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Pacemaker lead extraction is the treatment of choice in infectious complications regarding implantation procedure. The purpose of this study was to estimate the safety of the extraction in relation to the morphological changes of the pacing electrode. Research was carried out on materials consisting of 60 human hearts from 45 to 95 years of age (average 63 ± 15 yrs), with VVI or DDD pacing (pacing duration 84 ± 26 months) fixed in a formalin solution. Classical macroscopic anatomical methods were applied. In 44 hearts (73.3%) from the investigated group the posterior tricuspid leaflet was thickened only, and in 24 of these hearts the process regarded not only posterior leaflet but also the septal one and especially commissure between them. In 52 hearts (86.6%) inflammatory reaction spread also to the neighbouring part of the electrode. The length of the neointima-inflammatory tissue ranged from 4 to 8 mm (average 5 ± 2 mm). On the tip of the electrode in the right ventricle cavity in 56 hearts (93.3%) we observed that endocardial leads were surrounded by fibrous thickening , and partially covered by endocardial tissue. We concluded that from the anatomical point of view the extraction of the pacing electrode seems to be questionable, especially in long-term permanent pacing. The experimental traction shows that only recently implanted electrodes were removed without any complications and in others with fraction of the tip, myocardial tissue avulsion or such removal was not successful at all.
Heart rate turbulence (HRT) is a new electrocardiographic parameter used in human medicine to predict the possibility of death in patients with cardiac diseases. There is no information about HRT in healthy dogs and those with cardiac diseases. The aim of the present study was to compare the HRT in healthy Boxers dogs with Boxers with mild and moderate subaortic stenosis (SAS), to disclose the relationship between HRT and specific echocardiographic parameters and to evaluate if HRT can be used as a prognostic value in dogs with aortic stenosis. The study revealed significantly lower values of turbulence onset (TO) and turbulence slope (TS) HRT dogs with SAS (TO = -0.76 ± 2.6, TS = 7.1 ± 3.21) in compared with healthy dogs (TO = -7.45 ± 9.72, TS = 14.33 ± 8.76). TO values correlated with the left ventricular mass (LVM)/body mass factor (r = 0,32; p = 0.048). Based on the results obtained it can be stated that dogs with SAS have a compromised baroreceptor response, which can influence the mortality of the animals with described cardiac defect.
Echocardiography is a valuable tool for the evaluation of systolic and diastolic cardiac function. A high correlation between measurements of diastolic mitral inflow parameters analyzed with Doppler echocardiography and invasive methods makes the former valuable. The aim of this study was to ascertain if significant differences occur in diastolic myocardial parameters between dogs with no heart disease and dogs with subclinical or clinical dilated cardiomyopathy. Furthermore the aim of the study was to determine whether heart failure in dilated cardiomypathy is a result of systolic dysfunction alone or both systolic and diastolic dysfunction. Eleven parameters were analyzed: E wave, E-AT, E-DT, E time, A wave, A-AT, A-DT, A time, E+A time, E/A ratio, and IVRT. The study confirmed the value of noninvasive echocardiographic assessment of diastolic function in dogs with dilated cardiomyopathy. Significant differences were found in E wave, E-AT, E time, E/A ratio and IVRT between healthy dogs and dogs with dilated cardiomyopathy. All are characterized by a significant decrease compared to healthy dogs after taking into account age and body weight except for the E/A ratio, which significantly increased in value. There were no significant changes in any of the Doppler parameters for diastolic evaluation in subclinical cases of DCM. Advanced heart failure in dilated cardiomyopathy entails systolic and diastolic dysfunction.
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