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pacing complication

Kayo Sugiyama, Nobusato Koizumi, Toshiya Nishibe, Hitoshi Ogino
Temporary epicardial pacing wires (TEPWs) have been used routinely in cardiovascular surgery. Most TEPWs are associated with low morbidity, and serious complications rarely occur. Migration of TEPWs is rare and typically involves the right side of the heart. Migration into the left side of the heart is extremely rare, and most patients with this complication have been treated with open surgery. We describe 2 patients with migration of TEPWs into the left side of the heart who were treated using a catheter intervention technique...
February 26, 2018: Interactive Cardiovascular and Thoracic Surgery
Corey Toocheck, Daniel Pinkhas
Cardiac extramedullary plasmacytomas (EMPs) are rare and may be a seen as a complication of multiple myeloma (MM) or in isolation. Here, we describe a case of cardiac EMP that presented clinically as a congestive heart failure exacerbation in a patient with relapsed and refractory IgG lambda MM. We highlight radiographic imaging in conjunction with laboratory biomarkers at presentation and in response to D-PACE (dexamethasone, cisplatin (Platinol), doxorubicin (Adriamycin), cyclophosphamide and etoposide) systemic chemotherapy...
March 9, 2018: BMJ Case Reports
Shai Tejman-Yarden, Eyal Nof, Roy Beinart, Nadav Ovadia, Yuval Goldshmit, Jonathan Buber, Hagith Yonath, Eitan Keizman, Michael Glikson
Permanent cardiac pacing is the only effective solution for patients with symptomatic bradycardia and heart block. About 10% of patients undergoing implantation of the conventional pacing system develop complications related to the subcutaneous pocket or the leads and in pediatric patients lead problems may rise in up to 30% of the patients. The leadless pacemaker devices were developed in order to minimize some of those complications. We present a case of an 11-year-old patient who presented after the sudden death of his older brother, with recurrent episodes of syncope and documented prolonged sinus pauses...
March 8, 2018: Pediatric Cardiology
Gabriele Dell'Era, Matteo Ziacchi, Eleonora Prenna, Igor Diemberger, Marco Varalda, Cristian Martignani, Federico Guerra, Mauro Biffi, Eraldo Occhetta
BACKGROUND: The management of patients explanted for implantable defibrillator (ICD) infections may be complex when anti-bradycardia pacing and tachyarrhythmia protection are needed. We aimed to test the efficacy and safety of a conventional ICD externally connected to a transvenous dual-coil lead as bridging therapy before the re-implantation. METHODS AND RESULTS: We enrolled seven patients explanted for ICD infections and needing prolonged antibiotic therapy in two high-volume hospitals in Italy and treated them with a passive can external ICD for a mean of 13 (4-30) days before re-implant...
March 8, 2018: Pacing and Clinical Electrophysiology: PACE
Andreas Entenmann, Susann Dittrich, Vera Hessling, Christian Niederwanger, Gerard Cortina, Miriam Michel
BACKGROUND: Junctional ectopic tachycardia is a serious complication of surgery for paediatric congenital heart disease. R-wave synchronized atrial (AVT) pacing, an innovative temporary pacing technique, restores atrioventricular synchrony in these patients. The method is highly effective but technically complex. A standardized training model exists for doctors but not for paediatric intensive care nurses. AIMS: This study seeks to evaluate whether a standardized programme involving simulation and vignettes increases knowledge of AVT pacing and accuracy of its documentation, as well as recognition and management of specific complications...
March 6, 2018: Nursing in Critical Care
Takahiko Masuda, Masaki Hata, Kazuhiro Yamaya, Tomoyuki Suzuki, Naoya Terao
Thoracic endovascular aortic repair (TEVAR) is used to treat retrograde type A acute aortic dissection (RTAAD). In case 1, a 52-year-old man, who was conservatively managed, reported worsening back pain. Emergency TEVAR was performed 7 days after onset. After deploying two GORE Conformable TAG (CTAG) in the descending aorta, his symptoms disappeared. In case 2, a 52-year-old man with progressive worsening resistant hypertension, renal dysfunction, and respiratory failure despite maximal medical therapy underwent TEVAR 8 days after onset...
