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Pacing and Clinical Electrophysiology: PACE

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https://www.readbyqxmd.com/read/28512774/cybersecurity-and-medical-devices-a-practical-guide-for-cardiac-electrophysiologists
#1
REVIEW
Benjamin Ransford, Daniel B Kramer, Denis Foo Kune, Julio Auto de Medeiros, Chen Yan, Wenyuan Xu, Thomas Crawford, Kevin Fu
Medical devices increasingly depend on software. While this expands the ability of devices to perform key therapeutic and diagnostic functions, reliance on software inevitably causes exposure to hazards of security vulnerabilities. This article uses a recent high-profile case example to outline a proactive approach to security awareness that incorporates a scientific, risk-based analysis of security concerns that supports ongoing discussions with patients about their medical devices. This article is protected by copyright...
May 17, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28439940/impact-of-operator-experience-and-training-strategy-on-procedural-outcomes-with-leadless-pacing-insights-from-the-micra-transcatheter-pacing-study
#2
Mikhael El Chami, Robert C Kowal, Kyoko Soejima, Philippe Ritter, Gabor Z Duray, Petr Neuzil, Lluis Mont, Alexander Kypta, Venkata Sagi, J Harrison Hudnall, Kurt Stromberg, Dwight Reynolds
BACKGROUND: Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. METHODS: A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28436586/transesophageal-and-invasive-electrophysiologic-evaluation-in-children-with-wolff-parkinson-white-pattern
#3
Serhat Koca, Feyza Aysenur Pac, Ahmet Vedat Kavurt, Serkan Cay, Ajda Mihcioglu, Dursun Aras, Serkan Topaloglu
BACKGROUND: Risk stratification for Wolff-Parkinson-White (WPW) pattern either by non-invasive or invasive tests is important to determine whether an ablation is necessary or not. The aim was to compare non-invasive tests and invasive studies in a pediatric WPW population. METHODS: A total of 71 WPW patients [median age 14 years (IQR 11 - 16 years); 43 male] underwent Holter monitoring, exercise stress test (EST), and transesophageal electrophysiological study (TEEPS)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28436566/atrial-fibrillation-originating-from-superior-vena-cava-with-atrial-flutter-electrocardiogram-pattern
#4
Hung-Kai Huang, Shih-Lin Chang, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Yen-Chang Huang, Chung-Hsing Lin, Chao-Shun Chan, Hung-Yu Chang, Chin-Yu Lin, Yao-Ting Chang, Ching-Hui Huang, Shih-Ann Chen
BACKGROUNDS: Substrate property is related to the genesis and maintenance of atrial fibrillation (AF). The aim of the study was to investigate the impact of substrate property on the electrocardiogram (ECG) in patients with AF originating from the superior vena cava (SVC). METHODS AND RESULTS: Seventy-six patients with AF originating from SVC underwent catheter ablation were included from 2004 to 2013. Of these patients, 16 had a presentation of atrial flutter (AFL)-pattern ECG during AF (group 1), and 60 patients did not (group 2)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28436550/epicardial-brugada-syndrome-ablation-unmasking-inferior-j-waves
#5
Adam Lee, Heidi Kohler, Daniel Wright, Haris M Haqqani
Patients with Brugada syndrome are at risk of life threatening ventricular arrhythmias. Epicardial substrate ablation for Brugada syndrome has been described as a means of controlling these arrhythmias and recent reports describe elimination of the Brugada phenotype with ablation. We describe a unique case in which a patient developed inferior J waves with an early repolarization-type electrocardiogram following successful epicardial infundibular substrate ablation (which eliminated the Brugada syndrome ECG on ajmaline challenge)...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28436549/atrial-undersensing-secondary-to-quiet-timer-blanking-in-pediatric-and-congenital-heart-disease-patients
#6
Johannes C von Alvensleben, Michael Schaffer, Caitlin Brateng, Kathryn K Collins
