Table Of ContentASPECTS OF PACEMAKERS
– FUNCTIONS AND
INTERACTIONS IN CARDIAC
AND NON-CARDIAC
INDICATIONS
Edited by Oliver Vonend and Siegfried Eckert
Aspects of Pacemakers – Functions and Interactions
in Cardiac and Non-Cardiac Indications
Edited by Oliver Vonend and Siegfried Eckert
Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia
Copyright © 2011 InTech
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Technical Editor Teodora Smiljanic
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Image Copyright skyhawk, 2011. Used under license from Shutterstock.com
First published August, 2011
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from [email protected]
Aspects of Pacemakers – Functions and Interactions in Cardiac and Non-Cardiac
Indications, Edited by Oliver Vonend and Siegfried Eckert
p. cm.
ISBN 978-953-307-616-4
free online editions of InTech
Books and Journals can be found at
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Contents
Preface IX
Part 1 Devices in Hypertension 1
Chapter 1 Novel Approaches in Hypertension
Treatment - Modulation of the Sympathetic Overactivity 3
Sebastian A. Potthoff, Lars-Christian Rump and Oliver Vonend
Part 2 Mechanisms of Pacemaking 19
Chapter 2 MicroRNAs as Possible Molecular Pacemakers 21
Emanuela Boštjančič and Damjan Glavač
Chapter 3 Atrio-Ventricular
Block-Induced Torsades de Pointes: An Update 39
Chevalier Philippe and Scridon Alina
Chapter 4 Ultradian Rhythms
Underlying the Dynamics of the Circadian Pacemaker 51
Carolina Barriga-Montoya, Pablo Padilla-Longoria,
Miguel Lara-Aparicio and Beatriz Fuentes-Pardo
Chapter 5 Non-Ultradian
Cardiac Rhythms: Circadian Regulation of the Heart 67
Stephen Karaganis
Part 3 Indications, Complications and Other Clinical
Concerns with Implantable Electronic Devices 89
Chapter 6 Cardiac Resynchronization in
Mildly Symptomatic Heart Failure Patients 91
Paolo Pieragnoli, Giuseppe Ricciardi,
Gemma Filice, Antonio Michelucci and Luigi Padeletti
VI Contents
Chapter 7 Infections of Permanent
Transvenous Pacemakers - Etiology,
Medical Treatment and Optimal Surgical Techniques 107
Maria A. Gutierrez-Martin, Juan Gálvez-Acebal, Omar A. Araji,
Nuria Miranda-Balbuena and Jose M. Barquero
Chapter 8 Infections of Cardiac Implantable
Electronic Devices: Etiology, Prevention and Treatment 127
Cosimo Chelazzi, Valentina Selmi,
Luca Vitali and Angelo Raffaele De Gaudio
Chapter 9 Clinical Concerns and Strategies in Radiation Oncology 145
Michael S. Gossman
Part 4 Non-Cardiac Pacemakers 163
Chapter 10 Pacemakers in the Upper Urinary Tract 165
Antonina Di Benedetto, Salvatore Arena, Francesco Arena,
Carmelo Romeo, Piero Antonio Nicòtina and Carlo Magno
Chapter 11 Role of Pacing in Neurally Mediated Syncope 179
Vikas Kuriachan and Robert Sheldon
Preface
Pacemakers play an important role in our body homeostasis. The identification of
endogenous pacemakers and the exploration of their controllability lead to a
remarkable progress in human medicine. On cellular basis proliferation and
orientation are regulated, and contraction and organ interactions were modulated by
pacemaking cells. Dysfunctions lead to acute and chronic organ damage and can be
life-threatening. In this respect, overactive as well as underactive pacemaking can
bring a person in a very dangerous situation.
In the last decades, “artificial” pacemakers made outstanding steps forward, in
particular in cardiovascular science. The devices are now able to do much more than
solely pacemaking of the heart. Sensing, pacing, resynchronization, overstimulation
and defibrillation are just some of the functions that actual devices can cover. And not
only is the heart dependant on pacemaking cells; the urinary tract, the central nervous
system and the blood pressure is controlled to a certain extent by endogenous
pacemakers.
However, one has to be careful to find the correct indication before device
implantation. In addition, complications such as infections need to be minimised. It
should be noted that some diagnostic or therapeutic procedures cannot be performed
when a person carries an electrical device. Taken together, a correctly functioning
device can improve the quality of life substantially.
New devices, beside cardiac pacemakers, are currently under investigation. In order to
treat arterial hypertension various strategies were developed. Besides renal nerve
ablation, baroreceptor stimulation is one approach to reduce the sympathetic nerve
activity. Similar to a cardiac pacemaker, an electrical device stimulates the glomus
caroticus to feed back to the central nervous system in order to re-adjust the elevated
blood pressure.
X Preface
In this book, through eleven chapters different aspects of pacemakers –functions and
interactions were reviewed. In addition, various areas of application and the potential
side effects and complications of the devices were discussed.
Dr. med. Oliver Vonend
Department of Nephrology, Medical Faculty,
Heinrich Heine University, Duesseldorf,
Germany
Dr. med. Siegfried Eckert
Department of Cardiology,
Heart and Diabetes Center North Rhine-Westphalia,
Ruhr-University Bochum, Bad Oeynhausen,
Germany
