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https://www.readbyqxmd.com/read/29781854/salvage-of-threatened-cardiovascular-implantable-electronic-devices-case-series-and-review-of-literature
#1
Andrew M Simpson, W Tyler Rockwell, Roger A Freedman, W Bradford Rockwell
BACKGROUND: The treatment of infected or exposed cardiac pacing and defibrillator devices is controversial. The conservative and widely accepted management calls for removal of the device and leads with immediate or delayed replacement of new components in a new site. Lead extraction carries a 2% major complication risk. In this article, we describe our experience with device salvage techniques and review the current literature. METHODS: This is a retrospective case series of consecutive patients with infected, exposed, or at-risk implanted cardiac devices that were treated with aggressive surgical debridement, local pocket irrigation, and revision...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29779603/diaphragm-pacing
#2
REVIEW
Anthony F DiMarco
Diaphragm pacing (DP) is a useful and cost-effective alternative to mechanical ventilation in patients with ventilator-dependent spinal cord injury and central hypoventilation syndrome. Patients with SCI should be carefully screened to assess the integrity of their phrenic nerves. In eligible patients, DP improves mobility, speech, olfaction, and quality of life. The stigma of being attached to a mechanical device and risk of ventilator disconnection are eliminated. There is also some evidence that DP results in a reduction in the rate of respiratory tract infections...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29779297/cardiac-rhythm-management-devices
#3
Irene Stevenson, Alex Voskoboinik
BACKGROUND: The last decade has seen ongoing evolution and use of cardiac rhythm management devices, including pacemakers, cardiac resynchronisation therapy, implantable cardioverter defibrillators and loop recorders. General practitioners are increasingly involved in follow-up and management of patients with these devices. OBJECTIVE: The aim of this article is to provide an overview of different cardiac rhythm management devices, including their role, implant procedure, post-procedural care, potential complications and follow‑up...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29773512/increased-foot-strike-variability-in-parkinson-s-disease-patients-with-freezing-of-gait
#4
Jesal Shah, Lakshmi Pillai, David K Williams, Shannon M Doerhoff, Linda Larson-Prior, Edgar Garcia-Rill, Tuhin Virmani
INTRODUCTION: Freezing of gait (FOG) is a debilitating, late motor complication of Parkinson's disease (PD) that occurs in 50-80% of patients. Gait freezing significantly worsens quality of life by decreasing mobility and increasing falls. Studies have shown that patients with episodic freezing episodes also have deficits in continuous gait. We evaluated whether there was an objective gait correlate to the increased stumbling reported by many patients with gait freezing. METHODS: PD subjects and healthy controls (HC) were enrolled after IRB approval...
May 1, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29773429/real-life-experience-with-ponatinib-in-chronic-myeloid-leukemia-a-multicenter-observational-study
#5
Adi Shacham-Abulafia, Pia Raanani, David Lavie, Yulia Volchek, Ron Ram, Ilana Helman, Liat Shargian, Anna Gourevitch, Evgeni Chubar, Roy Ratzon, Uri Rozovski
BACKGROUND: The strict recruitment criteria of patients for clinical trials often lead to reduced generalizability of the findings. We studied how ponatinib is used outside clinical trials in patients with chronic myeloid leukemia (CML). PATIENTS AND METHODS: The present retrospective study included all patients with a diagnosis of CML who had received ponatinib in 7 medical centers in Israel. RESULTS: From 2011 to 2016, we identified 37 patients with CML who had received ponatinib, 21 in the chronic phase and 16 in the advanced phase...
May 7, 2018: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29771608/paced-breathing-and-phrenic-nerve-responses-evoked-by-epidural-stimulation-following-complete-high-cervical-spinal-cord-injury-in-rats
#6
Tatiana Bezdudnaya, Michael A Lane, Vitaliy Marchenko
Spinal cord injury (SCI) at the level of cervical segments often results in life-threatening respiratory complications and requires long-term mechanical ventilator assistance. Thus, restoring diaphragm activity and regaining voluntary control of breathing are the primary clinical goals for patients with respiratory dysfunction following cervical SCI. Epidural stimulation (EDS) is a promising strategy that has been explored extensively for non-respiratory functions, and to a limited extent within the respiratory system...
May 17, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29771327/propensity-score-matched-comparison-of-subcutaneous-and-transvenous-implantable-cardioverter-defibrillator-therapy-in-the-simple-and-effortless-studies
#7
Tom F Brouwer, Reinoud E Knops, Valentina Kutyifa, Craig Barr, Blandine Mondésert, Lucas V A Boersma, Pier D Lambiase, Nicholas Wold, Paul W Jones, Jeffrey S Healey
Aims: Comparison of outcomes between subcutaneous and transvenous implantable cardioverter-defibrillator (S-ICD and TV-ICD) therapy is hampered by varying patient characteristics and complication definitions. The aim of this analysis is to compare clinical outcomes of S-ICD and TV-ICD therapy in a matched cohort. Methods and results: Patients implanted with de novo implantable cardioverter-defibrillators without need for pacing were selected from two studies: SIMPLE (n = 1091 single and n = 553 dual chamber TV-ICDs) and EFFORTLESS (n = 798 S-ICDs)...
