J.Jpn. Surg. Soc.. 79(1): 1-9, 1978
Original article
STUDIES ON PACING FAILURE IN THE POSTOPERATIVE PERIOD FOLLOWING PACEMAKER IMPLANTS
|
The 1 st Department of Surgery, Fukushima Medical School (Director: Prof. K. Honda) T. Igari |
In order to diagnose the cause of pacing failure, I designed an idea of the angle between the tip of the catheter electrode and the thoracic vertebrae-alpha (α) angle -on the antero- posterior view of the chest x-ray film.
Since 1969, pacemakers were implanted in 85 cases at the Fukushima Medical School Hospital. Alpha angle of these cases were measured in the follow-up period and the following findings can be drawn.
1 ) No significant difference (p＜0.05 ) between alpha angle of the systolic phase and that of the diastolic phase.
2) Alpha angle showed 100° - 130° in patients whose tips of the catheter electrodes were wedged into the proper position in the right ventricle .
3) Alpha angle showed less 100° in patients whose tips of the catheter electrodes were inserted into the coronary sinus or into the improper position in the right ventricle. Alpha angle showed over 140° in patients whose catheter electrodes were slacked in the right atrium and vent ricle.
4) If alpha angle changed to less 100° or over 140° and if alpha angle decreased or increased over 20% in the follow-up period, these phenomenon suggested that pacing failure occurred due to dislocation of the tip of the catheter electrode.
5) No significant changes of alpha angle were recognized in patients with pacing failure due to exit block and interruption of the catheter electrode.
6) Alpha angle is useful diagnostically to judge of dislocation of the catheter electrode from the other cause of the pacing failure.
To read the PDF file you will need Adobe Reader installed on your computer.