En la actualidad, la estimulación cardiaca pretende no sólo mejorar la supervivencia de los pacientes con bloqueo auriculoventricular, como fue en un principio, sino también mejorar la calidad de vida de éstos y de los pacientes con enfermedad del nódulo sinusal y otras afecciones cardiacas a los que se implanta un marcapasos, según las diferentes indicaciones aceptadas. Para ello es muy importante conocer los intervalos de seguridad en estimulación unicameral y bicameral, así como las funciones automáticas complejas de los generadores actuales, tales como la confirmación automática de la captura y el ajuste automático de la salida, la autorregulación en frecuencia, el cambio automático de modo y los diferentes algoritmos de disminución de la estimulación apical derecha innecesaria, que han adquirido gran protagonismo últimamente al comprobarse sus efectos deletéreos.
Palabras clave
Bloqueo auriculoventricular
Enfermedad del nódulo sinusal
Estimulación cardiaca
Autorregulación en frecuencia
Cambio automático de modo
Confirmación automática de la captura
Reducción de la estimulación ventricular derecha
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Bibliografía
[1.]
A.S. Barold, R.X. Stroobandt, A.F. Sinnaece.
Cardiac Pacemakers step by step: An illustrated guide.
Blackwell Futura, (2004),
[2.]
J. Mugica, B. Lazarus, J. Buffet, M. Catte.
Pacemaker with automatic adaptation to the pacing threshold.
Cardiac pacing, Van Gorcum, pp. 50-55
[3.]
T.A. Preston, D.L. Bowers.
The automatic threshold tracking pacemaker.
Med Instr, (1974), 8 pp. 352-355
[5.]
F. Provenier, E. Germonpre, X. De Wagter.
Improved differentiation of the ventricular evoked response from polarization by modification of the pacemaker impulse.
Pacing Clin Electrophysiol, (2000), 23 pp. 2073-2077
[6.]
J. Sperzel, C. Kennergren, M. Biffi.
Clinical performance of a ventricular automatic capture verification algorithm.
Pacing Clin Electrophysiol, (2005), 28 pp. 933-937
[7.]
C. Alonso, A. Savouré, G. Jauvert.
Clinical testing of a new pacemaker function to monitor ventricular capture.
Pacing Clin Electrophysiol, (2005), 28 pp. S39
[8.]
R. Chen, K. Chen, F. Wang.
Impact of automatic threshold capture on pulse generator longevity.
Chin Med J, (2006), 119 pp. 925-929
[9.]
G. Boriani, M. Biffi, A. Branzi, A. Mininno, R. Sigliano, Pacemate Study Group.
Benefits in projected pacemaker longevity and in pacing related costs conferred by automatic threshold tracking.
Pacing Clin Electrophysiol, (2000), 23 pp. 1783-1787
[10.]
G. Boriani, L. Rusconi, M. Biffi.
Role of ventricular autocapture function in increasing longevity of DDDR pacemakers: a prospective study.
Europace, (2006), 8 pp. 216-220
[11.]
D.L. Hayes, L. Von Feldt, S.T. Higano.
Standardized informal exercise testing for programming rate adaptive pacemakers.
Pacing Clin Electrophysiol, (1991), 14 pp. 1772-1776
[12.]
H. Burri, H. Sunthorn, D. Shah, R. Lerch.
Optimization of device programming for cardiac resynchronization therapy.
Pacing Clin Electrophysiol, (2006), 29 pp. 1416-1425
[13.]
H.F. Tse, C.W. Siu, K.L. Lee, K. Fan, H.W. Chan, M.O. Tang, et al.
The incremental benefit of rate-adaptive pacing on exercise performance during cardiac resynchronization therapy.
J Am Coll Cardiol, (2005), 46 pp. 2292-2297
[14.]
G.A. Lamas, C.L. Pashos, S.L. Normand, B. McNeil.
Permanent pacemaker selection and subsequent survival in elderly Medicare pacemaker recipients.
Circulation, (1995), 91 pp. 1063-1069
[15.]
S.T. Connolly, C.R. Kerr, M. Gent, R.S. Roberts, M. Tech, S. Yusuf, for the Canadian Trial of Physiologic Pacinget Investigators, et al.
Effects of physiologic pacing versus ventricular pacing on the risk of stroke and death to cardiovascular causes.
N Engl J Med, (2000), 342 pp. 1385-1391
[16.]
H.R. Andersen, J.C. Nielsen, P.E. Thomsen, l. Thuesen, P.T. Mortensen, T. Vesterlund, et al.
Long-term follow-up of patients from a randomised trial of atrial versus ventricular pacing for sick-sinus syndrome.
Lancet, (1997), 350 pp. 1210-1216
[17.]
S.S. Barold, H.G. Mond.
Fallback responses of dual chamber (DDD and DDDR) pacemakers. A proposal classification.
