Electrical stimulation – modern treatment of heart rhythm and conduction disorders. Management of patient with pacemaker and implantable cardioverter‑defibrillator
Klinika Kardiologii i Chorób Wewnętrznych, Oddział Kardiologii Nieinwazyjnej i Telemedycyny, Wojskowy Instytut Medyczny. Kierownik Kliniki: dr hab. n. med. Andrzej Skrobowski
Adres do korespondencji: Agnieszka Jaguś‑Jamioła, Anna Kaźmierczak‑Dziuk, Klinika Kardiologii i Chorób Wewnętrznych, Oddział Kardiologii Nieinwazyjnej i Telemedycyny, Wojskowy Instytut Medyczny, ul. Szaserów 128, 04‑141 Warszawa, tel. kom.: 602 624 628, e‑mail: ajagus@gmail.com, akazmierczak‑dziuk@wim.mil.pl
Praca finansowana ze środków własnych
Pediatr Med rodz Vol 8 Numer 2, p. 137-147
ABSTRACT
Electrical stimulation is an undisputable, effective and wide‑spreading method of treating heart rhythm disorders. Currently there are 5 millions people living with implantable heart pacemakers. Electrical stimulation initializes electric activity in case of the absence of heart’s own activity. Basic pacemakers are single or dual chamber and also it is possible to program very specific parameters of stimulation. The number of people living with implanted cardioverter‑defibrillator (ICD) increases recently, in cases of primary or secondary prevention of sudden cardiac death. ICD recognizes brady‑ and tachyarrhythmias, terminates ventricular arrhythmias by means of cardioversion or defibrillation, ICD is able to stimulate cardiac rhythm and also enables the ECG recording during arrhythmia. The main clinical problems associated with pacemaker or ICD are function disorders of the device, infective complications, damage caused by the electromagnetic field and anxiety disorders. The patient qualified to implantation pacemaker or ICD should gain detailed information about indications for electrical stimulation, benefits but also restrictions connected with the therapy. It is very important to stay under the care of specialized medical unit, undergo necessary controls and be aware of basic rules in daily life, such as avoiding exposure on electromagnetic interferences, because they may influence the pacemaker or ICD. There is no doubt in effectiveness and legitimacy of implanted cardioverters‑defibrillators, but still exists the problem of the patient’s intolerance for hurtful, unpleasant interventions witch may achieve high energy. The patient’s anxiety should be reduced by precise and reliable information and permanent cooperation between doctor and patient.
Keywords: electrical stimulation, heart pacemaker, implantable cardioverter‑defibrillator, arrhythmia, electromagnetic interference