Marian Pieniak

Atrial mechanical and electrical dysfunction in patient with Emery-Dreifuss muscular dystrophy reason of change in electrotherapeutical approach: frequent result of rare disease

We present a case of a 35 year-old male patient with Emery-Dreifuss muscular dystrophy diagnosed in the age of 12 who was assigned to dual chamber pacing system due to bradycardia primarily recognised as sinus node insufficiency with the atrio-ventricular nodal rhythm. During the procedure permanent electrical atrial stand-still without atrial capture were detected and the mode of stimulation was change to VVIR.

Flexibility of Permanent Intracardiac Electrode Leads. Achieving a Balance between Perforation and Displacement

The three models (Biotronik IE-85-K-10-0, Tesla LES 165, Vitatron MIP 2147 LOES) of standard intracardiac electrodes with varying degrees of flexibility were tested in 655 patients during postoperative period. Twenty two cases (8.3%) of displacement and one case (0.3%) of myocardial wall perforation were observed in 264 patients with Biotronik leads. Fourteen displacements (4.2%) and six perforations (1.6%) occurred in 328 patients with Tesla leads. Eight perforations (12.6%) and one displacement (1.5%) were observed in 63 patients with Vitatron leads. The flexibility of the leads was determined by measurements of the bending and buckling forces in a developed mechanical model and by evaluation with Young’s modulus and electrode unit pressure. It seems evident that in the case of the less flexible leads, higher number of perforations and a lower incidence of displacements may be expected. Accurate evaluation of the bending and buckling forces and a determination of electrode unit pressure is also useful for a comparison of the flexibility of different leads and a prediction of the eventual clinical complications.