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Severe Bradycardia (severe + bradycardia)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Severe bradycardia in a patient with acute ophthalmoparesis without ataxia

MUSCLE AND NERVE, Issue 5 2010
Bengt Edvardsson MD
No abstract is available for this article. [source]

Overdrive Versus Conventional or Closed-Loop Rate Modulation Pacing in the Prevention of Atrial Tachyarrhythmias in Brady-Tachy Syndrome: On Behalf of the Burden II Study Group

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2008
ANDREA PUGLISI M.D.
Background:Optimizing dual-chamber pacing to prevent recurrences of atrial tachyarrhythmias (AT) in sinus node dysfunction is still debated. Despite the large number of studies, efficacy of sophisticated preventive algorithms has never been proven. It is not clear whether this is due to imperfect study designs or to a substantial inefficacy of pacing therapies. Aim:To intraindividually compare AT burden between an atrial overdrive and two heart rate modulation approaches: a conventional accelerometric-sensor-based DDDR mode and a contractility-driven rate responsive closed loop (CLS) algorithm. Methods and Results:Four hundred fifty-one patients with Brady-Tachy syndrome (BTS), severe bradycardia, and a documented episode of atrial fibrillation were enrolled. One month after implant, each pacing therapy was activated for 3 months in random order. A simple log transformation was used to handle large and skew AT burden distributions. Estimates were adjusted for false-positive AT episodes and reported as geometric means (95% confidence interval). A significantly higher AT burden was observed during overdrive, 0.14% (0.09%, 0.23%) (adjusted, 0.12%[0.07%, 0.20%]). Both DDDR and CLS performed better: respectively, 0.11% (0.07%, 0.17%) (adjusted, 0.08%[0.05%, 0.14%]), 0.06% (0.03%, 0.09%) (adjusted, 0.04%[0.03%, 0.07%]). All the comparisons were statistically significant. During overdrive significantly more patients had AT episodes of duration between 1 minute and 1 hour. No significant differences were observed for longer episodes. Conclusions:Atrial overdrive showed the worst performance in terms of AT burden reduction and should not be preferred to heart rate modulation approaches that still have to be considered as a first-choice pacing mode in BTS. [source]

Percutaneous Lead Implantation Connected to an External Device in Stimulation-Dependent Patients with Systemic Infection,A Prospective and Controlled Study

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 8 2006
MARTIN U. BRAUN
Background: Permanent pacemaker implantation usually is contraindicated in patients with systemic infection. The aim of the present study was to compare two different techniques of transvenous temporary pacing to bridge the infectious situation until permanent pacemaker implantation under infection-free conditions is possible. Methods and Results: Forty-nine patients with systemic infection and hemodynamic-relevant bradyarrhythmia/asystole were temporarily paced using either a conventional pacing wire/catheter (n = 26, reference group) or a permanent bipolar active pacing lead, which was placed transcutaneously in the right ventricle and connected to an external pacing generator (n = 23, external lead group). In both groups, there were no significant differences in patient characteristics. Whereas the sensing values were almost identical, the median pacing threshold was significantly higher in the reference group (1.0 V vs 0.6 V, P < 0.05). Within comparable duration of pacing (median: 8.2 vs 7.7 days), there were 24 pacing-related adverse events (including dislocation, resuscitation due to severe bradycardia, or local infection) in the reference group as compared to one event in the external lead group (P < 0.01). None of these complications resulted in cardiac death. Conclusion: Thus, transvenous pacing with active fixation is safe and associated with a significantly lower rate of pacing-related adverse events as compared to the standard technique of transvenous pacing using a passive external pacing catheter. [source]

Bradycardia and asystolic cardiac arrest during spinal anaesthesia: A report of five cases

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2000
R. Z. Løvstad
Sudden, severe bradycardia/asystolic cardiac arrest are considered infrequent, but are certainly the most serious complications of spinal anaesthesia. We report four cases of primary asystole and one of severe bradycardia in young to middle-aged, healthy patients scheduled for minor surgery at the day surgery unit. Bradycardia/asystole were not related to respiratory depression or hypoxaemia/hypercarbia; they occurred at different time intervals after the onset of spinal anaesthesia (10,70 min) and, apparently, were not dependent on the level of sensory block, which varied between T3 and T8. One patient was nauseated seconds before the asystole, otherwise there was no warning signs. All the patients were easily resuscitated with the prompt administration of atropine and ephedrine and, in the case of cardiac arrest, cardiac massage and ventilation with oxygen. One patient was treated with a small dose of adrenaline. Four patients had the surgery, as planned; one had the surgery postponed. All the patients were discharged from hospital in good health and did not suffer any sequelae. [source]