Paralyzed Patients Can Need Heart Pacing Help

Spinal cord injuries at the neck can slow cardiac function, researchers say

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WEDNESDAY, July 26, 2006 (HealthDay News) -- Patients who experience a dangerous dip in heart rate after spinal cord injury may need heart-pacing therapy, researchers report.

Cervical (neck) spinal cord injury can affect the nervous system's ability to regulate heart rate, resulting in a dangerously slow beat that can cause blood pressure to fall and insufficient levels of blood and oxygen to reach organs. The situation can progress to heart stoppage.

This study included 75 spinal cord injury patients, including six with high cervical injuries, three of whom required a permanent pacemaker.

Researchers at the Medical College of Georgia in Augusta concluded that less aggressive therapies, such as drugs and a pacemaker placed on top of the chest, weren't sufficient for patients with a very slow heart rate.

Intravenous pacing -- which involves insertion of a lead into the heart -- may be a better first treatment for patients with ongoing heart rate problems in the first hours and days after they suffer a cervical spinal cord injury, the study said.

"Nobody really knows the best therapy," study co-author Dr. Vincent J.B. Robinson, a nuclear cardiologist, said in a prepared statement.

"This gives us some direction that if you see a very slow heart rate, if the patient's heart is stopping for three, four or five seconds, you think about putting in a transvenous pacemaker and see how they do and maybe put a permanent pacemaker in sooner rather than later," Robinson said.

The study was published in the July/August issue of Cardiology in Review.

More information

The American Academy of Orthopaedic Surgeons explains cervical fracture.

SOURCE: Medical College of Georgia, news release, July 20, 2006

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