March 3, 2018: Annals of Thoracic and Cardiovascular Surgery
James H P Gamble, Neil Herring, Matthew R Ginks, Kim Rajappan, Yaver Bashir, Tim R Betts
BACKGROUND: Cardiac Resynchronization Therapy (CRT) is an effective treatment for selected patients with heart failure, but can be limited by the inability to place the left ventricular (LV) lead via the coronary sinus. OBJECTIVE: We have developed an alternative approach, placing the LV lead endocardially via an interventricular septal puncture; this study was designed to assess the feasibility and safety of this technique. METHODS: All patients were anticoagulated with warfarin (INR 2...
March 1, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
J William Schleifer, Sorin V Pislaru, Grace Lin, Brian D Powell, Raul Espinosa, Celeste Koestler, Trena Thome, Lynn Polk, Zhuo Li, Samuel J Asirvatham, Yong-Mei Cha
BACKGROUND: Pacing lead-related tricuspid regurgitation (TR), a recognized complication of ventricular pacing lead implantation, may be affected by lead position or diameter. OBJECTIVE: This study sought to determine the effect of ventricular pacing lead position and diameter on pacing lead-related TR. METHODS: A randomized, prospective trial compared pacing leads in the right ventricular apex (RVA), right ventricular mid septum (RVS), or left ventricle via the coronary sinus (LV-CS) in a 1:1:1 fashion...
February 26, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Jonathan Chica, Isaac Yepes, S Shelby Burks, Ricardo Komotar, Roger Carrillo
Intracranial malignant peripheral nerve sheath tumors (MPNSTs) are an extremely rare entity with only a handful of cases reported in the literature. MPNSTs typically occur in the extremities and the trunk. The treatment algorithm includes, when possible, gross-total resection as these tumors are extremely aggressive. When these tumors occur intracranially, they are termed malignant intracerebral nerve sheath tumors. The diagnosis hinges on immunohistochemistry and pathological features and often the diagnosis can be delayed for this reason...
January 2018: Asian Journal of Neurosurgery
Montaser Elsawy Abd Elaziz, Amr Mohammad Allama
Temporary pacemaker wires are usually inserted in patients after valve replacement and may be beneficial for optimizing myocardial function in patients that develop postoperative hemodynamically significant arrhythmias [Elmi 2002]. Indications for temporary cardiac pacing (TCP) are atrial, ventricular or atrioventricular pacing for bradyarrhythmias and for management of both atrial and ventricular tachyarrhythmias [De Belder 1990; Liebold 1998].Pacemaker wires have two ends - one end has a small needle, which is passed into the myocardial surface, then is cut off...
February 19, 2018: Heart Surgery Forum
Kalaimani Elango, Anne B Curtis
Clinical trials have demonstrated the benefits of cardiac implantable electrical devices, which include pacemakers, implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT), with respect to key clinical outcomes and survival. Women more often require permanent pacing for sick sinus syndrome, whereas atrioventricular block is more common in men. Women appear to have a higher incidence of complications with pacemaker implantation, as well as with ICD and CRT implantation. The indications for ICDs and CRT do not have any distinctions based on sex, and outcomes are comparable in men and women...
February 26, 2018: Clinical Cardiology
Mirko Mihalj, Dajana Vladić, Zoran Karlović, Željka Zadro, Višnja Majerić Kogler
Many papers have been published investigating the effects of intraoperative mechanical ventilation on the incidence of intra- and postoperative respiratory complications. The potential advantages of protective pressure over volume-controlled ventilation mode during laparoscopic surgery have yet to be proven. This study included 60 patients aged between 18 and 70 with ASA score 1-3, body mass index (BMI) ≤35 kg/m2, and without prior history of chronic respiratory diseases, who were scheduled for laparoscopic cholecystectomy under general anesthesia...
September 2017: Acta Clinica Croatica
Jaywant M Nawale, Sandip N Patil, Digvijay D Nalawade, Nikhil A Borikar, Bhushan S Sonawane, Ajay S Chaurasia
Implantation of temporary pacemaker lead is commonly performed procedure and is usually safe, but can sometimes develop rare and serious complication like intracardiac lead knotting which may require challenging retrieval techniques. We report a case of successful percutaneous retrieval of unusually knotted right internal jugular venous temporary pacing lead via left femoral transvenous approach using snare over a long sheath after cutting the electrode proximally and thus avoiding any surgical intervention...
