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Vol. 7. Núm. G.
Estimulación cardiaca con marcapasos: fisiopatología, uso clínico, seguimiento y complicaciones
Páginas 4G-19G (Octubre 2007)
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Vol. 7. Núm. G.
Estimulación cardiaca con marcapasos: fisiopatología, uso clínico, seguimiento y complicaciones
Páginas 4G-19G (Octubre 2007)
Estimulación cardiaca con marcapasos
Acceso a texto completo
Conceptos técnicos fundamentales de la estimulación cardiaca
Cardiac Pacing: Basic Technical Considerations
Visitas
2538
Jesús Rodríguez Garcíaa,
Autor para correspondencia
jrodriguez@vitanet.nu

Correspondencia: Dr. J. Rodríguez García. Unidad Coronaria. Hospital 12 de Octubre. Ctra. de Andalucía, s/n. 28041 Madrid. España.
, Diego Lorente Carreñob, Ricardo Ruiz Granellc, Enrique Bosch Novelad
a Unidad Coronaria. Hospital 12 de Octubre. Madrid. España
b Servicio de Cardiología. Hospital San Pedro. Logroño. La Rioja. España
c Servicio de Cardiología. Hospital Clínico Universitario de Valencia. Valencia. España
d Vitatron Medical España, S.A. Madrid. España
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Bibliografía
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Los marcapasos, para generar los impulsos eléctricos y alimentar sus circuitos, precisan de una fuente de energía, que en la actualidad es una pila de litio-yodo, de capacidad limitada aunque su carga sea tres veces mayor por unidad de volumen que la disponible en las baterías empleadas hace 30 años.

A continuación se exponen aspectos técnicos básicos cuyo conocimiento es necesario para obtener un bajo consumo de energía y de este modo prolongar la vida útil de los generadores.

La programación de la energía del impulso permite reducir el consumo, por lo que es fundamental obtener un óptimo umbral de estimulación, que en gran parte depende de la interfase electrodo-endocardio.

También se revisan los automatismos de respuesta en frecuencia, detección y reducción de la estimulación ventricular innecesaria, así como la digitalización de las señales intracardiacas.

Palabras clave:
Energía
Pila de litio-yodo
Umbral de estimulación
Detección
Digitalización de señales intracardiacas

Cardiac pacemakers need an energy supply to generate pulses and to power internal circuitry. At present, that energy is provided by a lithium iodine cell, which has a limited capacity although it holds three times the charge per unit volume of batteries used 30 years ago.

This article describes the basic techniques used for ensuring that energy consumption is low and, consequently, that the pacemaker's useful life is as long as possible.

Careful programming reduces the energy used in each impulse and lowers consumption. Therefore, it is essential to determine the optimum pacing threshold, which largely depends on the electrode-endocardium interface.

This article also contains a review of automatic pacemaker functions, such as rate-responsiveness and the detection and reduction of unnecessary ventricular pacing, and an update on digital processing of intracardiac signals.

Key words:
Energy
Lithium iodine cell
Pacing threshold
Detection
Digital processing of intracardiac signals
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