High-grade atrioventricular block

Safety and efficacy profile of an indigenous developed CHARAK DDDR 747R dual-chamber rate-responsive pacemaker

Aim:

The purpose of this study was to assess the safety and performance of the domestically manufactured Charak DDDR 747R (Pacetronix Ltd, Indore, India) pacemaker device.

Materials and Methods:

This was a prospective, controlled, single-center study conducted between March 2016 and August 2017. Eligible patients were implanted with a Charak DDDR 747R pacemaker with parameters set as specified on the packaging material unless otherwise advised by the physician. Patients were evaluated before discharge and at the 18-month follow-up. Data such as patient age, gender, and medical history were collected to determine patient eligibility for study participation, monitoring of study progress, and data analysis.

Results:

A total of 35 patients were analyzed. Males comprised 45.7% and females comprised 54.3% of patients. The average pacing threshold was threshold (atrium) was 1.05 V and the average pacing threshold (ventricle) was 1.07 V. The average impedance (atrium) was 641.09 Ω and the average impedance (ventricle) was 719.31 Ω. No serious adverse events were documented during the follow-up. One death occurred; however, this was not device-related.

Conclusions:

As per study findings, the Charak DDDR 747R, an indigenous pacemaker, is safe and effective in the Indian population. Durable lead parameters were obtained during the study which remained stable over time referring the same. Future larger studies are needed to confirm the preliminary data obtained from our study.

Arrhythmia detection and classification using ECG and PPG techniques: a review

Electrocardiogram (ECG) and photoplethysmograph (PPG) are non-invasive techniques that provide electrical and hemodynamic information of the heart, respectively. This information is advantageous in the diagnosis of various cardiac abnormalities. Arrhythmia is the most common cardiovascular disease, manifested as single or multiple irregular heartbeats. However, due to the continuous manual observation, it becomes troublesome for experts sometimes to identify the paroxysmal nature of arrhythmia correctly. Moreover, due to advancements in technology, there is an inclination towards wearable sensors which monitor such patients continuously. Thus, there is a need for automatic detection techniques for the identification of arrhythmia. In the presented work, ECG and PPG-based state-of-the-art methods have been described, including preprocessing, feature extraction, and classification techniques for the detection of various arrhythmias. Additionally, this review exhibits various wearable sensors used in the literature and public databases available for the evaluation of results. The study also highlights the limitations of the current techniques and pragmatic solutions to improvise the ongoing effort.

Dopamine and epinephrine for managing complete atrioventricular block due to nonreperfused acute inferior wall myocardial infarction in a rural hospital: A case report

Inferior wall myocardial infarction occurs in approximately 50% of all myocardial infarctions. The most common conduction disorder of this disease is complete atrioventricular block. Immediate attention must be given to the myocardial infarction patients with conduction block due to the increased mortality rate in these patients. Temporary pacemaker implantation and permanent pacemaker implantation are recommended in complete atrioventricular block cases that do not improve with reperfusion. In this case report, a 64-year-old-female patient came to the emergency department of a rural General Hospital with complaints of epigastric pain, dizziness, nausea, and vomiting for 2 days before admission. She had uncontrolled hypertension without a history of diabetes mellitus, dyslipidemia, smoking, or a family history of heart disease. The electrocardiogram displayed an acute inferior wall myocardial infarction and complete atrioventricular block with escape junctional rhythm with a heart rate of 17 bpm. She was diagnosed with nonreperfused inferior wall myocardial infarction and a complete atrioventricular block. She was successfully treated with only dopamine and epinephrine as the definitive treatment because the patient refused to be referred to a tertiary hospital for percutaneous coronary intervention and pacemaker implantation due to financial reasons. Dopamine and epinephrine may be considered for complete atrioventricular block if transfer to a higher level of care is not feasible and as bridge therapy while waiting for transfer.