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Cardiac Electrophysiology Clinics

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https://www.readbyqxmd.com/read/30396585/lead-management-for-electrophysiologists
#1
EDITORIAL
Noel G Boyle, Bruce L Wilkoff
No abstract text is available yet for this article.
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396584/lead-management
#2
EDITORIAL
Ranjan K Thakur, Andrea Natale
No abstract text is available yet for this article.
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396583/palliation-and-nonextraction-approaches
#3
REVIEW
Charles J Love
Although definitive therapy for infected cardiac implantable electronic device systems requires removal of all hardware in the infected areas with extraction of intravascular components as well, there are situations where extraction is not available or appropriate. Palliative procedures and chronic suppressive antibiotics may be used in these cases. There are also options that may in some cases result in long-term freedom from infection.
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396582/venoplasty-and-stenting
#4
REVIEW
Kevin P Jackson
With expanding indications for cardiac resynchronization therapy and increased survival of patients with cardiovascular disease, the need for lead addition or revision in the presence of an existing implantable electronic device is likely to increase. Partial or complete venous occlusion is frequently encountered and can be a significant barrier to successful procedural outcomes. Percutaneous options, including subclavian venoplasty, can reduce the need for significantly more invasive and morbid procedures and can readily be learned by the implanting physician...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396581/reimplantation-after-lead-removal
#5
REVIEW
Mohamed B Elshazly, Khaldoun G Tarakji
The number of implanted cardiovascular implantable electronic devices (CIEDs) has increased significantly in the last 30 years, which has led to an upsurge in CIED complications, such as infection and lead malfunction requiring CIED extraction. The decision-making process of CIED reimplantation requires meticulous planning that includes careful consideration of several aspects: the reason for extraction, the indication for CIED reimplantation, patients' wishes, timing of reimplantation, the need for a bridging device, and the type and location of device to be reimplanted...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396580/surgical-and-hybrid-lead-extraction
#6
REVIEW
Ryan Azarrafiy, Roger G Carrillo
Surgical and hybrid lead extraction has developed considerably over the past several decades. Although transvenous lead extraction is the standard approach to remove infected or malfunctioning cardiac implantable electronic device leads, surgical approaches may be necessary in complex cases not amenable to transvenous lead extraction or in cases that involve concomitant pathologies, such as tricuspid valve regurgitation. We describe our experience with 4 minimally invasive surgical approaches to lead extraction as well as our experience with hybrid open heart surgery and transvenous lead extraction as an option for patients who present with concomitant conditions...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396579/cardiac-and-vascular-injuries-sustained-during-transvenous-lead-extraction
#7
REVIEW
Jamil Bashir, Roger G Carrillo
The rise in indications for cardiac implantable electronic devices has necessitated the development of tools for removal of the electrodes that connect the heart to these externally located pacemakers and defibrillators. After implant of a cardiac electrode, variable but progressive fibrous adhesion occurs. Removal of these adhesions can cause devastating complications with high risk of mortality if not treated surgically in a highly expeditious and appropriate manner. This article describes the incidence, risk factors, and diagnosis of these injuries followed by discussion of recent evidence for use of superior vena cava balloon occlusion, and conventional surgical repair of these injuries...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396578/a-practical-approach-to-lead-removal-transvenous-tools-and-techniques
#8
REVIEW
Felix Krainski, Victor Pretorius, Ulrika Birgersdotter-Green
Removal of cardiovascular implantable electronic devices (CIED) is an important and growing field when managing patients presenting with device infections, need for upgrades, and lead failure. The complex skillset of transvenous lead removal is in high demand along with increasing numbers of implanted CIEDs. A systematic and comprehensive approach to this field, including knowledge of all available tools and vascular access techniques is essential for successful outcomes. This article serves as a practical resource presenting tools and techniques of transvenous lead extraction to help refine and master one's skill...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396577/lead-extraction-imaging
#9
REVIEW
Pierce J Vatterott, Imran S Syed, Akbar H Khan
Lead extraction procedures have a low but real risk of major complications, such as superior vena cava tear and cardiac tamponade. Complications during lead removal are commonly related to lead binding sites, lead malposition, and lead perforation. Lead extraction imaging may indicate lead vascular binding sites, lead position, and perforation. Several imaging modalities are available, including chest radiograph, cardiac computed tomography, and echocardiography. The information provided by various imaging modalities will help assess the challenges of each lead extraction procedure and allows for better preprocedure planning...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396576/anesthesia-considerations-for-lead-extraction
#10
REVIEW
Matthew Fischer, Reed Harvey, Noel G Boyle, Jonathan K Ho
The role of the anesthesiologist in lead extraction procedures is multifaceted and highlights the collaborative, multidisciplinary teamwork needed to ensure patient safety and procedural success in these complex cases. Thorough preoperative evaluation and identification of high-risk characteristics enable the anesthesiologist to tailor a comprehensive intraoperative and postoperative care plan for each case. Institutional practices may vary but anesthetic management typically includes general anesthesia with an endotracheal tube, invasive measurement of arterial blood pressure, vascular access for rapid volume expansion, echocardiographic monitoring, preparation for blood transfusion, and initiation of cardiopulmonary bypass in the event of an emergency...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396575/nomenclature-definitions-and-metrics-of-cardiovascular-implantable-electronic-device-lead-management
#11
REVIEW
Bruce L Wilkoff
Quality has a foundation that consists of the nomenclature, definitions, and metrics of success, failure, and complications. There is now a firm foundation for reporting outcomes and for making clinical decisions with patients and their families. This has developed from an international consensus, ratified by the four continental heart rhythm societies and by the overlapping cardiovascular, surgical, anesthesiology, and infectious disease societies. Reporting of outcomes, using these metrics and definitions, is now mandated to promote transparency and facilitate clinical decision making with patients...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396574/infection-management
#12
REVIEW
Daniel C DeSimone, Muhammad Rizwan Sohail
Cardiovascular implantable electronic devices (CIEDs) and the indications for their use have significantly risen over the past decades to include patients who are older with more medical comorbidities. Predictably, the rates of CIED infection have increased substantially. CIED infection is associated with high morbidity, mortality, and financial costs. This article discusses the appropriate management of CIED infections, which is imperative to limit the problems associated with infection.