Pacing Clin Electrophysiol, (1994), 17 pp. 1160-1165
[18.]
Medtronic AT500 Technical Manual. Minneapolis: Medtronic Inc.; 2000.
[19.]
J. Brandt, W. Worzewski.
Far-field QRS complex sensing: Prevalence and timing with bipolar atrial leads.
Pacing Clin Electrophysiol, (2000), 23 pp. 315-320
[20.]
C.-P. Lau, S.-K. Leung, H.-F. Tse, S.S. Barold.
Automatic Mode Switching of implantable pacemakers: I. Principles of instrumentation, clinical and hemodynamic considerations.
Pacing Clin Electrophysiol, (2002), 25 pp. 967-983
[21.]
K. Kamalvand, K. Tam, K. Kotsakis, C. Bucknall, N. Sulke.
Is mode switching beneficial? A randomized study in patients with paroxysmal atrial tachyarrhythmias.
J Am Coll Cardiol, (1997), 30 pp. 496-504
[22.]
H.J. Marshall, G.N. Kay, M. Hess, V.J. Plumb, R.S. Bubien, J. Hummel, et al.
Mode switching in dual chamber pacemakers: Effect of onset criteria on arrhythmia-related symptoms.
Europace, (1999), 1 pp. 49-54
[23.]
C.-P. Lau, S.-K. Leung, H.-F. Tse, S.S. Barold.
Automatic Mode Switching of implantable pacemakers: II. Clinical performance of current algorithms and their programming.
Pacing Clin Electrophysiol, (2002), 25 pp. 1094-1113
[24.]
R. García Calabozo.
Temas de actualidad en estimulación cardiaca.
Rev Esp Cardiol, (2005), 5 pp. A66-76
[25.]
A.R. Leon, W.T. Abraham, S. Brozena, W.G. Fisher, J.C. Gurley, C.S. Liang, Insync III Clinical Study Investigators, et al.
Cardiac resynchronization with sequential biventricular pacing for the treatment of moderate-to-severe heart failure.
J Am Coll Cardiol, (2005), 46 pp. 2298-2304
[26.]
C.W. Israel.
Analysis of mode switching algorithms in dual chamber pacemakers.
Pacing Clin Electrophysiol, (2002), 25 pp. 380-393
[27.]
J.A. Vasallo, D.M. Cassidy, J.M. Millar, A.E. Buxton, F.E. Marchlinski, M.E. Josephson.
Left ventricular endocardial activation during right ventricular pacing: effect of underlying Heart disease.
J Am Coll Cardiol, (1986), 7 pp. 1228-1233
[28.]
G. Lupi, B. Sassone, L. Badano, C. Peraldo, Sitges M. Gaddi, et al.
Effects of right ventricular pacing on intra-left ventricular electromechanical activation in patients with native narrow QRS.
Am J Cardiol, (2006), 98 pp. 219-222
[29.]
G. Lamas, K.L. Lee, M.O. Sweeney, R. Silverman, A. Leon, R. Yee, et al.
For the mode selection trial in sinus-node disease.
N Engl J Med, (2002), 346 pp. 1854-1862
[30.]
M. Santini, G. Alexidou, G. Ansalone, G. Cacciatore, R. Cini, G. Turitto.
Relation of prognosis in sick sinus syndrome to age, conduction defects and modes of permanent cardiac pacing.
Am J Cardiol, (1990), 65 pp. 729-735
[31.]
H.R. Andersen, J.C. Nielsen, P.E. Thompsen, L. Thuesen, T. Vesterlund, A.K. Pedersen, et al.
Atrioventricular conduction during longterm follow-up of patients with sick sinus syndrome.
Circulation, (1998), 98 pp. 1315-1321
[32.]
L. Kristensen, J.C. Nielsen, A.K. Pedersen, P.T. Mortensen, H.R. Andersen.
AV block and changes in pacing mode during long-term follow-up of 399 consecutive patients with sick sinus syndrome treated with an AAI/AAIR pacemaker.
Pacing Clin Electrophysiol, (2001), 24 pp. 358-365
[33.]
J.L. Moríñigo, A. Arribas, C. Ledesma, P.L. Sánchez, F. Martín, C. Martín Luengo.
Seguridad y eficacia clínica de la estimulación con el modo AAI en la disfunción del nódulo sinusal: seguimiento a largo plazo.
Rev Esp Cardiol, (2002), 55 pp. 1267-1272
[34.]
R. Coma-Sanmartín, R. García Calabozo, J. Martínez Ferrer, M.J. Sancho-Tello, F. Ruíz Mateas.
Registro Español de Marcapasos. III Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2005).
Rev Esp Cardiol, (2006), 59 pp. 1303-1313
[35.]
H. Ector, A. Rickards, l. Kappenberger, P. Vardas, A. Oto, M. Santini, et al.
The registry of the European Working Group on Cardiac Pacing (EWGCP).
