Talk:Pacemaker syndrome/GA1

GA Review

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Comments:

does not fulfill WP:LEAD
this is not refed "Pacemaker Syndrome is an iatrogenic disease that is often underdiagnosed." Done GiggsHammouri (talk) 14:17, 10 June 2009 (UTC)[reply]
needs an ECG demonstrating this condition Done GiggsHammouri (talk) 12:01, 20 June 2009 (UTC)[reply]
No section on history Done MaenK.A._Talk
No section epideimiology Done MaenK.A._Talk
needs to follow Wikipedia:Manual of Style (medicine-related articles) Done MaenK.A._Talk

--Doc James (talk · contribs · email) 07:53, 2 June 2009 (UTC)[reply]

Comments by Axl

This ECG shows intrinsic SA node activity with normal P waves followed by paced ventricular beats. Assuming that the default speed is used (25 mm/s), this gives a PR interval of about 120 ms. This is not a good example of pacemaker syndrome.

This is the best example I could get, since PM syndrome does not have a characteristic ECG, it differs in every case, but this is the closest ECG according to the emedicine reference, which shows a general idea of the syndrome. I couldnt get anything better, what do you suggest we should do? GiggsHammouri (talk) 14:14, 26 July 2009 (UTC)[reply]

Your linked source (emedicine) has two ECGs. The first shows normal pacemaker function. The second shows abnormal pacemaker function, where the ventricular pacing becomes progressively closer to the P wave. This is consistent with pacemaker syndrome. Axl ¤ [Talk] 08:59, 27 July 2009 (UTC)[reply]

Actually you are right, I managed to edit the ECG file and now it shows how the ventricular pacing progressively moves closer to the p wave. Please check it out and tell me what do you think. GiggsHammouri (talk) 21:30, 27 July 2009 (UTC)[reply]

The new ECG is good. Thanks. Axl ¤ [Talk] 14:12, 30 July 2009 (UTC)[reply]

From "Signs and symptoms": "Heart rate related - Chest fullness or pain". Chest fullness/pain strike me as unusual symptoms arising from heart rate problems. I would expect palpitations to be a more common symptom. Done GiggsHammouri (talk)

Thanks. Axl ¤ [Talk] 09:09, 27 July 2009 (UTC)[reply]

Why is "Cannon A waves" in the "Pathophysiology" section? Shouldn't it be in the "Signs and symptoms" section?

I included the cannon A waves in pathophysiology section in an attempt to help the reader understand why would PM syndrome cause the before mentioned hemodynamic symptoms characterized by pulsation in the neck and abdomen, choking sensation, jaw pain, and headache. While trying to follow the Wikipedia:Manual of Style (medicine-related articles), I thought this is the best way of representing it. If you still see that I need to change things around, please feel free to respond and explain to me what I should do and I'll be happy to do it. GiggsHammouri (talk)

Okay, that's fine. Axl ¤ [Talk] 09:09, 27 July 2009 (UTC)[reply]

Great, now we can tick it done. Thanks.

Done GiggsHammouri (talk) 21:33, 27 July 2009 (UTC)[reply]

"Surgical care"? Really?

I don't see what do you mean exactly, but it is believed that adding another lead by surgery would improve many symptoms, as mentioned in emedicine, so it had to be mentioned in the article. Please elaborate on your point of view so we can reach to a mutual solution that could only improve the article. GiggsHammouri (talk)

Emedicine says "Surgical Care: Consultation with an electrophysiologist determines the possible need for additional pacemaker lead placement." I am unconvinced that is actually performed by surgeons or requiring general anaethesia. My understanding is that such additional lead placement is usually either re-positioning of the right ventricular lead, or new lead placement in the coronary sinus to establish left ventricular pacing. Axl ¤ [Talk] 09:14, 27 July 2009 (UTC)[reply]

I note the emedicine reference. However I am sceptical of the use of diet to treat pacemaker syndrome. Those dietary recommendations apply to different disease processes: heart failure, autonomic insufficiency, and dehydration.

I agree, I added a line explaining that diet can not treat PM syndrome, but can relieve some of the symptoms associated with the syndrome. Thanks for the note.

Done GiggsHammouri (talk)

Thanks. Axl ¤ [Talk] 09:17, 27 July 2009 (UTC)[reply]

Axl ¤ [Talk] 19:25, 21 July 2009 (UTC)[reply]

GiggsHammouri, could you comment further on the relevance of surgery to this syndrome? Thanks. Axl ¤ [Talk] 11:02, 31 July 2009 (UTC)[reply]

Comments by RexxS

This has the makings of a good article but is not there yet. I've tried to expand the lead to summarize key points in the sections not covered, but would appreciate someone with medical knowledge to amend my efforts, as they only represent a lay understanding of a complicated topic. Two big issues that should also be addressed are:

WP:Jargon - despite some background in science, I was unable to penetrate a lot of this article. It is sometimes insufficient just wikilinking a phrase to explain it. It took me quite a while to ascertain just what the syndrome was (in lay terms) and what its effects are. Please check over the lead especially and try to re-write it so that an non-medic could read through it and get a reasonable idea of what the article is about. As a concrete example, I wanted to summarise in the lead the main risk factors, but I was simply unable to comprehend "a higher programmed lower rate limit". I'm not thick and English is my first language, but that collection of words, without any meaningful context, meant absolutely nothing that I could use to describe to a layman (like myself) what the risk factor was.
Is there no prognosis for this syndrome? If there is, it needs a section; if not, that should be mentioned somewhere.

--RexxS (talk) 23:57, 8 August 2009 (UTC)[reply]

Long GA Review

This article was originally nominated on 31 May 2009 by MaenK.A._Talk, and marked with a {{GAreview}} tag on 9 June 2009 by Doc James (talk · contribs · email). It is now August 13, 2009, and the review has been open for over two months. A quick look at the article shows many very short sections, and lots of subsections, which point to many possible issues with criterion #3 of the Good Article criteria. Since there appear to be other issues still prevalent in this article, I would recommend closing this review as a fail, and let editors work on it some more without the review going on. Once it meets the criteria and has a bit more information in it, it can be renominated at WP:GAN. Dr. Cash (talk) 21:17, 13 August 2009 (UTC)[reply]

You have a point there, two months is a long time, but I kindly request to keep the review going. I created the article, and I wanted to get it to the GA class, but unfortunately I got busy with some issues that kept me away from wikipedia. I know with that little bit extra time and effort we can get it there, without it being marked as failed. I hope you consider that thought, so we can get to an agreement. Thank you. GiggsHammouri (talk) 22:28, 18 August 2009 (UTC)[reply]

You can always renominate it when the issues are all taken care of, which may actually be a better option in the long run. Wizardman 15:11, 21 August 2009 (UTC)[reply]

Language

Some of the language is too technical such as "clinical consequences of suboptimal atrioventricular (AV) synchrony or AV dyssynchrony, regardless of the pacing mode, after the pacemaker plantation". Will fail at this point in time. This article is getting to GA but not there yet.Doc James (talk · contribs · email) 03:18, 2 September 2009 (UTC)[reply]