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  • bi-vent pacing

    [bi-vent pacing]

    Author: Dawn (---.cl.ri.cox.net)

    Date: 07-26-02 09:10

    Hello,

    Just had an in service at work this morning about bi-ventricle pacing for CHF. Too bad the person giving us the info had very little info and couldn't answer my questions.

    Bi-vent pacing helps the left and right vents contract at the same time, increasing cardiac output in CHF'ers. CHF'ers, their vents don't contract at the same time--conduction problems.

    Would this be any help in HCM'ers? Anyone have any info?

    Dawn

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    [Re: bi-vent pacing]

    Author: Board Moderator: Sarah Beckley (---.dialup.mindspring.com)

    Date: 07-26-02 11:00

    Dear Dawn

    Is this the same as dual-chamber pacing? I think there are several back threads in here on pacing, including on one the first page here. I'm not a pacing expert --yet.

    Sarah

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    [Re: bi-vent pacing]

    Author: Dawn (---.cl.ri.cox.net)

    Date: 07-26-02 14:16

    Hi Sarah,

    No, this is different from dual chamber pacing. Dual is the right atrium and vent are paced. Bi vent is pacing of the left and right vent. But I'll look into back threads.

    Dawn

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    [Re: bi-vent pacing]

    Author: Lisa (---.dyn.optonline.net)

    Date: 07-27-02 10:46

    Dawn -

    Bi - V pacing is use in those with burtout/endstage HCM in some cases (like my dad) I too am wondering about the application of this for more of us with HCM. There is little data at this time, but something I am very interested in myself, so I keep digging.

    Good catch on this and any information you can share will be greatly appreciated.

    Lisa

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    [Re: bi-vent pacing]

    Author: Dawn (---.cl.ri.cox.net)

    Date: 07-27-02 11:55

    Lisa,

    I found an article in a nursing journal. I couldn't bring it home from work, so I'm going off my memory......

    End stage CHF, with intraventricular condution problems (BBB), and with a long QRS (> 0.13) on an EKG, some of the criteria of bi-vent pacing. I'm sure I'm missing some more of the criteria but these were the big ones.

    The normal pacer has two leads, one the atrium and one to the vent. Bi vent has a third lead, to the other vent. So far only Insynic Medtronics has FDA approval, but a few more are in the works. I know they been doing these at the Cleve Clinic for awhile, even in the trial phase. Now that it's approved, I'm sure there will be more out there doing it. Even my little suburban hosp did it's first earlier this week! The procedure took around 4 hours. The article I read said about 2 hours. Not sure why ours took longer? He had been a pacer/icd before----took longer because they had to remove old???? I really have no idea.

    It sounds so interesting, I'll keep looking for more info. If I run into the doc doing them at my hosp, you can be sure I'll drill him with lots of questions about applications for HCM!!! And, Lisa, if you find info, please keep me posted!

    Dawn

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    [Re: bi-vent pacing]

    Author: Lisa Salberg (---.dyn.optonline.net)

    Date: 07-28-02 12:39

    Dawn -

    Re timing it took about 4 hours for my dads implant. But then again it took over 3 for my 1st pacer back in 1992 and again about 3 hours for my 1st ICD in 1997.

    I will let you know when I find out more!

    All the BEST!

    Lisa

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    [Re: bi-vent pacing]

    Author: Midge Rollins (---.obmo.socket.net)

    Date: 08-01-02 01:35

    Just returned tonight from Mayo and asked about bi-vent pacing. I was told they had not used it as of yet for HCM. My HCM specialist is going to look into it and see if I meet the requirements. I am in Diastolic failure and Restrictive Cardiomyopathy from the HCM. At this point they have only used the bi-vent in CHF patients. I will keep you posted with any thing they tell me.

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    [Re: bi-vent pacing]

    Author: Dawn (---.lkwh.org)

    Date: 08-01-02 05:13

    Hi,

    I'm at work and reviewing the bi-vent article. It's from a nursing journal. The web site is rnweb.com---haven't been to the site, so I can't tell you if it's a good site or not.

    "Cardiac resynchronization therapy (CRT) (fancy way of saying bi-vent pacing), is not indicated for all heart failure patients. It's effective only in those with systolic heart failure and concomitant ventricular dysynchrony (BBB). Need to meet all of the following criteria;

    ++Symptomatic heart failure even with optimal medical treatment.

    ++NYHA Class III or IV heart failure

    ++QRS interval at or greater than 0.13-0.15 second

    ++Left vent ejection fraction of 35% or lower."

    I'd have to say that since HCM is a dyastolic issue, this would not be an option.

    Have to go for now, get back to work!!

    Dawn

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    [Re: bi-vent pacing]

    Author: Lisa Salberg (---.dyn.optonline.net)

    Date: 08-01-02 08:38

    Yes and no... some with HCM do fit this outline. Many have BBB - mostly LBBB - As do I - the EF is really the key here, as most with HCM have normal or "better" EF's. Therefore it is mostly those with the burntout/endstage cases that benefit from Bi-V at this time.

    Lisa

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    [Re: bi-vent pacing]

    Author: Dawn (---.cl.ri.cox.net)

    Date: 08-01-02 10:26

    Me again, I'm at home now. At work I had a patient that needed me. It seems like some nights no one sleeps and last night was one of them.

    Lisa, I keep forgetting about the end-stage cases. I guess it would help them. But it's a new procedure---time will tell.

    The web site was listed on the bottom of the article I was reading. It's for the magazine RN. That's where someone copied the article from. Took a look at the site---for me and my job, it's helpful. Not sure if it would be helpful to anyone else unless you like reading about diseases and the nursing care. Lisa, you did say you needed a hobby.......just teasing!

    It's 10am, for me that's past my bed time. Love nursing on night shift--hate the sleeping in the day.

    Dawn
    NOTE: This is a post from the previous forum message board.
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