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S Serge Barold

Publications and source records attributed to S Serge Barold.

At least 19 recordsLinked to original sources
PubMed2006

VDD pacemaker replacement is safe and reliable independently of the previously implanted lead: a prospective and controlled study.

UNLABELLED: Theoretically, replacement of a VDD device requires using a similar pacemaker to provide the best match between the filtering characteristics of the pacemaker and the atrial dipole of the lead. This study evaluated the performance of newly implanted Vitatron VDD pacemakers connected to dedicated leads and compared the results with those of the same Vitatron pacemakers used as replacement but connected to a variety of nondedicated leads. METHODS: 23 consecutive patients (15 M, 8 F, 78 +/- 6 years) in Group 1 underwent pacemaker replacement with a VDD(R) Saphir 3 (Vitatron BV, Arnhem, The Netherlands) device designed for an 8.6 mm atrial dipole. Atrial dipoles of the previously implanted leads ranged from 5 to 30 mm. Another 22 consecutive patients (14 M, 8 F, 80 +/- 7 years) in Group 2 received a Saphir 3 pacemaker with the related dedicated lead. RESULTS: P-wave amplitude measured by the same Pacing Sensing Analyzer (PSA) at the first implantation was 1.7 +/- 0.8 vs. 1.7 +/- 0.5 mV (P = NS) in groups 1 and 2 respectively. P-wave amplitudes measured at 1 month follow-up after replacement in Group 1 and at 1 month follow-up after implantation in Group 2 were 0.69 +/- 0.5 vs. 0.85 +/- 0.3 mV (P = NS) respectively. The percentage of atrial sensing at the same follow-up was 97 +/- 3 vs. 95 +/- 5% (P = NS) in groups 1 and 2 respectively. CONCLUSIONS: Replacement of VDD pacemakers with the Saphir 3 model designed for a short dipole is safe and reliable when used in combination with previously implanted nondedicated leads.

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PubMed2006

Diagnostic value of the 12-lead electrocardiogram during conventional and biventricular pacing for cardiac resynchronization.

The paced 12-lead ECG is a valuable tool in the assessment of patients with pacemakers, and ideally should be recorded routinely at the time of implantation and during follow-up. It has become particularly important in patients undergoing cardiac resynchronization. The multiplicity of clinical situations described in this review highlight the pitfalls of using a single ECG lead in the overall evaluation of pacemaker patients. The design of programmers capable of registering a 12-lead ECG would obviate the need of an additional electrocardiograph and encourage the routine recording of the paced 12-lead ECG with each patient encounter. Such an arrangement would improve the care of pacemaker patients.

Arrhythmias, Cardiac↗
PubMed2006

Electrocardiographic diagnosis of myocardial infarction during left bundle branch block.

The electrocardiographic diagnosis of myocardial infarction (MI) in the presence of left bundle branch block (LBBB) has long been considered problematic or even almost impossible. Many proposed ECG markers in the old literature have now been discarded. However, the advent of reperfusion therapy has generated greater interest in the ECG diagnosis of acute MI in LBBB where ST-segment deviation is the only useful sign. As such, the ST-segment criteria cannot be used to rule out MI, but they can help to rule it in. Criteria for old MI (based on QRS changes) have not been reevaluated for almost 20 years and continue to exhibit low sensitivity, but high specificity.

Bundle-Branch Block↗
PubMed2006

Electrocardiographic diagnosis of myocardial infarction and ischemia during cardiac pacing.

For the diagnosis of myocardial infarction (MI) using the QRS complex, the ECG provides only a low sensitivity (25%) but high specificity (close to 100%), but one cannot determine the age of an MI from the QRS complex. Although one cannot determine with certainty the age of an MI (hours, days or even years) from a single ECG, the presence of primary ST-segment abnormalities strongly suggests the diagnosis of acute MI or severe ischemia and the possible need for emergency revascularization. For acute MI, ST elevation>or=5 mm in predominantly negative QRS complexes is the best marker with a sensitivity of 53%, and specificity of 88%. A recent investigation suggests that T wave abnormalities from ischemia can be differentiated from those caused by cardiac memory related to pacing.

Cardiac Pacing, Artificial↗
PubMed2006

Is a dual-sensor pacemaker appropriate in patients with sino-atrial disease? Results from the DUSISLOG study.

BACKGROUND: Rate-responsive pacemakers (PMs) are often supplied with accelerometer (XL) and minute ventilation (MV) sensors to provide a physiologic rate response according to patient needs. No information is available about the real benefit of dual-sensor rate-responsive pacing on the daily life of patients. METHODS: DUSISLOG (Dual Sensor vs Single Sensor comparison using patient activity LOGbook) is a two-arm prospective, randomized, multicenter study that enrolled 105 patients who received a rate-responsive PM (Insignia), Guidant Corp.). After 1 month of DDD pacing at 60 ppm lower rate, a single sensor (XL or MV, randomized) was activated for 3 months at the manufacturer's suggested nominal settings, followed by a 3-month period with dual sensors optimized with automatic response. During the last month of each period, the following data concerning patient physical activity were retrieved from PM diagnostics (Activity Log): mean percentage of physical activity, mean intensity of activity. Quality of life (QoL) scores and 6-minute walk test (WT) were also recorded. RESULTS: Single-sensor rate-responsive pacing resulted in symptomatic benefit equally with XL and MV sensors while no additional benefit was found using dual sensor. In a subgroup analysis, patients (17%) with marked chronotropic incompetence and with 0% atrial sensing received benefits from single sensor with an additional advantage from sensor (QoL: +21 +/- 14% P < 0.05; WT: +17 +/- 7% P < 0.02). CONCLUSION: In most patients with rate-responsive devices, a single sensor is sufficient to achieve a satisfactory rate response. A dual sensor combination and optimization provides an additional benefit only in a selected population with an advanced atrial chronotropic disease.

