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Pacing and Clinical Electrophysiology: PACE

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https://www.readbyqxmd.com/read/28295438/intermittent-failure-of-ventricular-pacing-what-is-the-mechanism
#1
Aditya Saini, Bruce S Stambler, Jason S McConnell, Kenneth A Ellenbogen
A 50 year old man with a past medical history of Tetralogy of Fallot and status post surgical repair at age 2 was found to have complete heart block with a ventricular escape rhythm of 37 beats per minute (bpm) on an electrocardiogram (ECG) performed during his annual physical exam. This article is protected by copyright. All rights reserved.
March 15, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28295442/cremation-of-leadless-pacemaker
#2
Lily Cheung, Gary C P Chan, Joseph Y S Chan, Chu-Pak Lau
Cremation of implanted cardiac electronic devices can be associated with explosion from rapid gas formation causing potential hazard to the crematoria staffs and facilities. We present four patients who had undergone cremation with a leadless pacemaker (Micra(TM) , Medtronic Inc., MN) left inside their bodies. There was neither reported explosion nor damage to the cremation chamber during the cremation process. In this small series, cremation of Micra(TM) is not associated with noticeable explosion. This article is protected by copyright...
March 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28295425/prophylactic-atropine-administration-prevents-vasovagal-response-induced-by-cryoballoon-ablation-in-patients-with-atrial-fibrillation
#3
Liping Sun, Jian-Zeng Dong, Xin DU, Rong Bai, Songnan Li, Mohamed Salim, Chang-Sheng Ma
BACKGROUND: Cryoballoon ablation of pulmonary vein (PV) ostia often induces a vagal response.This prospective study was designed to assess the effectiveness of prophylactic intravenous administration of atropine on hemodynamic impairment induced by cryoballoon ablation in patients with atrial fibrillation. METHODS: Twenty-five patients with paroxysmal atrial fibrillation undergoing cryoballoon ablation were prospectively enrolled and assigned to one of two groups...
March 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28294363/an-innovation-in-pacemaker-lead-implantation-via-persistent-left-superior-vena-cava-the-3d-alpha-curve-stylet
#4
Jahangir Rashid Beig, Mohd Iqbal Dar, Nisar A Tramboo, Imran Hafeez, Ajaz A Lone, Hilal A Rather
Persistent left superior vena cava (PLSVC) draining into coronary sinus is typically detected incidentally during transcatheter interventions utilizing left subclavian venous approach. In our experience, we have encountered this anomaly on a few occasions and in all these cases we successfully implanted leads in the right ventricle (RV) by shaping the stylet into a 'U-shaped' or 'pigtail shaped' curve. Herein, we report a case of an adult male who underwent successful dual chamber pacemaker implantation via PLSVC through left axillary venous approach...
March 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28294359/premature-trigger-of-eri-in-medtronic-enrhythm-devices
#5
Melissa E Middeldorp, Rajiv Mahajan, Adrian D Elliott, Rajeev K Pathak, Darragh Twomey, Lauren Wilson, Simon Stolcman, Dian A Munawar, Sharath Kumar, Dennis H Lau, Prashanthan Sanders
INTRODUCTION: Medical technology has made significant advances over the last few decades with smaller and more dynamic pacemakers. However, technical failures leading to premature replacement is a cause of concern. We present a series of Medtronic EnRhythm devices that reached premature elective replacement indicator (ERI). METHODS: The database of Centre of Heart Rhythm Disorders was searched for EnRhythm device implantation from 2006 to 2011. Battery depletion <8...
March 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28261825/electrical-storm-in-icd-recipients-with-arrhythmogenic-right-ventricular-cardiomyopathy
#6
Kang Yin, Ligang Ding, Wei Hua, Shu Zhang
BACKGROUND: Implantable cardioverter defibrillator (ICD) is the most important management for prevention of sudden cardiac death (SCD) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). However, some patients may receive multiple ICD therapies in a short period, a condition referred as "electrical storm". OBJECTIVES: This study aimed to determine the prevalence, therapeutic options, and prognostic implications of ES in ARVC patients with an ICD...
March 6, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28251658/catheter-ablation-of-recurrent-paroxysmal-atrial-fibrillation-is-gap-closure-combining-ganglionated-plexi-ablation-more-effective
#7
Feng-Qiang Xu, Rong-Hui Yu, Jun-Jie Guo, Rong Bai, Nian Liu, Y I An, Xue-Yuan Guo, Ri-Bo Tang, DE-Yong Long, Cai-Hua Sang, Xin DU, Jian-Zeng Dong, Chang-Sheng Ma
BACKGROUND: For repeat treatment with PAF (paroxysmal atrial fibrillation) recurrence, gap-closure at pulmonary vein ostia alone is not enough. Many recent studies indicated that GPs (ganglionated plexi) denervation could reduce the recurrence of AF. However it is unclear whether the clinical outcomes of additional GP ablation plus PVs (pulmonary veins) reisolation during a repeat procedure were associated with less recurrence in PAF patients. The purpose of this study was to evaluate if a repeat procedure of GPA (Ganglionated Plexi Ablation) combining re-PVI (repeated procedure of pulmonary vein isolation, i...
