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Document Details :

Title: Cardiale implanteerbare devices
Author(s): TIMMERS L, VAN HEUVERSWYN F
Journal: Tijdschrift voor Geneeskunde
Volume: 73    Issue: 7   Date: 2017   
Pages: 392-398
DOI: 10.2143/TVG.73.07.2002307

Abstract :
Het aantal cardiale implanteerbare devices (“cardiac implantable electronic devices” – CIED’s) neemt wereldwijd toe voor verschillende indicaties.
Een pacemaker wordt geplaatst bij bradycardie. Een implanteerbare cardioverter-defibrillator (ICD) vormt de hoeksteen van de behandeling van levensbedreigende ritmestoornissen en de preventie van plotse dood. Cardiale resynchronisatietherapie (CRT) heeft zijn prognostisch en symptomatisch nut bewezen bij hartfalen met linkerbundeltakblok.






Cardiac implantable electronic devices
There is a worldwide increase in implantion rate of cardiac implantable electronic devices (CIEDs) for different indications.
Pacemakers are indicated for the treatment of bradycardia. An implantable cardioverter-defibrillator is the cornerstone in the treatment of life-threatening arrhythmias and prevention of sudden cardiac death. Cardiac resynchronization therapy has proven prognostic and symptomatic benefits in the treatment of heartfailure in patients with left bundle branch block.
Implantation of these CIEDs carries a risk of complications both during the implantation procedure and in the short and long term follow-up.
Certain preventive measures can be applied to reduce the complication risk. Prompt recognition and treatment of the complications improve long term outcome. The most feared complication is infection of the CIED which requires a complete extraction of the device and all electrodes.
To prevent some of the known complications of transvenous CIEDs, new devices have been developed such as the leadless pacemaker and the subcutaneous defibrillator.
The different CIEDs, their indications, the implantation procedure and the possible related complications are described. New developments in the field of CIEDs are illustrated.


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