[Cardiology 1995].

Rapid progress in the field of cardiology calls for an almost continuous update on latest developments. In particular, this is the case with respect to indications for diagnostic and therapeutic interventions. The present contribution deals with some topics in this area.

[Indications and new developments in pacemaker therapy].

In the course of the past 25 years the indication for pacemaker implantation has changed from AV-block to the sick sinus syndrome in about 40% of patients. In the same period pacemaker technology has developed considerably and today there are, in addition to the ventricular inhibited pacemaker, two-chamber systems (essentially DDD pacemakers) and pacemakers with an increasing pulse rate during physical effort. The new nomenclature, mode of action and hemodynamic implications of the various systems are explained, and recommendations for implantation are given.

Hemodynamic effects of atrial synchronization in acute and long-term ventricular pacing.

The acute and long-term hemodynamic benefit from atrial synchronization in ventricular (VAT) pacing has been investigated at rest and during exercise in 10 patients undergoing pacemaker implantation for complete A-V block. The results were compared to conventional (VOO) ventricular stimulation at rates of 70 BPM and 96 BPM. Cardiac index (CI) in VAT-pacing increased at rest by 8% and during exercise by 15% more than with VOO pacing (p less than 0.

[Surgical treatment of heart rhythm disorders].

Six patients underwent cardiac surgery for refractory tachyarrhythmias. Four had Wolff-Parkinson-White syndrome and 2 ventricular tachycardias after myocardial infarction. The results of preoperative electrophysiologic studies corresponded in 5 cases to intraoperative findings of epicardial and pace-mapping.