Europace, (2000), 2 pp. 251-255
[36.]
R. Peinado, E. Torrecilla, J. Ormaetxe, M. Álvarez, en representación del Grupo de Trabajo de Desfibrilador implantable.
Registro Español de Desfibrilador Implantable. II Informe Oficial del Grupo de Trabajo de Desfibrilador Implantable de la Sociedad Española de Cardiología.
Rev Esp Cardiol, (2006), 59 pp. 1292-1302
[37.]
J.C. Nielsen, A.K. Pedersen, P.T. Mortensen, H.R. Andersen.
Programming a fixed long atrioventricular delay is not effective in preventing ventricular pacing in patients with sick sinus syndrome.
Europace, (1999), 1 pp. 113-120
[38.]
U. Stierle, D. Kruger, A.M. Vincent, R. Mitush, E. Giannitsis, U. Wiegand, et al.
An optimized AV delay algorithm for patients with intermittent atrioventricular conduction.
Pacing Clin Electrophysiol, (1998), 21 pp. 1035-1043
[39.]
E. Himmrich, L. Kramer, W. Fisher, T. Dorr, Reinecke H (Multi-Mode-Switch-Study group).
Support of spontaneous atrioventricular conduction in patients with DDR(R) pacemakers: effectiveness and safety.
Herz, (2001), 26 pp. 69-74
[40.]
Ch. Merzel, S. Sowelam, T. Sheldon, H.J. Bondke, G. Baumann, B. Combs, et al.
Reduction of right ventricular pacing in patients with sinus node dysfunction using an enhanced search AV algorithm.
Pacing Clin Electrophysiol, (2005), 28 pp. 521-527
[41.]
G. Milasinovic, J. Sperzel, T. Smith, H. Mead, J. Brandt, W. Haisty, on behalf of the worldwide EnPulse Investigators, et al.
Reduction of RV pacing by continuous optimization of the AV interval.
Pacing Clin Electrophysiol, (2006), 29 pp. 406-412
[42.]
B. Olhansky, J. Day, S. Moore, L. Gering, M. Rosenbaum, M. McGuire, et al.
Is dual-chamber progamming inferior to single-chamber programming in an implantable cardioverter-defibrillator? Results of the intrinsic RV (Inhibition of unnecesary RV pacing with AVSH in ICDs) study.
Circulation, (2007), 115 pp. 9-16
[43.]
M. Dennis, P. Sparks.
Pacemaker mediated tachycardia as a complication of the autointrinsic conduction search function.
Pacing Clin Electrophysiol, (2004), 27 pp. 824-826
[44.]
R. García Calabozo, J. Martínez Ferrer, M.J. Sancho-Tello de Carranza.
Temas de actualidad en estimulación cardiaca 2005.
Rev Esp Cardiol, (2006), 59 pp. 66-77
[45.]
F. Mansour, M. Talajic, B. Thibault, P. Khairy.
Pacemaker troubleshooting: when MVP is not the most valuable parameter.
Heart Rhythm, (2006), 3 pp. 612-614
[46.]
J.G. Martínez Martínez, A. García Fernández, A. Ibáñez Criado, J.L. Ibáñez Criado, S. Molina Garro, I. Lillo Rodenas, et al.
Valoración del funcionamiento del modo AAISafeR en pacientes con marcapasos por disfunción sinusal [resumen].
Rev Esp Cardiol, (2006), 59 pp. 154
[47.]
G. Fröligh, D. Gras, J. Victor, Ph. Mabo, D. Galley, A. Savouré, et al.
Use of a new cardiac pacing mode designed to eliminate unnecessary ventricular pacing.
Europace, (2006), 8 pp. 96-101
[48.]
A.M. Gillis, H. Pürerfellner, C.W. Israel, H. Sunthorn, S. Kacet, M. Anelli-Monti, on behalf of the Medtronic Enrythm Clinical Study Investigators, et al.
Reducing unnecessary right ventricular pacing with the managed ventricular pacing mode in patients with sinus node disease and AV block.
Pacing Clin Electrophysiol, (2006), 29 pp. 697-705
[49.]
M.O. Sweeney, K.A. Ellenbogen, D. Casavant, R. Betzold, T. Sheldon, F. Tang, For the Marquis MVP Download Investigators, et al.
Multicenter, prospective, randomized safety and efficacy study of a new atrial-based manager ventricular pacing mode (MVP) in dual chamber ICDs.
J Cardiovasc Electrophysiol, (2005), 16 pp. 811-817
[50.]
M.O. Sweeney, K.A. Ellenbogen, E. Hogan Miller, L. Sherfesee, T. Sheldon, D. Whellan.
The Managed Ventricular Pacing TM Versus VVI 40 Pacing (MVP) Trial: Clinical background, rationale, design and implementation.
J Cardiovasc Electrophysiol, (2006), 17 pp. 1295-1298
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