Stability of intrinsic rhythm in pacemaker-dependent patients during pacemaker replacement: Can we predict the need for temporary pacing?
| Autor: | Kenji Inoue, Masataka Sumiyoshi, Yasumasa Fujiwara, Takashi Tokano, Hidemori Hayashi, Kentaro Fukuda, Gaku Sekita, Yuki Kimura, Yuji Nakazato, Masayuki Shiozaki, Haruna Tabuchi, Hiroyuki Daida |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Torsades de points lcsh:Diseases of the circulatory (Cardiovascular) system Heart disease temporary pacing Sick sinus syndrome 03 medical and health sciences 0302 clinical medicine Rhythm Pacemaker replacement Internal medicine stability of intrinsic rhythm medicine Outpatient clinic 030212 general & internal medicine Asystole business.industry Original Articles medicine.disease Predictive value lcsh:RC666-701 030220 oncology & carcinogenesis Cardiology Original Article pacemaker replacement pacemaker‐dependent patients Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Arrhythmia Journal of Arrhythmia, Vol 34, Iss 4, Pp 450-454 (2018) |
| ISSN: | 1880-4276 |
| Popis: | Background In pacemaker‐dependent patients, the risk of asystole must be managed during device replacement. This study aimed to examine whether we could predict the indication for temporary pacing (TP) during the generator replacement. Methods We studied 105 consecutive patients who underwent pacemaker replacement due to battery depletion at Juntendo Nerima Hospital between September 2005 and December 2016. We examined the relationship between the stability of the intrinsic rhythm (IR) during pacemaker replacement and several clinical factors including age, gender, sick sinus syndrome or atrioventricular (AV) block, duration of pacing, structural heart disease, use of anti‐arrhythmic drugs, and the presence/absence of a stable IR (>40 bpm) at the outpatient clinic (OPC) just before pacemaker replacement. Results Of the 105 patients, we excluded 1 patient who required TP because of bradycardia‐dependent torsades de points. Therefore, we evaluated 104 patients for the indication for TP. TP was underwent in 19 patients (18%) because of an absence or instability of the IR during pacemaker replacement. The indication for TP was significantly correlated with AV block (84% vs 48%, P = .0044) and the absence of a stable IR at the last OPC visit (89% vs 24%, P < .0001). For predicting the indication for TP, the following values of no stable IR at the last OPC visit were obtained: 89% sensitivity, 77% specificity, 46% positive predictive value, and 97% negative predictive value. Conclusions The presence of a stable IR at the last OPC visit was a good predictor (97%) of no indication for TP during pacemaker replacement. |
| Databáze: | OpenAIRE |
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