Search PubMed⌕ Search

Biomedical subjects

B Dodinot

Publications and source records attributed to B Dodinot.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Cardiac stimulation in children. 20 years' experience].

Between July, 1967 and December, 1987, 71 children and adolescents (43 boys, 28 girls) aged from 9 days to 20 years (mean 7.8 years) underwent pacemaker implantation. In 91 p. 100 of the cases this treatment was performed for complete atrioventricular block (CAVB). Surgical CAVB was the reason for 59 p. 100 of implantations (correction of tetralogy of Fallot and, more recently, of complex cardiopathies), the second main reason (16.9 p. 100) being nonsurgical CAVB associated with heart disease; the children in this group were young (mean age 4.2 years), and the prognosis mainly depended on the heart disease. Isolated congenital CAVB accounted for only 8.5 p. 100 of pacemaker implantations; these were older children (mean age 13.7 years), and the decision to implant was often difficult to reach in the absence of major functional disorders; following implantation, it was frequently found that isolated congenital CAVBs regarded as being well tolerated in fact were unrecognized handicaps. Acquired CAVB (7 p. 100) mostly consisted of Kearns' syndrome (4/5 cases). In addition, 3 children with sinus node disease and 1 with Romano-Ward syndrome benefited from cardiac pacing. Seven children died; death was in no case due to pacing but to the heart disease associated with CAVB. Endocardial pacing (68.2 p. 100 of primary implantations during the last decade) was preferred to epicardial pacing. Since 1985 we have been using exclusively screwed endocardial monopolar electrodes. The pacemakers were usually of the single-chamber ventricular type (85.9 p. 100 of primary implantations), but since 1987 dual-chamber pacemakers have been increasingly preferred for children with permanent CAVB or for replacement of pacemaker cases. Single-chamber noncompetitive ("demand") pacemakers were implanted in only 2 children: one pacemaker was connected to a ventricular electrode (atrial paralysis), the other to an atrial electrode. Whatever the type of electrode used, the pacemakers were implanted in the abdominal region in very young infants and in the pectoral region in children older than 3 or 4 years. Breakage of the wire was the main complication. Rises in threshold are the major drawback of epicardial pacing, as they require reoperation when the energy delivered cannot be effectively programmed. Endocardial pacing, preferably with a dual-chamber instrument, seems to be the best method, being the least aggressive, with minimal complications in short and very long term; it is justified as first-line treatment of permanent or predominant CAVB.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1985

[Sudden death in patients wearing pacemakers].

10 to 30 p. cent of patients with cardiac pacemakers die suddenly. In most cases, the cause of death can not be established. Racing of the pacemaker is a rare but definite cause of sudden death. In contrast, failure of the stimulation, which occurs much more frequently, and which is due to failure of the pacemaker or the wire or to an elevation of the threshold of stimulation, rarely causes sudden death because of the development of an idioventricular rhythm, leading to detection of the fault. Competitive rhythms do not appear to be more dangerous than accidental inhibition in sentinel pacemakers; both of these mechanisms can lead to ventricular tachycardia which may degenerate to ventricular fibrillation. Programmable pacemakers have certain advantages and disadvantages, in that the programming may prove to be inappropriate. In most cases, the ventricular fibrillation is spontaneous, occurring in the context of myocardial failure. The extension of the indications for pacemakers is certainly responsible for the relatively high incidence of sudden death.

Death, Sudden↗
PubMed1983

[Tachycardia and ensuing electrosystole].

The benign or severe nature of a ventricular extrasystole depends on a number of parameters which involve the pathophysiological mechanism of the extrasystole: re-entry, exaggerated normal or abnormal automatism and therefore the presence or absence of an underlying cardiac disease. The prognosis depends directly on the morphology, the number and the characteristics of the arrhythmia. Various investigations are often necessary to evaluate this prognosis, including 24 hour Holter monitoring, stress test and electrophysiological investigations.

Cardiac Complexes, Premature↗
PubMed1983

[Syncope and fainting in patients with a cardiac pacemaker].