February 26, 2018: Indian Pacing and Electrophysiology Journal
Toshimasa Okabe, Mikhael F El-Chami, Michael S Lloyd, Benjamin Buck, Charles C Gornick, JoEllyn C Moore, Ralph S Augostini, John D Hummel
BACKGROUND: Atrioventricular junctional (AVJ) ablation and pacemaker implantation is indicated when pharmacotherapy fails to achieve adequate rate control in atrial fibrillation (AF). The purpose of our study is to assess the feasibility and safety of concurrent Micra leadless transcatheter pacemaker implantation and AVJ ablation. METHODS: We retrospectively assessed patients who underwent Micra implantation and concurrent AVJ ablation at three institutions between 8/2014 and 3/2016...
February 24, 2018: Pacing and Clinical Electrophysiology: PACE
Alexis Galloux, Erika Pace, Stephanie Franchi-Abella, Sophie Branchereau, Emmanuel Gonzales, Daniele Pariente
BACKGROUND: Hepatic venous outflow obstruction after paediatric liver transplantation is an unusual but critical complication. OBJECTIVES: To review the incidence, diagnosis and therapeutic modalities of hepatic venous outflow obstruction from a large national liver transplant unit. MATERIALS AND METHODS: During the period from October 1992 to March 2016, 917 liver transplant procedures were performed with all types of grafts in 792 children...
February 21, 2018: Pediatric Radiology
Dimosthenis Traganos, Peter Reinartz
Recent research studies have highlighted the decrease in the coverage of Mediterranean seagrasses due to mainly anthropogenic activities. The lack of data on the distribution of these significant aquatic plants complicates the quantification of their decreasing tendency. While Mediterranean seagrasses are declining, satellite remote sensing technology is growing at an unprecedented pace, resulting in a wealth of spaceborne image time series. Here, we exploit recent advances in high spatial resolution sensors and machine learning to study Mediterranean seagrasses...
2018: Frontiers in Plant Science
Elliot B Tapper, Rohit Loomba
NAFLD is a global epidemic. The prevalence of NAFLD is 20-30% in North America, northern Europe, Australia, Japan, India and China. It is crucial that patients with NAFLD receive an assessment for their risk of advanced fibrosis, which increases the risk of hepatocellular carcinoma and other complications of cirrhosis. Risk stratification that is efficient, cost-effective, patient-centred and evidence-based is one of the most important issues facing clinicians who care for those with liver disease. Given patients' preference to avoid liver biopsy, noninvasive alternatives to assess liver fibrosis are in high demand...
February 21, 2018: Nature Reviews. Gastroenterology & Hepatology
Daniel J Friedman, Craig S Parzynski, E Kevin Heist, Andrea M Russo, Joseph G Akar, James V Freeman, Jeptha P Curtis, Sana M Al-Khatib
Background -Compared to transvenous (TV) implantable cardioverter defibrillators (ICD), subcutaneous (S) ICDs require a higher energy for effective defibrillation. Although ventricular fibrillation (VF) conversion testing (CT) is recommended after S-ICD implantation to ensure an adequate margin between the defibrillation threshold and maximum device output (80J), prior work found that adherence to this recommendation is declining. Methods -We studied first time S-ICD recipients (between September 28, 2012 and April 1, 2016) in the National Cardiovascular Database Registry ICD Registry to determine: predictors of use of CT, predictors of an insufficient safety margin (ISM, defined as VF conversion energy >65J) during testing, and in-hospital outcomes associated with use of CT...
February 20, 2018: Circulation
Roger A Winkle, Ryan Moskovitz, R Hardwin Mead, Gregory Engel, Melissa H Kong, William Fleming, Jonathan Salcedo, Rob A Patrawala, John H Tranter, Isaac Shai
PURPOSE: The optimal radiofrequency (RF) power and lesion duration using contact force (CF) sensing catheters for atrial fibrillation (AF) ablation are unknown. We evaluate 50 W RF power for very short durations using CF sensing catheters during AF ablation. METHODS: We evaluated 51 patients with paroxysmal (n = 20) or persistent (n = 31) AF undergoing initial RF ablation. RESULTS: A total of 3961 50 W RF lesions were given (average 77...
February 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Sofian Johar, Nazar Luqman
A left atrial appendage occluder device (Watchman) and leadless pacemaker (Micra) was implanted from a single right femoral vein access in a 73-year-old female patient with persistent atrial fibrillation and symptomatic tachy-brady syndrome and unable to take oral anticoagulants. Standard methods of implantation were followed for both procedures. The Watchman device was implanted first followed by dilatation of the same venous access site in order to implant Micra transcatheter pacing system. The patient tolerated the procedures well and there were no complications...
February 16, 2018: BMJ Case Reports
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