Open Access Medical Books


Edited by Oliver Vonend and Siegfried Eckert .

Open Access .
206 pages .

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.

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,

Dr. med. Siegfried Eckert
Department of Cardiology,
Heart and Diabetes Center North Rhine-Westphalia,
Ruhr-University Bochum, Bad Oeynhausen,



Part 1 Devices in Hypertension .

 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 .

 2 MicroRNAs as Possible Molecular Pacemakers 21 Emanuela Boštjančič and Damjan Glavač

 3 Atrio-Ventricular Block-Induced Torsades de Pointes: An Update 39 Chevalier Philippe and Scridon Alina

 4 Ultradian Rhythms Underlying the Dynamics of the Circadian Pacemaker 51 Carolina Barriga-Montoya, Pablo Padilla-Longoria, Miguel Lara-Aparicio and Beatriz Fuentes-Pardo

 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 .

 6 Cardiac Resynchronization in Mildly Symptomatic Heart Failure Patients 91 Paolo Pieragnoli, Giuseppe Ricciardi, Gemma Filice, Antonio Michelucci and Luigi Padeletti

 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

 8 Infections of Cardiac Implantable Electronic Devices: Etiology, Prevention and Treatment 127 Cosimo Chelazzi, Valentina Selmi, Luca Vitali and Angelo Raffaele De Gaudio

 9 Clinical Concerns and Strategies in Radiation Oncology 145 Michael S. Gossman

Part 4 Non-Cardiac Pacemakers .

 10 Pacemakers in the Upper Urinary Tract 165 Antonina Di Benedetto, Salvatore Arena, Francesco Arena, Carmelo Romeo, Piero Antonio Nicòtina and Carlo Magno

 11 Role of Pacing in Neurally Mediated Syncope 179 Vikas Kuriachan and Robert Sheldon

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Published by: Unknown - Tuesday, May 7, 2013


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