Permanent pacemaker implantation

A decision to refer for permanent pacemaker implantation for loss of atrioventricular synchrony due to first degree AV nodal block is challenging. In the setting of normal conduction in the ventricles, the improvement that may be gained by improving atrioventricular synchrony must be weighed against... 

Manolis AG, Katsivas AG, Lazaris EE, Vassilopoulos CV, Louvros NE. Ventricular performance and quality of life in patients who underwent radiofrequency AV junction ablation and permanent pacemaker implantation due to medically refractory atrial tachyarrhythmias. J. Interv. Card. Electrophysiol. 1998 2 71-6. 

Holmes DR Jr (1986) Permanent pacemaker implantation. In Furman S, Hayes DL, Holmes DR Jr (eds) A practice of cardiac pacing. Futura, Mount Kisco, pp 97-127... 

Ellestad MH, French J (1989) Iliac vein approach to permanent pacemaker implantation. Pacing Clin Electrophysiol 12(7 Ptl) 1030-1033... 

Da Costa A, Kirkorian G, Cucherat M et al (1998) Antibiotic prophylaxis for permanent pacemaker implantation a meta-analysis. Circulation 97 1796-1801... 

Goto Y, Aabe T, Sekine S et al (1998) Long-term thrombosis after transvenous permanent pacemaker implantation. Pacing Clin Electrophysiol 21 1192- 1195... 

Mathur G, Stables RH, Heaven D et al (2001) Permanent pacemaker implantation via the femoral vein an alternative in cases with contraindications to the pectoral approach. Europace 3 56-59... 

From Belott PH, Reynolds DW. Permanent pacemaker implantation. In Ellenbogen KA, Kay N, Wilkoff BL, eds. Clinical cardiac pacing. Philadelphia WB Saunders, 1995, with permission. 

Fig. 4.5 Anterior orientation of the right ventricle. (From Belott PH. A practical approach to permanent pacemaker implantation. Armonk, NY Futura Publishing, 1995, with permission.)...

Fig. 4.18 Byrd s technique for access of the extrathoracic portion of the subclavian vein. Sequential needle punctures are walked posterolaterally along the first rib until the vein is entered. (From Belott PH, Reynolds DW. Permanent pacemaker implantation. In EUenbogen KA, Kay N, Wilkoff BL, eds. Clinical cardiac pacing. Philadelphia WB Saunders, 1995, with permission.)...

The jugular vein has been used for permanent pacemaker implantation as an alternate cutdown site (81). As a rule, the jugular vein has not been utilized for nonthoracotomy lead systems. This is a large venous structure that lies in the cervical triangle defined by the lateral border of the omohyoid muscle, inferior... 

Fig. 4.29 Use of the right iliac vein for placement of pacemaker leads. The leads are nltimately tunneled using a Penrose drain to a pocket created in the right upper quadrant. (From EUestad MH, French J. Iliac vein approach to permanent pacemaker implantation. Pacing Clin Electrophysiol 1989 12(7Pt 1) 1030-1033, with permission.)...

Stamato NJ, O Toole MF, Enger EL. Permanent pacemaker implantation in the cardiac catheterization laboratory versus the operating room an analysis of hospital charges and comphcations. PACE 1992 15 2236. 

Antonelli D, Freedberg NA, Rosenfeld T. Transiliac vein approach to a rate-responsive permanent pacemaker implantation. PACE 1993 16 1637. 

Implantation of transvenous ICD systems employs techniques similar to those used for permanent pacemaker implantations, and is discussed in detail in a separate chapter in this book. Connecting ICD leads to the device is slightly different than connecting pacemaker leads to pacemaker generators. All ICD pulse generators have at least three ports for single chamber devices (four ports for dual chamber devices, and five ports for CRT-D). One LV port is for the pace/sense IS-1 terminal pin, and two are for the defibrillation coil (usually DF+ and DF-). The second DF port may be capped if a single coil... 

Tobin K, Stewart J, Westveer D, Frumin H. Acute comphcations of permanent pacemaker implantation theh financial imphcation and relation to volume and operator experience. Am J Cardiol 2000 85 774-6, A9. 

Harcombe AA, Newell SA, Ludman PF, et al. Late complications following permanent pacemaker implantation or elective unit replacement Heart September 1998 80(3) 240-4. 

In the past, patients who developed significant bradyarrhythmias after the insertion of an ICD that did not have pacemaker function required a permanent pacemaker implanted at a separate location. This solved the patient s bradyarrhythmia issue, but potentiated significant interactions between the pacemaker and ICD. The most important of these was the non-detection of VF by the ICD due to the pacemaker s output. Here s how. 

Although this technique is associated with longer cross-clamp and donor ischemia times, the bicaval implantation procedure has significantly reduced the need for permanent pacemaker implantation in contrast to the standard biatrial technique (Deleuze et al. 1995 Meyer et al. 2005). 

The incidence of permanent pacemaker implantation varies between 6% and 23% (Melton et al. 1999) using the biatrial technique. If necessary a rate-responsive pacing system should be implanted as chronotropic incompetence is the rule. With the use of the bicaval anastomosis technique, the incidence of permanent pacemaker implantation diminished to less than 5%. 

In a series of 136 consecutive patients being transplanted with the bicaval anastomosis technique in our department only one (0.7%) needed permanent pacemaker implantation (AAI mode) because of sinus node dysfunction. 

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