May 15, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29764441/case-report-identification-of-an-hnf1b-p-arg527gln-mutation-in-a-maltese-patient-with-atypical-early-onset-diabetes-and-diabetic-nephropathy
#8
Nikolai Paul Pace, Johann Craus, Alex Felice, Josanne Vassallo
BACKGROUND: The diagnosis of atypical non-autoimmune forms of diabetes mellitus, such as maturity onset diabetes of the young (MODY) presents several challenges, in view of the extensive clinical and genetic heterogeneity of the disease. In this report we describe a case of atypical non autoimmune diabetes associated with a damaging HNF1β mutation. This is distinguished by a number of uncharacteristic clinical features, including early-onset obesity, the absence of renal cysts and diabetic nephropathy...
May 15, 2018: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29761338/-journey-of-the-s%C3%A2-icd-to-first-line-therapy
#9
REVIEW
Elif Kaya, Reza Wakili, Tienush Rassaf
The subcutaneous implantable cardioverter-defibrillator (S-ICD®, Boston Scientific, Marlborough, MA, USA, previously Cameron Health, San Clemente, CA, USA) represents an important milestone in ICD therapy for prevention of sudden cardiac death (SCD). Since the introduction of the S‑ICD in 2010, the device has undergone further development. Based on the unique feature of an entirely extracardiac implantation, the S‑ICD is able to reduce the common perioperative and long-term complications of the usual endovascular implanted ICD systems...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29759832/safety-and-efficacy-of-multipoint-pacing-in-cardiac-resynchronization-therapy-the-multipoint-pacing-trial
#10
Imran Niazi, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Robert Sheppard, Seth J Worley, Niraj Varma, Kwangdeok Lee, Gery Tomassoni
OBJECTIVES: The MultiPoint Pacing (MPP) trial assessed the safety and efficacy of pacing 2 left ventricular sites with a quadripolar lead in patients with heart failure indicated for a CRT-D device. BACKGROUND: Cardiac resynchronization therapy nonresponse is a complex problem where stimulation of multiple left ventricular sites may be a solution. METHODS: Enrolled patients were indicated for a CRT-D system. Bi-ventricular (Bi-V) pacing was activated at implant...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759829/acute-and-3-month-performance-of-a-communicating-leadless-antitachycardia-pacemaker-and-subcutaneous-implantable-defibrillator
#11
Fleur V Y Tjong, Tom F Brouwer, Brendan Koop, Brian Soltis, Allan Shuros, Brian Schmidt, Bryan Swackhamer, Anne-Floor E B Quast, Arthur A M Wilde, Martin C Burke, Reinoud E Knops
OBJECTIVES: The primary objective was to assess the acute and 3-month performance of the modular antitachycardia pacing (ATP)-enabled leadless pacemaker (LP) and subcutaneous implantable cardioverter-defibrillator (S-ICD) system, particularly device-device communication and ATP delivery. BACKGROUND: Transvenous pacemakers and implantable cardioverter-defibrillators (ICDs) have considerable rates of lead complications. We examined the next step in multicomponent leadless cardiac rhythm management: feasibility of pacing (including ATP) by a LP, commanded by an implanted S-ICD through wireless, intrabody, device-device communication...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759618/real-world-evaluation-of-magnetic-resonance-imaging-in-patients-with-a-magnetic-resonance-imaging-conditional-pacemaker-system-results-of-4-year-prospective-follow-up-in-2-629-patients
#12
Brian D Williamson, Douglas C Gohn, Brian M Ramza, Balbir Singh, Yan Zhong, Shelby Li, Liesa Shanahan
OBJECTIVES: This global, multicenter, prospective study, initiated to meet U.S. Food and Drug Administration condition-of-approval requirements, evaluated the safety and efficacy of the Medtronic magnetic resonance imaging (MRI)-conditional pacing system when used in an MRI environment in routine clinical practice. The primary endpoint was MRI-related complications. The secondary endpoint was the cumulative change in pacing capture threshold (PCT) for patients undergoing multiple MRI scans...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759494/impact-of-lowering-irrigation-flow-rate-on-atrial-lesion-formation-in-thin-atrial-tissue-preliminary-observations-from-experimental-and-clinical-studies
#13
Saurabh Kumar, Jorge Romero, William G Stevenson, Lori Foley, Ryan Caulfield, Akira Fujii, Shinichi Tanigawa, Laurence M Epstein, Bruce A Koplan, Usha B Tedrow, Roy M John, Gregory F Michaud
OBJECTIVES: The authors sought to investigate the effect of low irrigation flow rate on lesion characteristics and ablation outcomes in a clinicopathological study. BACKGROUND: Irrigated ablation produces deeper lesions compared with nonirrigated ablation, which may not be desirable in the thin-walled posterior left atrium (LA), where collateral esophageal injury is possible. METHODS: Lesions were placed on the smooth posterior right atrium in 20 swine and posterior LA in 60 patients at a maximum power of 20 to 25 W with either: 1) power-controlled ablation at an irrigation flow rate of 17 ml/min (high-flow group 10 swine; n = 40) or 2) temperature-controlled ablation at an irrigation flow rate of 2 ml/min (low-flow group 10 swine; n = 20)...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759063/discontinuation-of-the-pace-plus-trial-problems-in-patient-recruitment-in-general-practice
#14
M Schreijenberg, P A J Luijsterburg, Y D M Van Trier, D Rizopoulos, M A Koopmanschap, L Voogt, C G Maher, B W Koes
BACKGROUND: The PACE Plus trial was a multi-center, double-blinded, superiority randomized controlled trial (RCT) conducted in patients from Dutch general practice to investigate the efficacy of paracetamol and NSAIDs in acute non-specific low back pain (LBP). Because insufficient numbers of patients could be recruited (only four out of the required 800 patients could be recruited over a period of 6 months), the trial was prematurely terminated in February 2017, 6 months after the start of recruitment...
