Pacemaker Sounds

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Chest. 1992 Jul;102(1):323-4.
Pacemaker-induced friction rub and apical thrill.
Flickinger AL, Peller PA, Deran BP, Burket MW.
Department of Medicine, Medical College of Ohio, Toledo 43679.

A patient with acute myocardial infarction developed a loud systolic sound and apical thrill. Doppler ultrasound excluded interventricular septal rupture and significant mitral or tricuspid regurgitation. Auscultatory abnormalities disappeared after removal of a temporary pacing electrode, suggesting that the friction it created with intracardiac structures was responsible for these findings.

Acta Med Hung. 1991;48(3-4):157-66.
Retrograde (ventriculo-atrial) conduction, premature beats, pseudotricuspid regurgitation, systolic atrial sounds and pacemaker sounds observed together in two patients with ventricular pacing.
Gelleri D.
Jasz-Nagykun Szolnok Cardiovascular Care Station, Hungary.

Two patients were found to have retrograde atrioventricular conduction with premature beats during permanent ventricular pacing. In both patients the auscultatory phenomena had been heard and recorded that had been described as independent signs, but all together in the same patient had not been reported before. In one of the patients pseudotricuspid regurgitation was observed with Doppler echocardiography and the other was suspected having the same. It seems that patients with these symptoms deserve high preventive care and attention.

Kokyu To Junkan. 1981 Feb;29(2):203-8.
Evaluation of pacemaker induced endocardial friction rub by intracardiac phonocardiography
Watanabe I, Ozawa Y, Tanigawa N, Yamamoto M, Tomobe K, Koguchi Y, Ichikawa M, Takahashi N, Komaki K, Saito T, Imai K, Satomi Y, Nishizawa M, Saito S, Hatano M.

Am J Cardiol. 1977 Nov;40(5):811-4.
Pacemaker-induced endocardial friction rub.
Glassman RD, Noble RJ, Tavel ME, Storer WR, Schmidt PE.

Two patients had a typical sounding cardiac friction rub after placement of a temporary transvenous pacemaker. Absence of myocardial perforation was documented in one patient during thoracotomy for placement of an epicardial electrode and in the other with an electrogram recorded from the pacemaker as it was being withdrawn. The rubs disappeared during pacemaker removal. These cases are believed to represent endocardial friction rubs resulting from contact of the pacing wire with the endocardium.

Chest. 1976 Apr;69(4):490-4.
Pacemaker-induced change in prosthetic valvular sounds.
Brown DF, Prescott G.

Variable intensity and timing of valvular sounds were noted in two patients with permanent pacemakers and prosthetic valves. In the first patient, who had a mitral and a tricuspid prosthesis, valvular opening sounds became widely separated with a change from nodal to ventricular paced rhythm. In a second patient, who had a mitral prosthesis in sinus rhythm with first-degree atrioventricular block, a very quiet closing sound increased markedly in intensity with the onset of ventricular pacing. The mechanism for these changes is described using a technique which at brief intervals throughout the cardiac cycle permitted documentation of simultaneously recorded phonocardiogram, electrocardiogram, and pulse tracings with a visible image of the prosthesis. In the usual patient with a prosthetic valve auscultatory changes should arouse a suspicion of malfunction; however, in the relatively uncommon patient with a prosthesis and an artificial pacemaker, it should be recognized that auscultatory changes may well have a physiologic explanation.

Ann Intern Med. 1971 Feb;74(2):245-50.
Auscultatory findings in patients with cardiac pacemakers.
Misra KP, Korn M, Ghahramani AR, Samet P.

Am Heart J. 1971 Nov;82(5):711-2.
"Pacemaker heart sound" caused by diaphragmatic contractions.
Pupillo GA, Talley RC, Linhart JW.

Ann Intern Med. 1970 Sep;73(3):439-41.
Chest-wall stimulation and phonocardiography in the identification of the pacemaker heart sound.
Pupillo GA, Linhart JW.

Am J Cardiol. 1980 Aug;46(2):350.
Heart sounds induced by Swan-Ganz catheter
Hultgren HN.

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