1
|
Katkat F. Flight safety in patients with arrhythmia. Anatol J Cardiol 2021; 25:24-25. [PMID: 34464296 DOI: 10.5152/anatoljcardiol.2021.s109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As it is comfortable, fast, and safe, an increasing number of patients with heart disease prefer to travel by flight. However, there is not much information about the problems that patients with arrhythmia may experience during air travel. In addition, the precautions to be taken with these patients during a flight are uncertain. In this review, the management of patients with cardiac conduction problems during flight was examined in detail.
Collapse
Affiliation(s)
- Fahrettin Katkat
- Department of Cardiology, Health Sciences University, Bağcılar Training and Research Hospital; İstanbul-Turkey
| |
Collapse
|
2
|
Vontobel J. [Heart Patients and Exposure to Altitude]. PRAXIS 2021; 110:303-311. [PMID: 33906438 DOI: 10.1024/1661-8157/a003649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Overall, heart patients should be advised individually with respect to their tolerance of altitudes. However, the historical reflex that altitude 'per se' is bad for heart patients should become a thing of the past. Adequately treated and stable patients can usually go up to an altitude of 2500 m without any restrictions. Higher altitudes are also possible for a large number of patients, but may require an adaptation of the medication and further clarification. This is especially the case when physical work is to be performed at great heights.
Collapse
|
3
|
Koh CH. Commercial Air Travel for Passengers With Cardiovascular Disease: Stressors of Flight and Aeromedical Impact. Curr Probl Cardiol 2020; 46:100746. [PMID: 33213942 PMCID: PMC8514285 DOI: 10.1016/j.cpcardiol.2020.100746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 10/27/2020] [Indexed: 12/04/2022]
Abstract
The exponential growth of commercial flights has resulted in a sharp rise of air travellers over the last 2 decades, including passengers with a wide range of cardiovascular conditions. Notwithstanding the ongoing COVID-19 pandemic that had set back the aviation industry for the next 1 to 2 years, air travel is expected to rebound fully by 2023-2024. Guidelines and evidence-based recommendations for safe air travel in this group vary, and physicians often encounter situations where opinions and assessments on fitness for flights are sought. This article aims to provide an overview of the stressors of commercial passenger flights with an impact on cardiovascular health for the general cardiologist and family practitioner, when assessing the suitability of such patients for flying fitness.
Collapse
Affiliation(s)
- Choong Hou Koh
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS School of Medicine, National University of Singapore, Singapore; Changi Aviation Medical Centre, Changi General Hospital, Singapore.
| |
Collapse
|
4
|
Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, Festi L, Giardini G, Lironcurti A, Luks AM, Maggiorini M, Modesti PA, Swenson ER, Williams B, Bärtsch P, Torlasco C. Clinical recommendations for high altitude exposure of individuals with pre-existing cardiovascular conditions: A joint statement by the European Society of Cardiology, the Council on Hypertension of the European Society of Cardiology, the European Society of Hypertension, the International Society of Mountain Medicine, the Italian Society of Hypertension and the Italian Society of Mountain Medicine. Eur Heart J 2019; 39:1546-1554. [PMID: 29340578 PMCID: PMC5930248 DOI: 10.1093/eurheartj/ehx720] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 12/15/2017] [Indexed: 01/22/2023] Open
Abstract
Adapted from Bärtsch and Gibbs2 Physiological response to hypoxia. Life-sustaining oxygen delivery, in spite of a reduction in the partial pressure of inhaled oxygen between 25% and 60% (respectively at 2500 m and 8000 m), is ensured by an increase in pulmonary ventilation, an increase in cardiac output by increasing heart rate, changes in vascular tone, as well as an increase in haemoglobin concentration. BP, blood pressure; HR, heart rate; PaCO2, partial pressure of arterial carbon dioxide. ![]()
Collapse
Affiliation(s)
- Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, S. Luca Hospital, Piazzale Brescia, 20, 20149 Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milan, Italy
| | - Piergiuseppe Agostoni
- Department of Cardiology, Heart Failure Unit, Centro Cardiologico Monzino, via Parea 4, 20138 Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, via Festa del Perdono 7, 20122 Milan, Italy
| | - Buddha Basnyat
- Nuffield Department of Clinical Medicine, Oxford University Clinical Research Unit-Nepal and Centre for Tropical Medicine and Global Health, University of Oxford, Old Road campus, Roosevelt Drive, Headington, Oxford OX3 7FZ, UK
| | - Grzegorz Bilo
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, S. Luca Hospital, Piazzale Brescia, 20, 20149 Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milan, Italy
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine at the EURAC Research, viale Druso 1, 39100 Bolzano, Italy.,Medical University, Christoph-Probst-Platz 1, Innrain 52 A - 6020 Innsbruck, Austria
| | - Antonio Coca
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Luigi Festi
- Surgery Department, Ospedale di Circolo Fondazione Macchi, viale Luigi Borri, 57, 21100 Varese, Italy.,University of Insubria, via Ravasi 2, 21100 Varese, Italy
| | - Guido Giardini
- Department of Neurology, Neurophysiopathology Unit, Valle d'Aosta Regional Hospital, via Ginevra, 3, 11100 Aosta, Italy
| | - Alessandra Lironcurti
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, S. Luca Hospital, Piazzale Brescia, 20, 20149 Milan, Italy
| | - Andrew M Luks
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, 98195 WA, USA
| | - Marco Maggiorini
- Medical Intensive Care Unit, University Hospital, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Pietro A Modesti
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134 Florence, Florence, Italy
| | - Erik R Swenson
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, 98195 WA, USA.,Pulmonary, Critical Care and Sleep Medicine, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, 98108 WA, USA
| | - Bryan Williams
- University College London (UCL) and NIHR UCL Hospitals Biomedical Research Centre, NHS Foundation Trust, University College, Gower St, Bloomsbury, London WC1E 6BT, UK
| | - Peter Bärtsch
- Department of Internal Medicine, University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Camilla Torlasco
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, S. Luca Hospital, Piazzale Brescia, 20, 20149 Milan, Italy
| |
Collapse
|
5
|
Przibille O, Weise FK, Nowak B. [Travelling with a pacemaker or implanted defibrillator]. Herzschrittmacherther Elektrophysiol 2019; 30:144-149. [PMID: 31025098 DOI: 10.1007/s00399-019-0624-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There are no guidelines for patients travelling with implanted pacemakers or defibrillators. Only few publications deal with specific problems that this patient group might face. In this article different aspects of travelling with implanted electric devices are summarized. Patients with pacemakers and implanted defibrillators have nearly no limits when travelling. An exception to that rule is scuba diving, which mostly is limited because of the device. In general it is the underlying heart disease or arrhythmia that limits patients' travel activities. It is reasonable to travel after implantation only after wound healing is complete because arm movement on the implant site is limited and the risk of wound infection and lead dislocation is elevated in the early phase. However, if necessary, flying is possible 2 days after an uncomplicated implantation if pneumothorax can be excluded. Security checks can be passed safely by patients with pacemakers/defibrillators. Only repetitive movement of a handheld metal detector over the device should be avoided. When travelling to different time zones it might be reasonable to deactivate a programmed sleep rate (Medtronic, Biotronik). Patients at risk for ventricular arrhythmia (mainly patients with an implantable cardioverter-defibrillator) must make sure to take all possible preventive measures to avoid travelers' diarrhea. In case of infection early replacement of fluids and electrolytes is essential.
