Hodnocení efektivity přímé elektrické stimulace myokardu

Abstract

Cardiac pacing is a standard therapeutic method for the treatment of arrhythmias and pathological heart rhythm disorders, such as asystole, bradycardia, conduction blocks or asynchronous contractions. In acute conditions, therapy is provided by a temporary pacemaker, generating a monophasic or biphasic pacing pulse.

Biphasic stimulation is evaluated as more effective and more friendly, in studies focused on biphasic myocardial stimulation, but spread this method in clinical practice does not correspond to this evaluation. Anyone of the studies have been performed on the myocardium of the human heart. The aim of this research is to verify the effectivity and more friendly effect of biphasic stimulation in in vivo stimulation of the human heart.

Comparative measurements of pacing thresholds were performed during pacemaker implantation to verify biphasic pacing. 16 patients were measured and based on non-parametric analysis of variance, biphasic stimulation was evaluated as more friendly. During biphasic stimulation, a lower charge was added for effective stimulation. The energy required for effective stimulation is greater with a biphasic pulse and therefore this pulse cannot be assessed as more effective than a monophasic cathodic pulse.