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Symptomatic Bradycardia (symptomatic + bradycardia)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Impact of Right Ventricular Pacing Sites on Exercise Capacity during Ventricular Rate Regularization in Patients with Permanent Atrial Fibrillation

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2009
HUNG-FAT TSE M.D., Ph.D.
Background:The deleterious effects of right ventricular apical (RVA) pacing may offset the potential benefit of ventricular rate (VR) regularization and rate adaptation during an exercise in patient's atrial fibrillation (AF). Methods:We studied 30 patients with permanent AF and symptomatic bradycardia who receive pacemaker implantation with RVA (n = 15) or right ventricular septal (RVS, n = 15) pacing. All the patients underwent an acute cardiopulmonary exercise testing using VVI-mode (VVI-OFF) and VVI-mode with VR regularization (VRR) algorithm on (VVI-ON). Results:There were no significant differences in the baseline characteristics between the two groups, except pacing QRS duration was significantly shorter during RVS pacing than RVA pacing (138.9 ± 5 vs 158.4 ± 6.1 ms, P = 0.035). Overall, VVI-ON mode increased the peak exercise VR, exercise time, metabolic equivalents (METs), and peak oxygen consumption (VO2max), and decreased the VR variability compared with VVI-OFF mode during exercise (P < 0.05), suggesting that VRR pacing improved exercise capacity during exercise. However, further analysis on the impact of VRR pacing with different pacing sites revealed that only patients with RVS pacing but not patients with RVA pacing had significant increased exercise time, METs, and VO2max during VVI-ON compared with VVI-OFF, despite similar changes in peaked exercise VR and VR variability. Conclusion:In patients with permanent AF, VRR pacing at RVS, but not at RVA, improved exercise capacity during exercise. [source]

Delayed Restoration of Atrioventricular Synchrony with Beat-to-Beat Mode Switch

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 8 2001
FRANK BODE
BODE, F., et al.: Delayed Restoration of Atrioventricular Synchrony with Beat-to-Beat Mode Switch. This case report describes a patient with complete AV block and a VDD pacemaker who experienced repetitive episodes of symptomatic bradycardia. Episodes occurred due to activation of an automatic beat-to-beat mode switch algorithm. After mode switch to VDI operation, the pacemaker failed to immediately switch back to AV synchronous pacing when regular sinus rhythm (, 100 beats per minute) resumed despite adequate P wave sensing. Dizziness was felt for up to several minutes of asynchronous pacing at the lower rate limit until VDD mode was restored. Episodes were completely eliminated by programming the mode switch function from an automatic beat-to-beat algorithm to a fixed rate algorithm. [source]

Syncope and sinus bradycardia from combined use of thalidomide and , -blocker,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 10 2008
Takashi Yamaguchi MD
Abstract We present a case of a 76-year-old Japanese man with hypertension and multiple myeloma (MM) presented with syncope and sinus bradycardia. Thalidomide therapy for MM was added to longstanding atenolol therapy one month prior to presentation. His heart rate (HR) was around 70 beats per minute (bpm) before addition of Thalidomide. His HR on presentation was less than 30,bpm. He was treated with intravenous atropine followed by temporary pacemaker and taken off atenolol. His HR returned to around 70,bpm few days after discontinuation of atenolol, even though he was still taking thalidomide, permitting outpatient management without a pacemaker. Both thalidomide and atenolol have been reported to cause bradycardia. Neither agent caused bradycardia when used alone in this patient, but simultaneous use caused symptomatic bradycardia. As thalidomide is prescribed more frequently, clinicians should be aware of the possibility of drug-induced sinus bradycardia due to the interaction of thalidomide and , -blockers. Copyright © 2008 John Wiley & Sons, Ltd. [source]

Effects of theophylline on exercise indices in a patient with chronotropic incompetence

CLINICAL CARDIOLOGY, Issue 10 2000
William C. Dixoniv M.D.
Abstract Several investigators have documented the successful use of oral sustained-release theophylline in treating symptomatic bradycardia and sick sinus syndrome. This paper reports a case of chronotropic incompetence in which specific exercise indices, including the chronotropic response index, were used to measure the therapeutic efficacy of theophylline. [source]