BACKGROUND: Atrial undersensing despite normal atrial lead parameters and high amplitude electrograms has been described in adult patients as a consequence of atrial amplifier saturation. Repetitive inputs cause amplifier ringing and undersensing occurs as consequence of quiet timer blanking. High amplitude ventricular electrograms can also result in atrial blanking secondary to cross chamber effect. This has not been described in pediatric patients or epicardial pacing systems and specific risk factors are not known...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28436547/are-type-d-personality-and-depression-predictors-of-anxiety-and-posttraumatic-stress-symptoms-among-icd-patients
#7
EDITORIAL
Jessica Ford
The literature surrounding posttraumatic stress symptoms (PSS) and anxiety among patients living with implantable cardioverter defibrillators (ICD) is becoming increasingly sophisticated with evidence linking traumatic stress and anxiety to cardiovascular outcomes, examinations of psychosocial treatment of PSS and anxiety, and predictive modeling all contributing to a more nuanced understanding of the predictors, course, and treatment of PSS and anxiety among ICD patients. In this issue of PACE, Habibovic, Denollet, and Pedersen report secondary analyses from the WEBCARE trial data in which the author employed Latent Class Analysis (LCA) to identify trajectories of trauma and anxiety symptoms among patients implanted with ICDs across the 12-month post-implant period and examined associations between the identified trajectories and demographic, clinical, and psychological characteristics of the participants...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28436533/left-atrial-appendage-electrical-isolation-for-atrial-fibrillation-ice-and-fire
#8
EDITORIAL
Jorge Romero, Andrea Natale, Luigi Di Biase
No abstract text is available yet for this article.
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28436092/effects-of-creatine-supplementation-on-cardiac-autonomic-functions-in-bodybuilders
#9
Kadir Uğur Mert, Serdar Ilgüy, Muhammet Dural, Gurbet Özge Mert, Engin Özakin
Bodybuilder-type workouts may affect heart rate variability (HRV), which has considerable potential to assess the role of autonomic nervous system (ANS). A scientifically designed approach is necessary for bodybuilders to achieve better results while protecting their health. In this study, we aimed to investigate HRV parameters in bodybuilders compared to healthy control subjects and effects of creatine supplementation. Total 48 male participants (16 controls, 16 supplement(-), 16 supplement(+) were evaluated in our study...
April 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28432805/pitfalls-in-electrogram-interpretation-subcutaneous-cardioverter-defibrillator-malfunction-in-brugada-syndrome
#10
Giovanni Morani, Bruna Bolzan, Luca Tomasi, Ruggero Tomei, Corrado Vassanelli
A patient with Brugada Syndrome implanted with subcutaneous cardioverter defibrillator (S-ICD) had oversensing episodes treated with S-ICD shocks. Comparable artefacts weren't evocable with S-ICD pocket manipulation. The fluoroscopy excluded S-ICD macroscopic damage. The device extraction revealed undamaged pulse generator and connector, but the lead was inappropriately tunnelled under the sixth rib. Then the S-ICD malfunction was due to lead microscopic damage caused by lead rubbing the rib surface. This article is protected by copyright...
April 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28432794/posttraumatic-stress-and-anxiety-in-patients-with-an-implantable-cardioverter-defibrillator-trajectories-and-vulnerability-factors
#11
M Habibović, J Denollet, S S Pedersen
BACKGROUND: Implantable cardioverter defibrillator (ICD) therapy is first-line treatment for the primary and secondary prevention of sudden cardiac death. Despite the unequivocal medical benefits, living with an ICD may affect patients' psychological functioning and general well-being. We examined the trajectories of symptoms of posttraumatic stress disorder (PTSD) and anxiety in patients with an ICD and the vulnerability factors associated with an increased risk of symptoms of PTSD and anxiety...
April 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28383202/tachycardia-cycle-and-atrioventricular-nodal-conduction-properties-in-children-with-supraventricular-tachycardia
#12
LETTER
Marcos Mills, Anne M Dubin, Kara S Motonaga, Scott R Ceresnak
No abstract text is available yet for this article.
April 6, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28378381/left-atrial-appendage-ablation-using-cryoballoon
#13
Guram Imnadze, Wolfgang Kranig, Joachim Thale, Thomas Zerm
No abstract text is available yet for this article.
