Experimental atrioventricular block without thoracotomy: a new instrument

Experimental permanent total atrioventricular block was produced by a simplified method, without thoracotomy, by one person, and without the aid of x-ray apparatus. For this purpose, a newly designed cannula for the injection of 40% formalin into the bundle of His was mad

Experimental atrioventricular block without thoracotomy: a new instrument

Experimental permanent total atrioventricular block was produced by a simplified method, without thoracotomy, by one person, and without the aid of x-ray apparatus. For this purpose, a newly designed cannula for the injection of 40% formalin into the bundle of His was mad

Frequenzverhalten von Lithium-Schrittmachern bei Batterieerschopfung. [Stimulation rate of lithium powered pacemakers in the event of battery depletion]

Between 1976 and 1977, 347 lithium powered pacemakers with capacity below 1.8 Ah have been implanted at Zurich University Hospital. 25 (7%) had to be explanted after an average of 37.3 months because of premature battery depletion, the reason for which was low resistance electrodes (Elema EMT 588 A and C) in CPI-502 UD and Telectronics 150B. Both types showed a drop in stimulation rate as an EOL-characteristic, as predicted by manufacturer. Rate controls at 6 month intervals have proven a reliable means of detecting premature failure. With ARCO Li-3D, prediction of battery depletion was possible only in one case out of 5 because of sudden and unpredictable EOL. In pacemaker dependent patients this type should be explanted by the end of the guarantee period at the latest

Die chirurgische Behandlung von Herzrhythmusstorungen. [Surgical treatment of heart rhythm disorders]

Six patients underwent cardiac surgery for refractory tachyarrhythmias. Four had Wolff-Parkinson-White syndrome and 2 ventricular tachycardias after myocardial infarction. The results of preoperative electrophysiologic studies corresponded in 5 cases to intraoperative findings of epicardial and pace-mapping. These patients were free of symptoms for the 4-16 months' follow-up. In one patient with divergent results, tachycardia and preexcitation returned two months postoperatively. In the light of the foregoing the authors suggest surgical treatment for 1. preexcitation with life-threatening arrhythmias, 2. refractory ventricular tachycardias with coronary artery disease and 3. preexcitation in patients undergoing open heart surgery for other reasons

Hemodynamic effects of atrial synchronization in acute and long-term ventricular pacing

The acute and long-term hemodynamic benefit from atrial synchronization in ventricular (VAT) pacing has been investigated at rest and during exercise in 10 patients undergoing pacemaker implantation for complete A-V block. The results were compared to conventional (VOO) ventricular stimulation at rates of 70 BPM and 96 BPM. Cardiac index (CI) in VAT-pacing increased at rest by 8% and during exercise by 15% more than with VOO pacing (p less than 0.01). No significant change between the two different rates of asynchronous pacing was observed. CI at rest and during exercise was unchanged after 10 weeks of VAT-pacing. CI is regulated by change of stroke volume in VOO-pacing and by heart rate only with VAT-pacing. In contrast to earlier results with asynchronous ventricular pacing, the hemodynamic benefit of pacing in an atrial synchronized mode is long-lasting. Physiologic mechanisms regulate hemodynamics during exercise and in heart failure