Collapse
Affiliation(s)
- Oliver Przibille
- CCB Schrittmacher-Centrum, Im Prüfling 23, 60389, Frankfurt, Deutschland.
| | | | - Bernd Nowak
- CCB Schrittmacher-Centrum, Im Prüfling 23, 60389, Frankfurt, Deutschland
| |
Collapse
|
6
|
Hammadah M, Kindya BR, Allard-Ratick MP, Jazbeh S, Eapen D, Wilson Tang WH, Sperling L. Navigating air travel and cardiovascular concerns: Is the sky the limit? Clin Cardiol 2017; 40:660-666. [PMID: 28597566 DOI: 10.1002/clc.22741] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 05/15/2017] [Accepted: 05/18/2017] [Indexed: 11/06/2022] Open
Abstract
As the population ages and our ability to care for patients with cardiac disease improves, an increasing number of passengers with cardiovascular conditions will be traveling long distances. Many have had cardiac symptoms, recent interventions, devices, or surgery. Air travel is safe for most individuals with stable cardiovascular disease. However, a thorough understanding of the physiologic changes during air travel is essential given the potential impact on cardiovascular health and the risk of complications in passengers with preexisting cardiac conditions. It is important for clinicians to be aware of the current recommendations and precautions that need to be taken before and during air travel for passengers with cardiovascular concerns.
Collapse
Affiliation(s)
- Muhammad Hammadah
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Bryan R Kindya
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Marc P Allard-Ratick
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Sammer Jazbeh
- Department of Radiology, University of Oklahoma, Oklahoma City
| | - Danny Eapen
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | | | - Laurence Sperling
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| |
Collapse
|
7
|
Agostoni P. Considerations on Safety and Treatment of Patients with Chronic Heart Failure at High Altitude. High Alt Med Biol 2013; 14:96-100. [DOI: 10.1089/ham.2012.1117] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Dipartimento di scienze cliniche e di comunità, Università di Milano, Milan Italy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington
| |
Collapse
|
8
|
High-Altitude Exposure in Patients with Cardiovascular Disease: Risk Assessment and Practical Recommendations. Prog Cardiovasc Dis 2010; 52:512-24. [DOI: 10.1016/j.pcad.2010.03.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
9
|
Higgins JP, Tuttle T, Higgins JA. Altitude and the heart: is going high safe for your cardiac patient? Am Heart J 2010; 159:25-32. [PMID: 20102863 DOI: 10.1016/j.ahj.2009.10.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 10/21/2009] [Indexed: 11/24/2022]
Abstract
Our aging population combined with the ease of travel and the interest in high altitude recreation pursuits exposes more patients to the acute physiologic effects of high altitude and lower oxygen availability. Acute exposure to high altitude is associated with significant alterations to the cardiovascular system. These may be important in patients with underlying cardiovascular disease who are not able to compensate to such physiologic changes. Exacerbating factors pertinent to patients with cardiovascular disease include acute hypoxia, increased myocardial work, increased epinephrine release, and increased pulmonary artery pressures. This review summarizes the physiology and clinical evidence regarding acute altitude exposure on the cardiopulmonary system with practical recommendations to address the question: "Is it safe for me to ski in the Rockies or climb Mt. Kilimanjaro?"