April 4, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28374478/prognostic-implication-of-left-atrial-sphericity-in-atrial-fibrillation-patients-undergoing-radiofrequency-catheter-ablation
#14
Jeonggeun Moon, Hye-Jeong Lee, Jongwook Yu, Hui-Nam Pak, Jong-Won Ha, Moon-Hyoung Lee, Young Jin Kim, Boyoung Joung
BACKGROUND: Left atrial (LA) sphericity can predict recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA). We sought to reconfirm the prognostic role of atrial sphericity after RFCA of AF, assess any relationship between the atrial pressure and sphericity, and determine the characteristics of the patients for whom atrial sphericity was most highly predictive. METHODS: All 148 non-valvular AF patients (57±11 years, 121 men, 95 paroxysmal AF [PaAF]) who underwent RFCA were enrolled...
April 4, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28374449/post-mortem-therapy-from-a-subcutaneous-icd-what-is-the-mechanism
#15
Benedict M Wiles, Samantha J Fitzsimmons, Paul R Roberts
No abstract text is available yet for this article.
April 4, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28370137/effect-of-ablation-pattern-on-mechanical-function-in-the-atrium
#16
Thien-Khoi N Phung, Christian B Moyer, Patrick T Norton, John D Ferguson, Jeffrey W Holmes
BACKGROUND: Atrial fibrillation (AF) is often treated with catheter ablation, which induces scar formation to isolate misfiring electrical signals in the left atrium. Successful ablation restores sinus rhythm at the cost of replacing viable myocardium with scar. The impact of ablation scar on mechanical function of the left atrium is poorly understood. OBJECTIVE: We used a computational model to simulate various ablation patterns and determine their effect on atrial global and regional mechanical function...
March 31, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28370132/infant-sudden-death-mutations-responsible-for-impaired-nav1-5-channel-trafficking-and-function
#17
Ivan Gando, Jace Morganstein, Kundan Jana, Thomas V McDonald, Yingying Tang, William A Coetzee
BACKGROUND: Two genetic variants in SCN5A, encoding the Nav1.5 Na(+) channel α-subunit, were found in a five month-old girl who died suddenly in her sleep. The first variant is a missense mutation, resulting in an amino acid change (Q1832E), which has been described (but not characterized) in a patient with Brugada syndrome. The second is a nonsense mutation that produces a premature stop codon and a C-terminal truncation (R1944Δ). METHODS AND RESULTS: To investigate their functional relevance with patch clamp experiments in transfected HEK293 cells...
March 31, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28369968/asystole-during-pacemaker-magnet-application
#18
James E Ip, Todd J Liu, Carol L Chen, Bruce B Lerman
Pacemaker magnet application during surgery for patients who are pacemaker-dependent is often utilized to avoid peri-operative inhibition from electromagnetic interference. We present a case during which such routine magnet use resulted in an unexpected response and discuss the limitations and nuances of this common practice. This article is protected by copyright. All rights reserved.
March 31, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28369957/extraction-of-looped-transvenous-pacing-leads-to-reduce-tricuspid-regurgitation
#19
Jay A Montgomery, Christopher R Ellis, George H Crossley
Transvenous leads are a known source of iatrogenic tricuspid regurgitation. It is commonly held that extraction of chronic pacing and defibrillator leads will not reduce this, due to the inevitable trauma to the valve associated with the procedure. We demonstrate three cases of clinically significant reductions in tricuspid regurgitation after extraction of leads that were looped across the tricuspid valve.
March 31, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28349586/transfemoral-access-when-superior-venous-approach-is-not-feasible-equals-overall-success-of-permanent-pacemaker-implantation-ten-year-series
#20
Juan J García Guerrero, Joaquín Fernández de la Concha Castañeda, Manuel Doblado Calatrava, Ángel Redondo Méndez, Manuel Lázaro Medrano, Antonio Merchán Herrera
BACKGROUND: When permanent pacemaker implantation is not possible or advisable via superior venous access (i.e., axillary or subclavian veins), safe and feasible surgical alternatives are required. The femoral approach is relatively unknown and seldom studied. This single-centre study analysed 10-year outcomes of a femoral implantation approach. METHODS: Data about the implantation procedure (indication, approach, lead and pacemaker models, complications), patient characteristics (age, sex, medications, comorbidities), and follow-up were analysed for all permanent pacemaker implantations using the femoral approach between June 2001 and June 2011...
March 28, 2017: Pacing and Clinical Electrophysiology: PACE
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