Abstract
Pacing and defibrillation systems monitor and treat inappropriate cardiac rhythms. In general, these inappropriate rhythms result in cardiac outputs that are inadequate to meet metabolic demands, and thus can be life-threatening. In order to best understand the function of such pacing and defibrillation systems, the underlying physiologic situations indicated for their use must also be defined and understood. Furthermore, as with the design of any biomedical device or system, a first principles understanding of the appropriate physiologic behavior is a prerequisite to the definition of the performance characteristics of the device. This chapter primarily aims to provide a basic understanding of the physiologic conditions that require intervention with pacing and/or defibrillation systems, as well as introduce technical information about these systems to provide the reader with a foundation for future research and reading on this topic.
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References
Maisel WH, Sweeney MO, Stevenson WG, Ellison KE, Epstein LM (2001) Recalls and safety alerts involving pacemakers and implantable cardioverter-defibrillator generators. JAMA 286:793–799
Epstein AE, Darbar D, DiMarco JP et al (2012) ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guide. Circulation 127:e283–e352
Bernstein AD, Daubert JC, Fletcher RD et al (2002) The revised NAPSE/BPEG generic code for antibradycardia, adaptive-rate, and multisite pacing. Pacing Clin Electrophysiol 25:260–264
Furman S (1995) A brief history of cardiac stimulation and electrophysiology—the past fifty years and the next century. NASPE Keynote Address
His W Jr (1893) Die Tatigkeit des embryonalen Herzens und deren Bedcutung fur die Lehre von der Herzbewegung beim Erwachsenen. Artbeiten aus der Medizinischen Klinik zu Leipzig 1:14–49
Tawara S (1906) Das reizleitungssystem des saugetierherzens, Eine anatomisch-histologische studie uber das atrioventrikularbundel und die purkinjeschen faden, Jean, Germany: Gustav Fischer 9–70, 114–156
Lillehei CW, Gott VL, Hodges PC, Long DM, Bakken EE (1960) Transistor pacemaker for treatment of complete atrioventricular dissociation. JAMA 172:2006–2010
Furman SC. Walton Lillehei http://www.naspe.org/ep-history/notable_figures/walton_lillehei. Accessed 25 Nov 2003
Winters SL, Packer DL, Marchlinski FE et al (2001) Consensus statement on indications, guidelines for use, and recommendations for follow-up of implantable cardioverter defibrillators. Pacing Clin Electrophysiol 24:262–269
Parsonnet V (1984) Indications for dual-chamber pacing. NASPE Position Statement, June 1, 1984
Stokes KB, Kay GN (1995) Artificial electrical stimulation. In: Ellenbogen KA, Kay GN, Wilkoff BL (eds) Clinical cardiac pacing. W.B. Saunders, Philadelphia
Epstein AE, DiMarcok JP, Ellenbogen KA et al (2008) ACC/AHA/HRS 2008 Guidelines for device-based therapy of cardiac rhythm abnormalities. Circulation 117:e350–e408
Fogoros RN (1997) Antiarrhythmic drugs: a practical guide. Blackwell Science, Boston, p 112
Legreid Dopp A, Miller JM, Tisdale JE (2008) Effect of drugs on defibrillation capacity. Drugs 68:607–630
Wilkoff BL, Cook JR, Epstein AE et al (2002) Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator: the Dual-chamber and VVI Implantable Defibrillator (DAVID) Trial. JAMA 288:3115–3123
Karpawich PP, Rabah R, Haas JE (1999) Altered cardiac histology following apical right ventricular pacing in patients with congenital atrioventricular block. Pacing Clin Electrophysiol 22:1372–1377
Andersen HR, Nielsen JC, Thomsen PE et al (1997) Long-term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sick-sinus syndrome. Lancet 350:1210–1216
Lamas GA, Orav EJ, Stambler BS et al (1998) Quality of life and clinical outcomes in elderly patients treated with ventricular pacing as compared with dual-chamber pacing. Pacemaker Selection in the Elderly Investigators. N Engl J Med 338:1097–1104
Lamas GA, Lee K, Sweeney M et al (2000) The mode selection trial (MOST) in sinus node dysfunction: design, rationale, and baseline characteristics of the first 1000 patients. Am Heart J 140:541–551
Deshmukh P, Casavant DA, Romanyshyn M, Anderson K (2000) Permanent direct His bundle pacing: a novel approach to cardiac pacing in patients with normal His-Purkinje activation. Circulation 101:869–877
Karpawich P, Gates J, Stokes K (1992) Septal His-Purkinje ventricular pacing in canines: a new endocardial electrode approach. Pacing Clin Electrophysiol 15:2011–2015
Karpawich PP, Gillette PC, Lewis RM, Zinner A, McNamera DG (1983) Chronic epicardial His bundle recordings in awake nonsedated dogs: a new method. Am Heart J 105:16–21
Scheinman MM, Saxon LA (2000) Long-term His-bundle pacing and cardiac function. Circulation 101:836–837
Williams DO, Sherlag BJ, Hope RR, El-Sherif N, Lazzara R, Samet P (1976) Selective versus non-selective His bundle pacing. Cardiovasc Res 10:91–100
de Cock CC, Giudici MC, Twisk JW (2003) Comparison of the haemodynamic effects of right ventricular outflow-tract pacing with right ventricular apex pacing: a quantitative review. Europace 5:305–308