March 2, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28247926/non-invasive-determination-of-hv-interval-using-magnetocardiography
#8
Sengottuvel Senthilnathan, Raja J Selvaraj, Rajesh Patel, Santhosh Satheesh, Gireesan Katholil, Madhukar P Janawadkar, Thimmakudy S Radhakrishnan
BACKGROUND: The HV interval is an important index of atrio-ventricular conduction, but at present can be reliably measured only during an invasive electrophysiology (EP) study. Magnetocardiography (MCG) is a non-invasive measurement of weak magnetic fields generated by the heart. We compared HV interval non-invasively assessed using MCG with the corresponding values measured directly in an EP study. METHODS: MCG was measured using a 37 channel system inside a magnetically shielded room in patients who had previously undergone an EP study...
March 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28244210/clinical-characteristics-and-outcome-of-patients-with-situational-syncope-compared-to-patients-with-vasovagal-syncope
#9
Kevin E Wenzke, Kathleen E Walsh, Matthew Kalscheur, Stephen Wasmund, Richard L Page, Michele Brignole, Mohamed H Hamdan
BACKGROUNDS: The purpose of the study was to assess the clinical outcome of patients with situational syncope (SS) compared to patients with vasovagal syncope (VVS). METHODS: We assessed the prevalence, patients' characteristics and outcome of consecutive patients with SS and VVS who presented to the Faint and Fall Clinic (University of Wisconsin) between January 2013 and December 2015. RESULTS: SS was found in 55/1401(4.0%) syncope patients with follow-up data available in 47 patients: defecation (n = 16), micturition (n = 15), cough (n = 10), swallow (n = 3), laughter (n = 1), sneeze (n = 1) and cough plus laughter (n = 1)...
February 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28244206/surface-ecg-and-fluoroscopy-are-not-predictive-of-right-ventricular-septal-lead-position-compared-to-cardiac-ct
#10
Matthew Rowe, Peter Moore, Jit Pratap, John Coucher, Paul Gould, Gerald Kaye
BACKGROUND: Controversy exists regarding the optimal lead position for chronic right ventricular (RV) pacing. Placing a lead at the RV septum relies upon fluoroscopy assisted by a surface 12-lead electrocardiogram (ECG). We compared the post-implant lead position determined by ECG-gated Multi-Detector contrast enhanced CT (MDCT) with the position derived from the surface 12 lead ECG. METHODS: Eighteen patients with permanent RV leads were prospectively enrolled...
February 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28244117/early-detection-and-treatment-of-atrial-arrhythmias-alleviates-the-arrhythmic-burden-in-aced-patients-the-setam-study
#11
Walid Amara, Christian Montagnier, Saïda Cheggour, Michel Boursier, Claude Gully, Claude Barnay, Frederic Georger, Antoine Deplagne, Stephane Fromentin, Marcin Mlotek, Arnaud Lazarus, Jerôme Taïeb
BACKGROUND: Remote Monitoring (RM) can remotely detect atrial tachyarrhythmias (ATA). The benefit of RM compared to conventional follow-up in the detection and management of ATA was assessed in recipients of dual chamber pacemakers. METHODS: The multicentre randomized SETAM study enrolled 595 patients in sinus rhythm with a CHA2 DS2 -VASc score ≥2, without ATA history and untreated with antiarrhythmics and antithrombotics, randomly assigned to RM (RM-ON; n = 291) versus ambulatory follow-up (RM-OFF; n = 304) during 12...
February 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28240419/enhanced-antimicrobial-effects-of-decellularized-extracellular-matrix-cormatrix-with-added-vancomycin-and-gentamicin-for-device-implant-protection
#12
Thomas F Deering, Carlos Chang, Carl Snyder, Selvamuthu K Natarajan, Robert Matheny
BACKGROUND: The incidence of cardiac implantable electronic device (CIED) infections has risen significantly over the past years. Although several devices are currently available to decrease the incidence of infection, most are made from non-viable synthetic material and are more prone to infection than vascularized tissue. OBJECTIVE: This study was undertaken to assess the resistance to infection of the CorMatrix CanGaroo, a CIED envelope made of decellularised extracellular matrix (ECM) hydrated in different antibiotic solutions...
February 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28240382/minimal-invasive-left-ventricular-lead-repositioning-is-safe-and-effective-in-distal-left-ventricular-lead-positions
#13
István Osztheimer, Szabolcs Szilágyi, Zsuzsanna Pongor, Endre Zima, Levente Molnár, Tamás Tahin, Béla Merkely, László Gellér
BACKGROUND: Treatment of left ventricular electrode dislocation and phrenic nerve stimulation remains an issue in the era of new electrode designs. METHODS: Safety and efficacy of minimal invasive lead repositioning and pocket opening reposition procedures were evaluated between December 2005 and December 2012 at our center. Minimal invasive method was developed and widely utilized at our center to treat phrenic nerve stimulation. The distally positioned left ventricular lead is looped around by a deflectable catheter in the right atrium introduced from the femoral vein access and then pulled back...
