Öz
It has been shown that potentials from the skeletal muscle are capable of inhibiting the demand mechanism and causing temporary pacemaker failure. Myopotential oversensing by pulse generators can cause symptoms such as dizziness, syncope and etc. This problem appears more İreguentiy with unipolar systems than bipolar pacemakers,Some provocative muscle exercises (maneuvers), which appear to be significantiy effective in provoking myopotentials, were applied to 19 patients (1 of them with unipolar system, and 8 patients with bipolar pacemaker). Myopotential inhibition occured in 9 patients (8 of them with unipolar system, 1 patient with bipolar pacemaker). The İreguencies of myopotential inhibition were 72,7 & in unipolar, and 12,5 in bipolar systems. The maneuvers which freguently cause this
problem, were «to push one hand by the others and «to push the opposite shoulder by the hande». Of 9 patients with myopotential inhibition, 4 had some symptoms.
In 2of them the pulse generator sensitivity was decreased by external programming, Pacemaker was changed in one symptomatic patient, because her pacemaker was not programmable and it was an old one. In the last patient with bipolar system, the electrod was changed and the problem was resolved. In conclusion bipolar systems should be preferred bec
Anahtar Kelimeler
Pacemaker sensitivity Unipolar and bipolar systems Myopotential interference
Kaynakça
- 1. Hurst JW Sechland RC Rackley CE Sonnenblick EH Wenger NK : The Heart, Arteries and Veins, MecGraw-Hill Information Services Company, Seventh editlon, 1990 : p 566, 578.
- 2.Fetter J Bobeldyk GL Engman FJ : The celinical incidence and signifiçance of myopotential sensing with unipolar pacemakers. PACE 7 : 871, 1984
- 3. Güldal Muharrem ; Aritmi tedavisinde kardiyak pacemaker'ler ve antiaritmik ilaçlar. Ankara : Sistem Ofset, 1988 : 92-95.
- 4, Brandenburg RO : Cardiology : Fundamentals and Practise, Printed in the United States of America, 1987 : p 916, 917.
- 5. Ohm OJ Bruland H Pedersen OM Waerness E : Interference etfeçt of myopotantials on function of unipolar demand pacemakers, Br, Heart J 36 : 71, 1974,
- 6. Barold SS Ong 1S Falkoff MD Heinle RA : Imhibition of bipolar demand pacemaker by diaphragmatic myopotentials. Circulation 56, 4 : 679, 1977
- 7. Peter T Harper R Sloman G : Inhibition of demand pacemakers caused by potentials assoctated with inspiration. Br Heart J38:211, 1978.
- 8. Anderson ST Pit A Whitford JA Davis BB : Interlerence with function of unipolar pacemaker due to muscle potentials. J Thorac Cardiovasc Surg 71 : 696, 1978.
- 9. Amikam S Peleg H Lemer J Riss E : Myopotential inhibition or a bipolar pa&r cemaker caused by electrode inşulation defect, Br Heart J 39: 1279, 1977.
Öz
Adale potansiyellerinin pacemaker tarafından sens edilmesi sonucunda, bazı hastalar semptomatik hale gelebilirler. Unipolar pacemaker'lerde bu problemin ortaya çıkması, bipolar sistemlere göre çok daha kolaydır. 19 hastaya (11 inde unipolar sistem, 8 inde bipolar sistem) adale potansiyellerini ortaya çıkaran çeşitli manevralar yaptırıldı. 9 hasta- da (8 inde unipolar, 1 inde bipolar sistem) adale potansiyellerinin pacemaker tarafından sens edildiği tespit edildi, Unipvlar sislemli haştalarda sens oranı X 72,7 iken, bipolar sistemli hastalarda & 12,5 idi. Bu duruma en sık sebep olan hareketlerin, «bir eli öteki elle itmek ve bir elle aksi taraftaki omuzu itmek» olduğu gözlendi. Semptomatik olan 4 hastanın 2 sinde sensitivite programlanarak,; birinde programsız olduğu ve ömrünün tükenmesine az bir süre kaldığı için pacemaker değiştirilerek, bipolar sistemli hastada da elektrod değiştirilerek bu problem çözüldü. Netice olarak; adele potansiyellerinin sens edilme sorununun çok,
düşük oranda görülmesi sebebiyle, bipolar sistemlerin terçih edilmesi uygun olur.
Anahtar Kelimeler
Pacemaker duyarlılığı Unipolar ve bipolar sistemler Miyopotansiyel interferansı
Kaynakça
- 1. Hurst JW Sechland RC Rackley CE Sonnenblick EH Wenger NK : The Heart, Arteries and Veins, MecGraw-Hill Information Services Company, Seventh editlon, 1990 : p 566, 578.
- 2.Fetter J Bobeldyk GL Engman FJ : The celinical incidence and signifiçance of myopotential sensing with unipolar pacemakers. PACE 7 : 871, 1984
- 3. Güldal Muharrem ; Aritmi tedavisinde kardiyak pacemaker'ler ve antiaritmik ilaçlar. Ankara : Sistem Ofset, 1988 : 92-95.
- 4, Brandenburg RO : Cardiology : Fundamentals and Practise, Printed in the United States of America, 1987 : p 916, 917.
- 5. Ohm OJ Bruland H Pedersen OM Waerness E : Interference etfeçt of myopotantials on function of unipolar demand pacemakers, Br, Heart J 36 : 71, 1974,
- 6. Barold SS Ong 1S Falkoff MD Heinle RA : Imhibition of bipolar demand pacemaker by diaphragmatic myopotentials. Circulation 56, 4 : 679, 1977
- 7. Peter T Harper R Sloman G : Inhibition of demand pacemakers caused by potentials assoctated with inspiration. Br Heart J38:211, 1978.
- 8. Anderson ST Pit A Whitford JA Davis BB : Interlerence with function of unipolar pacemaker due to muscle potentials. J Thorac Cardiovasc Surg 71 : 696, 1978.
- 9. Amikam S Peleg H Lemer J Riss E : Myopotential inhibition or a bipolar pa&r cemaker caused by electrode inşulation defect, Br Heart J 39: 1279, 1977.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Kalp ve Damar Cerrahisi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mart 1991 |
| Yayımlandığı Sayı | Yıl 1991 Cilt: 44 Sayı: 1 |
