Seymour Furman’s research while affiliated with Albert Einstein College of Medicine and other places

... It is therefore not surprising that apical RV pacing is pathologic and imposes acute and chronic adverse effects on ventricular hemodynamics, function, myocardial perfusion, and cellular structure [2,3]. These experimental data are validated by the above mentioned clinical observations that chronic ventricular pacing in both the VVI/VVIR and the DDDR modes causes autonomic dysfunction [35,36], increased left heart size and reduced LV function compared with normal heart activation and atrial pacing which presumably explains the adverse outcomes in the clinical trials cited previously. Ventricular desynchronization itself may also cause severe mitral regurgitation that may precipitate AF and CHF [37,38]. ...

Reference:

The quest for physiological pacing

... The AIDs were relatively bulky (over 290 grams and a volume of over 150 ml), placed subcutaneously in the abdominal region and needed a median sternotomy/left lateral thoracotomy to fix the two patch electrodes on the epicardial surface; features such as pacing or other adjustable functions were unavailable at the time [3]. The second generation systems (AID-B) had bradycardia pacing and minimal programmability and the third generation systems, introduced in the early 1990s had antitachycardia pacing (ATP), low energy shocks for ventricular tachycardia (VT) treatment, extensive programmability and telemetry [4]. Since 1988 thoracotomy became unnecessary and the pacing lead system was placed transvenously [5], monophasic waves were no longer satisfactory for the transvenous approach, and which benefited the development of biphasic waveforms in 1991. ...

Reference:

No routine defibrillation threshold testing in all implantable cardioverter-defibrilator recipients – Still a question?

... The initial indications for ICD usage emerged largely from expert consensus documents, but have now been replaced by evidence-based practice guidelines, which, in significant part, are based on these trial data, and have seriously expanded ICD indications [3,4]. Despite apparently robust clinical trial evidence, clinical usage patterns and therapeutic benefits have been repeatedly questioned [5]. ...

Reference:

Twenty-five years of implantable defibrillator practice in the USA: Are we ready for globalization?

... [Zehender M et al., 1992;Zehender M et al., 1994]. [Bohm A et al., 2000;Tegtmeyer CJ et al., 1981;Vijayaraman P et al., 2002;Wallace WA et al., 1970] oder durch Defekte der Elektrode bedingt sein [Alonso C et al., 2001;Glikson M et al., 1994a;Glikson M et al., 1994b;Kawanishi DT et al., 1996;Kazama S et al., 1993;Ohm OJ, 1980;Parsonnet V et al., 1981]. Als Schrittmacher-Twiddler-Syndrom wird die ineffektive Impulsgabe durch den Herzschrittmacher bezeichnet, wenn diese durch multifaktorielle Rotation des Aggregates oder Isolationsschäden an der Elektrode aufgrund von Knickbildungen oder Längstorsion bedingt ist [Ellringmann U et al., 1977;Gialafos J et al., 1995;Lal RB et al., 1990;Young KR et al., 2002]. ...

Reference:

Ventrikuläre Tachyarrhythmien und der plötzliche Herztod bei Patienten nach Herzschrittmacherimplantation

... [1][2][3][4] Despite this, there are medical indications for ICD deactivation/explantation that include remission of cardiac arrhythmia, infection, lead failure, and heart transplant. 5 Furthermore, as the rate of ICD implantation increases and patients with ICDs approach the end of their lives, it is likely that clinicians will receive an increasing number of requests to discontinue ICD support. Clinicians may also receive such requests due to impaired quality of life (QOL) associated with ICD shocks. ...

Reference:

Implantable cardioverter defibrillator implant-explant-implant case study: Addressing the psychological adjustment to multiple shocks

... Various studies show infection rates of CEIDs between 1% and 7%. Likewise, the rate of dysfunctional leads reaches 7% [3][4][5][6][7]. The gold standard for treating CIED infection is device explanation as there is no therapy successful enough to eradicate the infection [8,9]. ...

Reference:

Octogenarian patients and laser-assisted lead extraction: Should we put a limit?

... A specific HRV analysis is executed with the aid of KUBIOS software developed by the Biosignal Analysis and Medical Imaging Group of the University of Eastern Finland. KUBIOS analysis is based on the heart rate variability guidelines (Malik, 1996). After filtering outliers in the RR time trace, a spectral analysis is executed. ...

Reference:

Differences in Workload of Both Skippers and Pilots Due to Changes in Environmental Bank Lights

... The choice between a unipolar and a bipolar pacing lead system is an old dilemma that has so far remained unresolved. Although some doubts can be expressed concerning the reliability of bipolar lead models [1] [2] , the advantages of these types of leads are evident in clinical practice, in particular because of the absence of extracardiac interference including that from skeletal muscle. But there are also differences between unipolar and bipolar electrodes from the point of view of electrical performance, in terms of pacing threshold, sensing and energy consumption [3] [4] [5] [6] . ...

Reference:

Latest generation of unipolar and bipolar steroid eluting leads: Long-term comparison of electrical performance in atrium and ventricles

... We found predominance of the sympatho-excitatory effect of adenosine [17] that overrides cardiac inhibition comparable to patients without SND resulting in a significant increase in HR. We selected DOO pacing only in patients with sinusbradycardia <45 bpm to prevent competitive atrial stimulation which can induce AF [18], also considering the fact that adenosine may promote AF by shortening the atrial action potential and refractory period [19]. Avoiding competitive atrial stimulation by pacing above intrinsic HR is not useful due to the acceleration of HR under adenosine (up to 40 bpm in tis study). ...

Reference:

Deactivation vs. asynchronous pacing - prospective evaluation of a protocol for rhythm management in patients with magnetic resonance conditional pacemakers undergoing adenosine stress cardiovascular magnetic resonance imaging

... For all studies, we set the "active mode" length to 1 ms. This stimulation duration is considered to be in the upper range for an effective pulse width as a result of the leveling effect of the strength-duration curve [35]. At 60 beats per minutes (BPM), this 1 ms "active mode" would be separated by intervals of 999 ms in "idle mode." ...

Reference:

A Multi-Dimensional Analysis of a Novel Approach for Wireless Stimulation