When a patient with a cardiac pacemaker presents with syncope or faintness, one's first thought should be failure of the pacemaker. If the abnormality is not apparent, the patient needs a full cardiological investigation, including "active" electrocardiographic recordings: magnet test, programming, or even Holter monitor should be performed in order to exclude the responsibility of the pacemaker. Modern pacemakers can fail and cause syncope, especially if they have been inadequately or incorrectly regulated. The so-called physiological (double chamber) pacemakers can induce dangerous arrhythmias. Programming of the pacemaker can avoid further operation and can relieve the syncope: acceleration to prevent twisting of the apex, increase in the power of the impulses to eliminate the defects in stimulation due, for example, to a rise in the threshold. The syncope may also be caused by an extracardiac cause: associated pathology or useless implantation; the simplicity of implantation techniques sometimes means that pacemakers are implanted in inappropriate cases.

Arrhythmias, Cardiac↗
PubMed1982

[Multi-programmed pacemakers: one more gadget or practical usefulness?].

More than 60% of pacemakers presently implanted are programmable. Their parameters (rate, power, sensitivity, etc.) can be non-invasively modified by a "programmer" transmitting a coded signal to the pacemaker's circuit. It may be useful to select a high or low rate to achieve a normal cardiac output or to prevent arrhythmias. Output programmability may avoid reoperations and, if the threshold is low, decrease the current drain through low output programming. Clinical or technical indications for programming exist but this is frequently an unnecessary gimmick: many programmable pacemakers are never programmed. The absence of standardization decreases the advantages of the system. The trend will obviously be towards the routine implantation of programmable models, particularly for initial implant, but it is surely unnecessary to condemn the non-programmable models, particularly for replacements.

Aged↗
PubMed1982

[Physiologic stimulation: the future or a passing phase?].

Pacing techniques achieving normal AV synchrony are termed "physiologic". All rely on an atrial pacing or/and pacing system usually coupled with ventricular pacing. The major advantage is haemodynamic, usually related to the varying ventricular pacing rate obtained with atrial sensing systems only. Problems related to the more complex implantation technique, the cost of this system, its limited lifetime, more frequent iatrogenic complications and in particular the risk of reentry electronic "tachycardias" with the presently available models including an atrial sensing function, should limit the use of these devices to patients who really need AV synchrony if the implantation is technically possible, i.e., in our opinion, 10 to 15% of patients.

Arrhythmias, Cardiac↗
PubMed1982

[A chronological linkage technic of records and use of the obtained information. Application to the functional control of cardiac stimulators].

The application of information processing to the study of the evolution of the patient's state requires the constituting of a file which contains the values of different items as functions of time. There are many methods for doing this and most of them appeal to the construction of a complex database. The technique presented in the paper paper tries at first to constitute, for each patient, some records, of which every one corresponds to a determined "operation' (the term "operation' is taken in the wide sense; example: consultation, surgical intervention,...) then to link them according to the chronological order. It has the advantage of being easy so that it may be used even on minicomputers. Furthermore, the exploitation of the resultant data file is very easy. This method is well suited to problems such as the examination of the longitudinal investigations, the treatment of records of the patients who went through several operations, etc. The application presented here is the checking of the functioning of pacemakers. We wrote on a minicomputer MITRA 15/125 transferable general program (using FORTRAN IV exclusively), which allows one to carry out the linking and to exploit the resultant file. It is so designed that the addition of new procedures involved in new applications may be very easy.

Computers↗
PubMed1979

[Harmful interference between preoperative prophylactic cardiac pacemaker and cutting diathermy. Case report].

The authors report the case of a patient suffering the consequences of harmful preoperative between a prophylactic cardiac pacemaker system and cutting diathermy, resulting in irreversible ventricular fibrillation. After reviewing the different mechanisms responsible for this accident, they attribute the blame to a phenomenon of capture of electromagnetic currents with the pacemaker catheter playing the role of an aerial. They reconsider the indications for the use of prophylactic pacing and recall the safety precautions which must be respected at the time of simultaneous use of an external pacemaker and cutting diathermy.

Diathermy↗