Collapse
|
10
|
KOBZA RICHARD, DURU FIRAT, ERNE PAUL. Leisure-Time Activities of Patients with ICDs: Findings of a Survey with Respect to Sports Activity, High Altitude Stays, and Driving Patterns. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2008; 31:845-9. [DOI: 10.1111/j.1540-8159.2008.01098.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Tomaske M, Harpes P, Dodge-Khatami A, Amacker N, Bauersfeld U. Do daily threshold trend fluctuations of epicardial leads correlate with pacing and sensing characteristics in paediatric patients? Europace 2007; 9:662-8. [PMID: 17573359 DOI: 10.1093/europace/eum100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To evaluate whether the magnitude of daily ventricular pacing threshold fluctuations (Deltafluctuation) in trend graphs of stored diagrams correlate with ventricular threshold and sensing changes over time. METHODS AND RESULTS A total of 56 children received AutoCapture devices (St. Jude Medical, Sylmar, CA, USA) connected to steroid-eluting epicardial leads. Maximum lead age at study closure was 12.2 years (median 4.0). Telemetry data and daily Deltafluctuation were obtained every 6 months. Regression slope coefficients and mean values of repeated measurements were calculated for each patient's course. High daily Deltafluctuation correlated with higher pacing thresholds (rho = 0.68, P < 0.001), lower impedances (rho = -0.38, P = 0.004), and a Deltafluctuation-incline (rho = 0.34, P = 0.01) over time. Furthermore, a Deltafluctuation-incline correlated with a pacing threshold-incline (rho = 0.34, P = 0.01). No correlation was observed for ventricular sensing. Higher daily Deltafluctuation were observed if lead age was > 5 years compared with <or= 5 years (0.75 vs. 0.55 V@0.5 ms, P = 0.028). CONCLUSION High amplitudes of daily Deltafluctuation correlate with higher and increasing pacing thresholds and lower impedances. Theoretically, this results from electrode microinstability on the epicardial surface. A decrease of the steroid-eluting potency of the electrode can be hypothesized to cause higher daily Deltafluctuation beyond a lead age of 5 years. Potential implications of marked daily Deltafluctuation are short-term follow-up and lead replacement in the presence of high pacing thresholds.
Collapse
Affiliation(s)
- Maren Tomaske
- Division of Pediatric Cardiology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | | | | | | | | |
Collapse
|
12
|
Angerer P, Nowak D. Working in permanent hypoxia for fire protection-impact on health. Int Arch Occup Environ Health 2003; 76:87-102. [PMID: 12733081 DOI: 10.1007/s00420-002-0394-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2002] [Accepted: 08/28/2002] [Indexed: 10/25/2022]
Abstract
OBJECTIVES A new technique to prevent fires is continuous exchange of oxygen with nitrogen which leads to an oxygen concentration of between 15% and 13% in the ambient air. This paper reviews the effect of short-term, intermittent hypoxia on health and performance of people working in such atmospheres. METHODS We reviewed the effect of ambient air hypoxia on human health in the literature using Medline, as well as reference lists of articles and handbooks. Articles were assessed from the perspective of working conditions in fire-protected rooms. RESULTS Oxygen reduced to 15% and 13% in normobaric atmospheres is equivalent to the hypobaric atmospheres found at 2,700 and 3,850-m altitudes. When acutely exposed, a healthy person responds within minutes to hours with increased ventilation, stimulation of the sympathetic system, increased heart rate, increased pulmonary-circulation resistance, reduced plasma volume, and stimulation of erythropoesis. Acute mountain sickness occurs frequently at these oxygen partial pressures, but the full syndrome is rare if continuous exposure is limited to 6 h. Mood, cognitive, and psychomotor functions may be mildly impaired in these conditions, but data are inconclusive. Persons suffering from cardiac, pulmonary, or hematological diseases should consult a specialist in order for their individual risk to be assessed, and medical screening for any of these diseases is strongly recommended prior to exposure. CONCLUSION Preliminary evidence suggests that working environments with low oxygen concentrations to a minimum of 13% and normal barometric pressure do not impose a health hazard, provided that precautions are observed, comprising medical examinations and limitation of exposure time. However, evidence is limited, particularly with regard to workers performing strenuous tasks or having various diseases. Therefore, close monitoring of the health problems of people working in low oxygen atmospheres is necessary.