May 14, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29758585/comparative-study-about-the-tensile-strength-and-yielding-mechanism-of-pacing-lead-among-major-manufacturers
#15
Chan Chi-Wo, Chan Lip-Kiong, Lam Tongny, Tsang Kin-Keung, Chan Kin-Wing
BACKGROUND: With extraction of cardiovascular implantable electronic devices (CIED) increasingly necessitated, various studies have contemplated to investigate clinical predictors for its success and complications. Intrinsic parameters of CIED leads have been studied less extensively and are the foci of this study. METHODS: Three major pacemaker manufacturers accepted invitation. Leads then underwent tensile test in-vitro with their composite tensile strength (TS) compared...
May 14, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29749035/trends-in-replacement-of-pacemaker-leads-in-the-netherlands-a-long-term-nationwide-follow-up-study
#16
L M de Vries, M J G Leening, W A Dijk, C A M Hooijschuur, B H Ch Stricker, N M van Hemel
BACKGROUND: Our objective was to investigate trends over time in longevity and reasons for replacement with or without extraction of pacemaker leads after first implantation. METHODS: Data collected between 1984 and 2006 in the national Dutch pacemaker registry were used. This registry covered 84% of sold leads. First lead replacement with or without extraction of one or more leads implanted with a first pacemaker generator was the endpoint of interest. The time interval of and reason for first replacement were analysed...
May 10, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29745977/a-simple-technique-for-relocating-chronic-cied-leads-to-a-sub-pectoral-position-for-relief-of-erosion-and-pain
#17
Aaron B Hesselson
BACKGROUND: Methodology specific for moving superficial chronically implanted trans-venous pacing leads to a sub-pectoral pocket is not described in the literature. Relocation of pre-pectoral leads and generator to a sub-muscular pocket for relief of erosion and pain with minimal pectoral trauma is possible by applying a variant of a previously described sub-mammary tunneling technique. METHODS: All patients presenting for device follow-up, elective battery replacement, or system upgrade over an 8-month period were considered for relocation if experiencing significant thinning or pain over their pre-pectoral implant...
May 10, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29744993/paroxysmal-complete-atrioventricular-block-in-pediatric-heart-transplant-recipients-following-cardiac-catheterization-a-case-series
#18
Defne A Magnetta, Brian Feingold, Lee B Beerman, Brian Blasiole, Gaurav Arora
Late-onset paroxysmal AVB has been described as a rare complication after HT and has been associated with AR or CAV. We describe 4 pediatric HT recipients who developed paroxysmal AVB hours after routine cardiac catheterization in the absence of AR, CAV, or underlying conduction system disease. Four pediatric HT recipients who were >1 year post-transplant had episodes of paroxysmal AVB hours after surveillance cardiac catheterization with EMB. Telemetry demonstrated high-grade block, ranging from 2:1 AVB to complete AVB without ventricular escape for several seconds...
May 10, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29743900/complications-of-electrotherapy-the-dark-side-of-treatment-with-cardiac-implantable-electronic-devices
#19
REVIEW
Szymon Domagała, Michał Domagała, Jakub Chyła, Celina Wojciechowska, Marianna Janion, Anna Polewczyk
In the past years we have been observing the dynamic development of electrotherapy, as evidenced by the steadily rising number of implanted pacemakers (PM), as well as devices used in the treatment of dangerous arrhythmia and heart failure, such as implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy (CRT-P/D). This is a consequence of the ageing of the populations of the majority of developed countries and also the gradually widening indications for the use of such devices. Along with the observed rise in the number of new implantations, the number of complications of electrotherapy is rising as well...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29742737/inadvertent-defibrillator-lead-placement-into-the-left-ventricle-after-mitraclip-implantation-a-case-report
#20
Giuseppe Santarpia, Francesco Passafaro, Eugenia Pasceri, Annalisa Mongiardo, Antonio Curcio, Ciro Indolfi
RATIONALE: Inadvertent pacemaker/defibrillator lead placement into the left ventricle is an unusual cardiac device-related complication and its diagnosis is not always easy and often misunderstood. Thromboembolic events are frequently associated with this procedural complication. Percutaneous lead extraction should be performed when diagnosis is made early after device implantation while long-life oral anticoagulation is a wise option when the diagnosis is delayed and the lead is not removed...
May 2018: Medicine (Baltimore)
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