Manual threshold measurements were
obtained during RA unipolar and bipolar pacing and compared across device indications.
Results: Data were collected from 38 patients with RA bipolar leads from four manufacturers. AER signals were analyzed from 34 patients who were indicated for a pacemaker (five), implantable cardioverter-defibrillator (11), or cardiac resynchronization therapy pacemaker (six) or defibrillator (12). The minimum AER amplitude was larger (P < 0.0001) when recorded from RA(Ring) -> Can (1.6 +/- 0.9 mV) than from RA(Ring) -> Ind (1.3 Linsitinib nmr +/- 0.8 mV). The algorithm successfully measured the pacing threshold in 96.8% and 91.0% of tests for RA(Ring) -> Can and RA(Ring) -> Ind, respectively.
No statistical difference between the unipolar and bipolar pacing threshold was observed.
Conclusions: The RA(Ring) -> Can AER sensing configuration may provide a means of implementing an independent pacing/sensing method for ACV in the RA. RA bipolar pacing therapy based on measured RA unipolar pacing thresholds may be feasible. (PACE 2009; 32:579-587)”
“Study Design. Report of a traumatic posterior lumbosacral spondyloptosis in a 6-year-old.
Objectives. To describe this type of fracture-dislocation in children. To evaluate a possible trauma mechanism. To evaluate specific characteristics of this type of lesion in children.
Summary of Background VE-821 ic50 Data. Fractures of the lumbar spine in children are rare. They are without exception caused by high-energy trauma. Fracture-dislocations mostly occur in the anterior direction. There are several reports of traumatic retrolisthesis in adults. To our knowledge, this is the first report of a retrolisthesis at the lumbosacral junction in a child.
Methods. While sitting, a 6-year-old boy was hit
by a truck. He presented with a flaccid paraparesis below L3. Radiologic investigations showed a posterior spondyloptosis at L5-S1. He was treated by open reduction with a pediatric posterior spinal instrumentation and posterolateral grafting.
Results. After 1 year, the patient showed good radiologic fracture reduction and graft find more incorporation. There was no pain in the lumbar area. There was still a complete neurologic deficit beneath the L3 level, with loss of bladder and anal sphincter function. The patient was entered into a children’s rehabilitation program 5 weeks after surgery and is continuously improving his overall functional level.
Conclusion. Traumatic retrolisthesis of the lumbosacral spine is extremely rare, especially in children. We believe shear force while sitting is the key traumatic factor. We believe a simple posterior fusion with posterolateral grafting is sufficient to stabilize the spine in children. Extensive soft tissue damage causes an elevated risk of infection. Because of root avulsion, the level of paralysis can be several levels higher than the level of dislocation.