Herzschrittmachertherapie & Elektrophysiologie
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Herzschrittmacherther Elektrophysiol · Jun 2005
Clinical Trial[First responder defibrillation in the LAGO-die Therme--results and experiences].
The use of automated external defibrillator (AED) by persons other than paramedics and emergency medical technicians is advocated by several US- and European organizations. However, at the present time it is still unclear to identify public places with a high incidence of out-of-hospital cardiac arrest. There are few data on the potential impact of public access defibrillators on survival after out-of-hospital cardiac arrest in sporting arenas or water parks. ⋯ In addition, in 2004, AED was noticed by 480 visitors (83%) and 277 visitors (48%) did more sporting activities. There were no significant differences between 2002 and 2004 (p=ns). Despite no out-of-hospital cardiac arrest in the waterpark during the 3 year follow- up, it seems reasonable to install AED in sporting places with thousands of visitors per year.
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Herzschrittmacherther Elektrophysiol · Mar 2002
[Pathophysiology of pacing in patients with atrial fibrillation].
The limited efficacy of and side effects associated with antiarrhythmic drug therapy have led to renewed interest in non-pharmacologic treatment options for paroxysmal atrial fibrillation. In addition to catheter ablation of the initiating ectopic atrial beats, electrical stimulation of the atrium is a new and promising method to reduce the frequency of arrhythmia recurrences. Recent studies have confirmed the importance of both the initiating triggers and the electrophysiologic substrate for the recurrence and perpetuation, respectively, of atrial fibrillation. ⋯ Finally, attempts are being made to terminate recurrences of atrial tachycardia or atrial flutter with antitachycardia pacing algorithms in order to avoid progression into atrial fibrillation. Based on experimental and clinical evidence, the initial phase of the majority of atrial tachyarrhythmia recurrences is not 'leading circle reentry'. Most episodes start relatively regular and seem to have an excitable gap, allowing capture and pace termination.
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Herzschrittmacherther Elektrophysiol · Mar 2002
[Preventive pacing in patients with paroxysmal atrial fibrillation: programming and follow-up of patients with dual-chamber pacemakers and triggered preventive pacing functions].
A treatment of patients with paroxysmal atrial fibrillation is the implantation of DDDRP pacemakers for preventive pacing. Atrial pacing with the aim for preventive pacing of atrial fibrillation can be classified as continuous constant pacing with a fixed manually programmed lower atrial pacing rate. The second approach is continuous dynamic overdrive pacing realized by new pacing algorithms, e.g., Pace Conditioning in the Vitatron DDDRP pacemakers. ⋯ After pacemaker implantation the pacemaker can be programmed individually according to the onsets of atrial fibrillation observed in the patient or the patient receives a standard programming and subsequently an individual adjustment of the pacing functions. The success of preventive pacing should be assessed a each follow-up visit by interrogation of the extended diagnostic pacemaker counters. There are at present no prospective studies concerning the effects of different pacemaker programming.