February 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28240372/using-the-surface-ecg-to-identify-right-ventricular-pacing-lead-position-a-cautionary-tale
#14
Gerald C Kaye, Matthew K Rowe, Paul A Gould
Chronic right ventricular (RV) apical pacing may lead to the development of heart failure in some patients. Although pacing of the right ventricular septum has been proposed as an alternative, positioning a lead in the true septum has proven challenging. In addition to fluoroscopy at implant it has been suggested that 12-lead surface ECG can be used to determine septal lead position, however studies show this may be inaccurate. We present a case where a change in the ECG QRS axis late after pacemaker insertion with an active fixation lead highlights the difficulties of ECG localisation of pacing leads...
February 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28240366/high-patient-satisfaction-with-deep-sedation-for-catheter-ablation-of-cardiac-arrhythmia
#15
Paula Münkler, Philipp Attanasio, Abdul Shokor Parwani, Martin Huemer, Leif-Hendrik Boldt, Wilhelm Haverkamp, Alexander Wutzler
Patients' satisfaction with invasive procedures largely relies on periprocedural perception of pain and discomfort. The necessity for intraprocedural sedation during catheter ablation of cardiac arrhythmias for technical reasons is widely accepted, but data on patients' experience of pain and satisfaction with the procedural sedation are scarce. We have assessed patients' pain and discomfort during and after the procedure using a standardized questionnaire. One-hundred seventeen patients who underwent catheter ablation answered a standardized questionnaire on periprocedural perception of pain and discomfort after different anesthetic protocols with propofol/midazolam with and without additional piritramide and ketamine/midazolam...
February 27, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28224636/the-contactless-vital-sensing-system-precisely-reflects-r-r-interval-in-electrocardiograms-of-healthy-subjects
#16
Kentaro Suga, Hikaru Hori, Asuka Katsuki, Masahiro Ohashi, Tadanori Tezuka, Masatoshi Matsuo, Tsuyoshi Nakamura, Reiji Yoshimura
BACKGROUND: The aim of the present study was to investigate the validity of the contactless vital sensing system that we previously developed. METHODS: A total of one hundred and eleven healthy Japanese subjects were recruited from the University of Occupational and Environmental Health and the Panasonic Corporation AVC Networks Company. All subjects underwent an evaluation using the contactless vital sensing system and electrocardiography (ECG). We compared the R-R interval (RRI) obtained using the new contactless sensing system to that obtained using ECG...
February 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28224629/clinical-performance-of-magnetic-resonance-imaging-conditional-and-non-conditional-cardiac-implantable-electronic-devices
#17
Anand D Shah, Adarsh U Patel, Andrea Knezevic, Michael H Hoskins, David S Hirsh, Faisal M Merchant, Mikhael F El Chami, David B Delurgio, Anshul M Patel, Angel R Leon, Jonathan J Langberg, Michael S Lloyd
OBJECTIVES: This study compared risks associated with magnetic resonance imaging (MRI) in patients with non-MRI conditional and MRI conditional pacing and defibrillator systems with particular attention to clinically actionable outcomes. BACKGROUND: While recipients of new MRI conditional pacemaker and defibrillator systems may undergo MRI scanning with very low risk, safety and regulatory concerns persist regarding such scanning in recipients of non- MRI conditional systems...
February 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28220947/does-anyone-really-believe-the-results-of-the-danish-trial-implanting-an-icd-in-non-ischemic-cardiomyopathy-patients
#18
EDITORIAL
J Rod Gimbel, Judith Mackall
The recent publication of the DANISH Trial seems to leave clinicians and patients at a point of therapeutic equipoise regarding the implantation of an ICD in patients with non-ischemic cardiomyopathy. Limitations of the DANISH Trial are discussed and suggestions for a potential way forward are outlined in this controversial area of patient care. This article is protected by copyright. All rights reserved.
February 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28220945/off-label-mri-in-2017-of-cieds-a-daily-fork-in-the-road-for-implanters-and-the-case-for-common-sense
#19
EDITORIAL
J Rod Gimbel
Both non-MRI conditional and MRI conditional systems are widely available. Physicians must choose which type of device to place. While off-label MRI can often be done safely, significant administrative and financial burdens remain to the physician posing a significant dilemma as to which device to choose. These issues are reviewed in a detailed direct manner. This article is protected by copyright. All rights reserved.
February 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28220942/crt-induced-ventricular-tachyarrhythmia-what-s-the-mechanism
#20
Sanoj Chacko, Enes Gul, Chris Simpson, Adrian Baranchuk
A 56-year-old woman with non-ischemic dilated cardiomyopathy and severe left ventricular systolic dysfunction received cardiac resynchronization defibrillator therapy (CRT-D; St Jude Medical Quadra Assura, CA, USA), for primary prevention and management of heart failure. This article is protected by copyright. All rights reserved.
February 21, 2017: Pacing and Clinical Electrophysiology: PACE
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