Cleland JG, Daubert JC, Erdmann E et al (2001) The CARE-HF study (CArdiac REsynchronisation in Heart Failure study): rationale, design and end-points. Eur J Heart Fail 3:481–489
Leclercq C, Daubert JC (2003) Cardiac resynchronization therapy is an important advance in the management of congestive heart failure. J Cardiovasc Electrophysiol 14:S30–S39
Saksena S (2003) The role of multisite atrial pacing in rhythm control in AF: insights from sub-analyses of the dual-site atrial pacing for prevention of atrial fibrillation study. Pacing Clin Electrophysiol 26:1565
Leclercq JF, De Sisti A, Fiorello P, Halimi F, Manot S, Attuel P (2000) Is dual-site better than single site atrial pacing in the prevention of atrial fibrillation? Pacing Clin Electrophysiol 23:2101–2107
Kindermann M, Schwaab B, Berg M, Frohlig G (2000) The influence of right atrial septal pacing on the interatrial contraction sequence. Pacing Clin Electrophysiol 23:1752–1757
Miake J, Marban H, Nuss B (2002) Biological pacemaker created by gene transfer. Nature 419:132–133
Go AS, Mozaffarian D, Roger VL et al (2014) Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation 129:e28–e292
Myerburg RJ (ed) (1997) Heart disease: a textbook of cardiovascular medicine (Chapter 24), 5th edn. W.B. Saunders, Philadelphia
Coronary artery disease overview. http://imaginis.com/heart-disease/cad_ov.asp?mode=1. Accessed 1 Dec 2014
Electricity and the heart: a historical perspective. http://www.naspe.org/ep-history/timeline. Accessed 25 Nov 2003
Hayes DL, Lloyd MA, Friedman PA (eds) (2000) Cardiac pacing and defibrillation: a clinical approach. Blackwell Publishing, Inc., New York, pp 1–599
Cummins RO (1989) From concept to standard-of-care? Review of the clinical experience with automated external defibrillators. Ann Emerg Med 18:1269–1275
Wathen MS, Sweeney MO, DeGroot PJ et al (2001) Shock reduction using antitachycardia pacing for spontaneous rapid ventricular tachycardia in patients with coronary artery disease. Circulation 104:796–801
Electricity and the heart: a historical perspective. http://www.naspe.org/ep-history/timeline/1980s. Accessed 26 Nov 2003
Carnes CA, Mehdirad AA, Nelson SD (1998) Drug and defibrillator interactions. Pharmacotherapy 18:516–525
Moss AJ, Hall WJ, Cannom DS et al (1996) Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med 335:1933–1940
Kloner RA, Birnbaum Y (eds) (2002) Cardiovascular trials review, 7th edn. Le Jacq Communications Inc., Shelton, CT, pp 1065–1066
Brabec S, Laske TG (2003) The evolution of bradycardia pacing electrodes. XII World Congress on Cardiac Pacing & Electrophysiology (Hong Kong)
Eggen MD, Bonner MD, Williams ER, Iaizzo PA (2014) Multimodal imaging of a transcatheter pacemaker implantation within a reanimated human heart. Heart Rhythm 11:2331–2332. doi:10.1016/j.hrthm.2014.03.052
Micra Transcatheter Pacing Study [cited 2014 November 13]; Available from: http://clinicaltrials.gov/show/NCT02004873
Reddy VY, Knops RE, Sperzel J et al (2014) Permanent leadless cardiac pacing: results of the LEADLESS trial. Circulation 129:1466–1471
Koruth JS, Rippy MK, Khairkhahan A et al (2015) Feasibility and efficacy of percutaneously delivered leadless cardiac pacing in an in vivo ovine model. J Cardiovasc Electrophysiol 26:322–328. doi:10.1111/jce.12579
Auricchio A, Delnoy PP, Butter C et al (2014) Feasibility, safety, and short-term outcome of leadless ultrasound-based endocardial left ventricular resynchronization in heart failure patients: results of the Wireless Stimulation Endocardially for CRT (WiSE-CRT) study. Europace 16:681–688
Additional Text Sources
Furman S, Hayes DL, Holmes DR (eds) (1993) A practice of cardiac pacing. Futura Publishing Company, Inc., New York, pp 1–753
Ellenbogen KA, Kay GN, Wilkoff BL (eds) (1995) Clinical cardiac pacing. W.B. Saunders, Philadelphia
Acknowledgements
 We would like to thank Mike Leners for the development of procedural animations, Medtronic Training and Education for the use of various graphics, the Visible Heart® team for support in capturing the intracardiac footage, Monica Mahre for editorial support, LifeSource, and Drs. Anne Fournier and Suzanne Vobecky of Sainte-Justine Hospital, Montreal, Quebec, Canada for the radiographic images.
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145597_3_En_30_MOESM22_ESM.mpg
Video 30.22. Defibrillation lead in the right ventricle of a swine heart, ventricular fibrillation is induced with a shock on the T-wave and then converted to sinus rhythm with a high-energy shock (MPEG 18,892 KB)
145597_3_En_30_MOESM23_ESM.mpg
Video 30.23. Defibrillation lead in the right ventricle of a human heart, ventricular fibrillation is converted to sinus rhythm with a high-energy shock (MPEG 4,584 KB)
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Laske, T.G., Dopp, A.L., Eggen, M.D., Iaizzo, P.A. (2015). Pacing and Defibrillation. In: Iaizzo, P. (eds) Handbook of Cardiac Anatomy, Physiology, and Devices. Springer, Cham. https://doi.org/10.1007/978-3-319-19464-6_30
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DOI: https://doi.org/10.1007/978-3-319-19464-6_30
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