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PubMed2006

Seymour Furman.

Explore the source record for details and available documents.

Cardiac Pacing, Artificial↗
PubMed2006

Latency during left ventricular pacing from the lateral cardiac veins: a cause of ineffectual biventricular pacing.

We report three patients with cardiomyopathy and pronounced stimulus to QRS latency during left ventricular (LV) pacing from an epicardial cardiac vein. Delayed LV activation during simultaneous biventricular pacing produced an electrocardiographic pattern dominated by right ventricular stimulation. Hemodynamic parameters improved immediately after advancing LV stimulation (in one patient) or pacing the LV only (in two patients) coupled with dramatic improvement of heart failure symptoms.

Cardiac Pacing, Artificial↗
PubMed2006

The risk profile for obstructive sleep apnea does not affect the recurrence of atrial fibrillation.

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to increased prevalence and recurrence of atrial fibrillation (AF). We hypothesized that OSA may aggravate AF in patients with pacemakers implanted for sinus bradycardia who had documented paroxysmal AF. METHODS: Seventy-two patients (36 M, aged 77 +/- 6 years) completed the study. All patients received a dual-chamber pacemaker equipped with diagnostic and preventive functions for AF. OSA was diagnosed with the Berlin Questionnaire, which is validated to identify patients with OSA. Four-month continuous pacemaker recordings were collected for all patients. RESULTS: OSA was diagnosed in 28% of patients. Patients at high risk for OSA (HR group) and patients at low risk for OSA (LR group) were equivalent for gender, age, and body mass index. The rate of hypertension was higher in HR than in LR group (90% vs 44%, P < 0.01). The prevalence of paroxysmal AF during the study period was similar in HR and LR group (53% vs 44%, P = NS). Overall number of AF episodes per month was not significantly different between HR and LR group (7 +/- 13 vs 36 +/- 122, P = NS). Similarly, AF burden (AF%) was not significantly different between HR and LR group (0.3 +/- 0.6 vs 2.0 +/- 4.8, P = NS). Circadian distribution of AF episodes was similar in both groups. CONCLUSION: Long-term pacemaker recording of AF recurrence, AF burden, and its circadian distribution is similar in patients with paroxysmal AF at high risk for OSA and those at low risk for OSA.

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PubMed2006

Mechanical esophageal deflection during ablation of atrial fibrillation.

To prevent esophageal damage during ablation of atrial fibrillation, we developed a technique to move the esophagus away from a desired ablation site too close to the esophagus. Under fluoroscopy, a transesophageal echocardiography probe was used to deflect the barium-opacified esophagus from the ablation site. This technique was successfully employed in three patients where critical sites of the posterior left atrial wall were very close to the esophagus.

Atrial Fibrillation↗
PubMed2006

Implantation of left ventricular leads using a telescopic catheter system.

BACKGROUND: Implantation procedures for cardiac resynchronization therapy (CRT) remain challenging with regard to coronary sinus (CS) cannulation and left ventricular (LV) lead positioning. Technologic advances in catheter design may facilitate CS cannulation and LV lead placement. AIMS: To evaluate two different telescoping dual-catheter systems, RAPIDO Guiding Catheter System (Group R) and RAPIDO ADVANCE Guiding Catheter System (Group A) (Guidant Inc., St. Paul, MN, USA), during implantation of a CRT device. METHODS: Seventy-four consecutive patients randomly received a CRT device using the R or A system. RESULTS: An LV lead was successfully implanted in 74 patients (100%). (1) Median times for CS cannulation in groups R and A were 0.3 minutes (range from 0.05 to 14 minutes) and 0.5 minutes (range from 0.05 to 9 minutes), respectively (P = NS). (2) Median times for LV lead placement were 8 minutes (range from 0.8 to 100 minutes) and 3.5 minutes (range from 0.25 to 30 minutes), respectively, for groups R and A (P = 0.032). (3) Median total fluoroscopy times were 12.33 minutes (range from 5 to 70 minutes) and 14.33 minutes (range from 6 to 53 minutes) for groups R and A, respectively (P = NS). (4) Median procedural times for CRT implantation were 80 minutes (range from 40 to 200 minutes) and 75 minutes (range from 45 to 180 minutes) (P = NS) in groups R and A, respectively. There were no major complications. CONCLUSION: CS cannulation and LV lead placement with a telescopic dual-catheter system is a safe and feasible approach that may reduce fluoroscopy and overall CRT implantation times. Our observations suggest that the RAPIDO ADVANCE System is faster than the RAPIDO System in terms of median time for LV lead positioning.

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