follow-up and devise assessment (p=<0,001 and p=<0,001, respectively).Conclusions: Though pacemaker is an opportunity to prolong survival, however systematic assessment of anxiety and all the associated factors is considered to be of primary importance in clinical pacemaker settings.