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396573/monitoring-for-and-diagnosis-of-lead-dysfunction
#13
REVIEW
Sandeep G Nair, Charles D Swerdlow
The predominant structural mechanisms of transvenous lead dysfunction (LD) are conductor fracture and insulation breach. LD typically presents as an abnormality of electrical performance; the earliest sign usually is either oversensing or out-of-range pacing or shock impedance. Accurate diagnosis of LD requires discriminating patterns of oversensing and impedance trends that are characteristic of LD from similar patterns that occur in other conditions. Implantable cardioverter-defibrillators have advanced features to detect and mitigate the consequences of LD; these features operate both independently and in conjunction with remote monitoring networks...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396572/vein-management-for-cardiac-device-implantation
#14
REVIEW
Ali Bak Al-Hadithi, Duc H Do, Noel G Boyle
Transvenous approaches for pacemaker and defibrillator lead insertion offer numerous advantages over epicardial techniques. Although the cephalic, axillary, and subclavian veins are most commonly used in clinical practice, they each offer their own set of advantages and disadvantages that leave their usage dependent on patient anatomy and physician preference. Alternative methods using the upper and lower venous circulation have been described when these veins are not available or practical for lead insertion...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30396571/overview-of-lead-management
#15
REVIEW
Noel G Boyle, Bruce L Wilkoff
Lead management describes a comprehensive approach to cardiac implantable electronic device lead utilization, encompassing lead and device selection, vascular access, implant techniques, handling lead failures and recalls, managing infectious and other complications, and performing device and lead extraction. Device and lead selection should be based on the latest guidelines and the available data to choose the optimal device system for each patient. Lead extraction is a highly specialized procedure and should be carried out by a team of personnel extensively trained in the procedure at centers with cardiac surgical support...
December 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30172294/his-bundle-pacing-everything-old-is-new-again
#16
EDITORIAL
Pramod Deshmukh, Kenneth A Ellenbogen
No abstract text is available yet for this article.
September 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30172293/his-bundle-pacing-a-100-year-journey
#17
EDITORIAL
Ranjan K Thakur, Andrea Natale
No abstract text is available yet for this article.
September 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30172291/future-developments-in-his-bundle-pacing
#18
REVIEW
Harsimran Saini, Kenneth A Ellenbogen, Jayanthi N Koneru
Because there has been a significant push toward His bundle pacing (HBP), multiple studies and advancements are underway to provide new and improved delivery tools and lead designs, allowing one to apply this technology in daily practice. A better understanding of the pacing configurations and ultimately development of dedicated algorithms will alleviate some of these aforementioned challenges. Ultimately, with such technological advances and mounting clinical evidence, one can surely anticipate HBP to revolutionize the field of cardiac pacing...
September 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30172290/long-term-results-of-his-bundle-pacing
#19
REVIEW
Faiz A Subzposh, Pugazhendhi Vijayaraman
Right ventricular pacing is associated with pacing-induced cardiomyopathy in some patients. His Bundle Pacing (HBP) is an alternative site to pace to achieve ventricular contraction with fewer adverse hemodynamic effects. HBP has been shown to be safe and feasible in the short term. The few studies that look at long-term results of HBP are promising with regard to electrophysiological, echocardiographic, and clinical outcomes. Further randomized clinical trials are needed to fully understand the long-term effects of HBP...
September 2018: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/30172289/pacing-treatment-of-atrial-fibrillation-patients-with-heart-failure-his-bundle-pacing-combined-with-atrioventricular-node-ablation
#20
REVIEW
Weijian Huang, Lan Su, Shengjie Wu
As an alternative to antiarrhythmic drugs and catheter ablation of atrial fibrillation (AF) for rate and rhythm control, pacing combined with atrioventricular node (AVN) ablation is suitable for many AF patients with heart failure (HF) who suffer from symptoms despite optimal medical therapy or have failed AF ablation. Studies have demonstrated His bundle pacing in conjunction with AVN ablation to treat refractory AF patients with HF provide long-term clinical benefits. Here we introduce the clinical application and procedures of His bundle pacing and AVN ablation...
September 2018: Cardiac Electrophysiology Clinics
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