[Permanent pacemaker treatment. Test procedure for evaluating the correct positioning and function of the electrode].
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Biomedical subjects
Publications and source records attributed to L Segadal.
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The different complications of endocardial electrode systems in 185 patients during the last seven years are discussed. The surgical technique for the now routinely used cephalic route is described. The choice of anaesthesia is discussed. In the last 39 implantations there have not been any displacements or retractions. Of the total number of patients only 3 required replacement of endocardial by myocardial electrodes. This was caused by unstable position and high stimulation threshold. Fracture of the electrode occurred in 4 cases. Stimulation of the diaphragm occurred in 10%, displacement and retraction of the electrodes in 6,5% and heart penetration or perforation in 3,8% of the patients. There was one death from cardiac tamponade due to electrode perforation of the right ventricle. One case had irreversible brain damage due to prolonged asystole during pulse generator replacement. Unimportant wound infections and haematomas occurred in 5 patients and phlebitis in 3 patients. More or less serious electrode complications have been seen in 56 of the 185 patients, 18 patients having more than one complication.
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Two methods based on different techniques for construction of cross-sectional flow velocity profiles from Doppler ultrasound signals were compared: an intraluminal method using pulsed-wave Doppler echocardiography and an extraluminal method using two-dimensional (color) Doppler ultrasound. The methods were applied to an in vitro pulsatile flow model. With the intraluminal method, pulsed Doppler recordings obtained throughout several flow pulses at different positions across a tube were digitized, and cross-sectional flow velocity profiles were obtained by matching the onset of flow velocity at the various positions. With the extraluminal method, cross-sectional flow velocity profiles were obtained by time interpolation between the digital flow velocity data obtained from several flow velocity maps. The first flow velocity map was recorded at onset of flow and the following maps were incrementally delayed with 20 msec from one flow pulse to the next. The time lag caused by the time needed to update each of the flow velocity maps was compensated for by time interpolation between the sequentially recorded flow velocity maps. The cross-sectional flow velocity profiles obtained with the two methods were compared at identical positions within the tube model at equal flow settings and throughout the pulsatile flow periods. At three different flow settings with peak flow velocity of 0.3, 0.5, and 0.7 m/sec, the difference (mean +/- SD) between the obtained velocities were 0.01 +/- 0.04, -0.01 +/- 0.05, and -0.03 +/- 0.07 m/sec, respectively. The findings suggest that cross-sectional flow velocity profiles from pulsatile flow velocity recordings can be obtained equally well with both methods.