Collapse
Affiliation(s)
- Peter Angerer
- Institute and Outpatient Clinic for Occupational and Environmental Medicine, Ludwig-Maximilians-University, Ziemssenstrasse 1, 80336, Munich, Germany.
| | | |
Collapse
|
13
|
Roach R. Mountain medicine citations. High Alt Med Biol 2001; 2:305-8. [PMID: 11443011 DOI: 10.1089/152702901750265404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
|
14
|
Simeon L, Duru F, Fluri M, Jenzer HR, Rahn M, Candinas R. The impact of automatic threshold tracking on pulse generator longevity in patients with different chronic stimulation thresholds. Pacing Clin Electrophysiol 2000; 23:1788-91. [PMID: 11139924 DOI: 10.1111/j.1540-8159.2000.tb07019.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Automatic adjustment of the stimulation output of pacemakers to changing stimulation thresholds using the Autocapture feature increases patient safety and decreases energy consumption. This study examined the impact of Autocapture on pulse generator longevity in patients with different chronic stimulation thresholds. Eighty patients (mean age 79 +/- 9 years; 37 men, 43 women) with Pacesetter Regency SR+ pacemakers were included in the study. Data were collected before discharge of the patients from the hospital, 6-12 weeks postimplant, and then every 6-12 months. Pulse generator longevity was calculated theoretically, assuming 100% stimulation with a stable threshold, at a pacing rate of 65 +/- 6 beats/min and 1% backup pulses. Theoretical pulse generator longevity was calculated for low (< 1 V), intermediate (> or = 1 V and < 2 V), and high (> or = 2 V) stimulation thresholds. Pulse generator longevity was compared among three groups: (A) Autocapture programmed On, (B) Autocapture programmed Off, (C) theoretical calculations using thresholds of patients in group A with the stimulation voltage programmed at twice pacing threshold, or at a minimum of 2.4 V. The mean follow-up time since implantation was 19 +/- 8 months. The calculated longevity benefits for patients in group A were 36%, 59%, and 30% compared to group B, and 19%, 32%, and 49% compared to group C in patients with low, intermediate, and high chronic stimulation thresholds, respectively. Theoretical calculations based on chronic stimulation thresholds in our patient population with Regency SR+ pacemakers suggest that Autocapture may markedly prolong pulse generator longevity in patients with a broad range of long-term pacing thresholds.
Collapse
Affiliation(s)
- L Simeon
- Cardiac Arrhythmia Unit, University Hospital of Zurich, Rämistr. 100, Zurich, CH-8091 Switzerland.
| | | | | | | | | | | |
Collapse
|
15
|
Duru F, Bauersfeld U, Schüller H, Candinas R. Threshold tracking pacing based on beat by beat evoked response detection: clinical benefits and potential problems. J Interv Card Electrophysiol 2000; 4:511-22. [PMID: 11046190 DOI: 10.1023/a:1009864615632] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Continuous monitoring of pacemaker stimulation thresholds and automatic adjustment of pacemaker outputs were among the longstanding goals of the pacing community. The first clinically successful implementation of threshold tracking pacing was the Autocapture feature which has accomplished automatic ventricular capture verification for every single stimulus by monitoring the Evoked Response (ER) signal resulting from myocardial depolarization. The Autocapture feature not only decreases energy consumption by keeping the stimulation output slightly above the actual threshold, but also increases patient safety by access to high-output back-up pulses if there is loss of capture. Furthermore, it provides valuable documentation of stimulation thresholds over time and serves as a valuable research tool. Current limitations for its widespread use include the requirements for implantation of bipolar low polarization leads and unipolar pacing in the ventricle. Fusion/pseudofusion beats with resultant insufficient or even non-existent ER signal amplitudes followed by unnecessary delivery of back-up pulses and a possible increase in pacemaker output is not an uncommon observation unique to the Autocapture feature. The recent incorporation of the Autocapture algorithm in dual chamber pacemakers has been challenging because of more frequent occurrence of fusion/pseudofusion beats in the presence of normal AV conduction. Along with a review of the previously published studies and our clinical experience, this article discusses the clinical advantages and potential problems of Autocapture.
Collapse
Affiliation(s)
- F Duru
- Cardiac Arrhythmia Unit, University Hospital of Zurich, Switzerland.
| | | | | | | |
Collapse
|