Acute Results of Permanent Pacemaker Implantation in Cipto Mangunkusumo General Hospital, Jakarta  

Oleh:

Harun, Sjaharuddin ; Yamin, Muhammad

Jenis: Article from Journal - ilmiah nasional - terakreditasi DIKTI
Dalam koleksi: Acta Medica Indonesiana vol. 39 no. 01 (Jan. 2007), page 19.
Topik: pacemaker implantation; New York Heart Association (NYHA); technical parameters; clinical parameters.

Ketersediaan

Perpustakaan FK Nomor Panggil: A02.K.2004.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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ABSTRACT Aim: to investigate the acute results (parameters at ill/plant and clinical parameters) of permanent pacemaker ill/plantation at our institution. Methods: twenty five patients undergoing pacemaker ill/plantation were included in this study. Subjects underwent lI/edicalhistOlY andfimctional class was assessed using New York Heart Association (NYHA) classification. All technical parameters (pacing threshold, sensing, and pacing ill/pedance) and clinical parameters (complication and procedure time) were measured during and post implant. Results: majority (80%) of patients were in NYHA fUllctional class II. The commonest indication for pacemaker ill/plant was the complete heart block (56%). The most frequent pacemaker type was single chamber (80%) with the COlI/lllOllest pacing mode of VVIR (72%). Average optimal parameters achieved were pacing threshold of 0.5 volt, sellsing of 12.6 mY, and impedance of 829 Ohm. Average procedure time was 1.6 hour. Major complication (pocket illfection) was noted in only one patient. Conclusion: it is confirmed from this study that penna¬lie/It pacemaker implantation could be carried out safely and effectively with low complication rate in a general hospital. Optimal pacing parameters could be achieved in the acute phase. Most patients still could not afford appropriate pacillg devices due to limitedfinancial support. Government illsurance coverage for the poor should be encouraged to cover llwre people pacing impedance) are measured to ensure the optimal function of the device both in the short and long term.2.3 Other clinical parameters (complication and procedure time) are considered as indicators of successful implant. We investigate the acute results (sensing, threshold, pacing impedance, complications, and the length of procedure) in 25 patients undergoing pacemaker implant in our institution during the period of January 2004-May 2006. METHODS All patients undergoing pacemaker implantation were included in this study. The pacemaker implant procedure was performed in the cardiac catheterization laboratory by a consultant cardiologist and assisted by a scrub nurse, a cardiac technician, and a radiographer. The procedure was conducted under local anesthesia, using cephalic vein cut-down or subclavian vein puncture approach. Atrial lead was positioned at right atrial appendage and ventricular lead is preferably positioned at right ventricu¬lar outflow tract (RVOT) septum. Diaphragmatic pacing was evaluated. In the presence of positive diaphragmatic pacing, the position of lead was moved to a different suitable site. Three doses of prophylactic antibiotic (cefotaxime) was given intravenously: one dose prior to procedure and two doses after implant. Chest radiography and pacemaker programming was performed one day after procedure and patients were discharged subsequently if all parameters were acceptable

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