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Biomedical subjects

H Bakema

Publications and source records attributed to H Bakema.

7 recordsLinked to original sources
PubMed1997

[Good experiences with an implantable automatic defibrillator with transvenous electrodes for patients with life-threatening arrhythmias].

OBJECTIVE: To describe the results of treatment of patients with a life-threatening arrhythmia by implantation of an second generation implantable cardioverter defibrillator with transvenous electrodes. DESIGN: Descriptive. SETTING: St.-Antonius Hospital, Nieuwegein, the Netherlands. METHOD: In the period October 1991-February 1996 the ICD with transvenous electrodes was implanted in 44 patients. After a year the quality of life was assessed by written questionnaire. RESULTS: The in-hospital mortality was 1/44 (2%), without peroperative death. During follow-up 4 patients died: 3 due to congestive heart failure and 1 due to sudden cardiac death. Within one year 50% of the patients had a therapeutical ICD discharge. In 30/44 (68%) patients antiarrhythmic drugs were prescribed to reduce the number of ICD discharges or because they were suffering from paroxysmal atrial fibrillation with high heart rates, which could result in an inappropriate ICD discharge. Quality of life analysis showed a good acceptance of the ICD, although 86% of the patients considered it a very serious limitation that they were not allowed to drive a motor vehicle anymore. CONCLUSION: The ICD constitutes a major step forward in the treatment of life-threatening ventricular arrhythmias because the implantation is easier and follow-up shows adequate antiarrhythmic effects and survival.

Adult↗
PubMed1997

Effective use of a novel rate-smoothing algorithm in atrial fibrillation by ventricular pacing.

BACKGROUND: It is still unknown whether a fast heart rate or an irregular ventricular response in atrial fibrillation causes tachycardiomyopathy. Reduction in the variability of RR intervals without an increase in heart rate might be an alternative treatment when antiarrhythmic drugs fail to control the irregularity accompanying atrial fibrillation. SUBJECTS AND METHODS: Eight patients underwent temporary right ventricular pacing, using a novel rate-smoothing algorithm prior to DC cardioversion or His bundle ablation. A rate-smoothing algorithm was utilized by right ventricular apical stimulation. Spontaneous and paced RR intervals during atrial fibrillation were quantified and processed for statistical analysis. RESULTS: The rate-smoothing algorithm resulted in a substantial reduction in the variance of the RR intervals (slow mode 73.1%, fast mode 40.0%) and RR range (slow mode 49.3%, fast mode 34.3%). In contrast to previous algorithms, the mean heart rate during pacing intervention in atrial fibrillation did not change significantly to the heart rate directly preceding the pacemaker intervention (+2%). CONCLUSIONS: This initial study of the novel rate-smoothing algorithm shows that pacing intervention is a relatively safe, rapid and reliable alternative therapy for controlling irregular ventricular rhythms due to atrial fibrillation. Incorporation of the algorithm in implantable pacemakers appears justified, but demands further prospective studies in patients to evaluate relief of symptoms and reduction of tachycardiomyopathy due to atrial fibrillation.

Aged↗
PubMed1981

Long-term follow-up after pacemaker implantation in sick sinus syndrome.

In 74 symptomatic patients suffering from sick sinus syndrome, survival after pacemaker implantation and additional drug therapy was determined. The 5-year survival was poor (47.2%). Evidence of other cardiac disease (present in 44.6%) influenced the prognosis unfavorably, especially in combination with continuing symptoms. As yet the phase of SSS in which chronic cardiac pacing is required, should be considered as a critical stage.

Adult↗