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Implantable cardiac defibrillator

Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
Andrea Igoren Guaricci, Pier Giorgio Masci, Valentina Lorenzoni, Jurg Schwitter, Gianluca Pontone
BACKGROUND: Implantable cardioverter defibrillator (ICD) represents the most valuable sudden cardiac death (SCD) prophylactic strategy in patients with heart failure and severely reduced left ventricular ejection fraction (LVEF). To date, it is still unknown how to integrate the information given by cardiac magnetic resonance (CMR) into clinical and transthoracic echocardiography (TTE) work-up of non-ischemic cardiomyopathy (NICM) and ischemic cardiomyopathy (ICM) patients for accurate risk stratification...
March 11, 2018: International Journal of Cardiology
Adetola Ladejobi, Deepak K Pasupula, Shubash Adhikari, Awais Javed, Asad F Durrani, Shantanu Patil, Dingxin Qin, Shahzad Ahmad, Muhammad Bilal Munir, Shasank Rijal, Max Wayne, Evan Adelstein, Sandeep Jain, Samir Saba
BACKGROUND: Current guidelines recommend implantable cardioverter-defibrillator (ICD) therapy in survivors of sudden cardiac arrest (SCA), except in those with completely reversible causes. We sought to examine the impact of ICD therapy on mortality in survivors of SCA associated with reversible causes. METHODS AND RESULTS: We evaluated the records of 1433 patients managed at our institution between 2000 and 2012 who were discharged alive after SCA. A reversible and correctable cause was identified in 792 (55%) patients...
March 2018: Circulation. Arrhythmia and Electrophysiology
Philipp Stieger, Obaida R Rana, Erol Saygili, Haschmatulla Zazai, Thomas Rauwolf, Conrad Genz, Rajen Bali, Ruediger C Braun-Dullaeus, Samir M Said
BACKGROUND: Implantable cardioverter/defibrillator (ICD) shocks can cause myocardial injury, contributing to the progression of the underlying heart disease. The aim was to evaluate whether internal electrical cardioversion (int-CV) via the ICD or conventional external CV (ext-CV) of persistent atrial fibrillation (AF) in heart failure (HF) patients induces myocardial injury and initiates inflammation. METHODS AND RESULTS: A total of 115 HF patients with an ejection fraction between 20% and 45% were prospectively enrolled...
March 12, 2018: Journal of Cardiology
Susanne Röger, Stefanie L Rosenkaimer, Anna Hohneck, Siegfried Lang, Ibrahim El-Battrawy, Boris Rudic, Erol Tülümen, Ksenija Stach, Jürgen Kuschyk, Ibrahim Akin, Martin Borggrefe
BACKGROUND: The wearable cardioverter-defibrillator (WCD) has emerged as a valuable tool to temporarily protect patients at risk for sudden cardiac death (SCD). The aim of this study was to determine the value of the WCD for therapy optimization of heart failure patients. METHODS: One hundred five consecutive patients that received WCD between 4/2012 and 9/2016 were included in the study. All patients were followed for clinical outcome and echocardiographic parameters during WCD therapy and had continued follow-up after WCD therapy, irrespective of subsequent implantable cardioverter-defibrillator (ICD) implantation...
March 15, 2018: BMC Cardiovascular Disorders
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Jonathan W Waks, Christopher Hamilton, Saumya Das, Ashkan Ehdaie, Jessica Minnier, Sanjiv Narayan, Mark Niebauer, Merritt Raitt, Christine Tompkins, Niraj Varma, Sumeet Chugh, Larisa G Tereshchenko
PURPOSE: Implantable cardioverter-defibrillators (ICDs) improve survival of systolic heart failure (HF) patients who are at risk of sudden cardiac death (SCD). We recently showed that electrocardiographic (ECG) global electrical heterogeneity (GEH) is independently associated with SCD in the community-dwelling cohort and developed GEH SCD risk score. The Global Electrical Heterogeneity and Clinical Outcomes (GEHCO) study is a retrospective multicenter cohort designed with two goals: (1) validate an independent association of ECG GEH with sustained ventricular tachyarrhythmias and appropriate ICD therapies and (2) validate GEH ECG risk score for prediction of sustained ventricular tachyarrhythmias and appropriate ICD therapies in systolic HF patients with primary prevention ICD...
March 14, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Sérgio Barra, Rui Providência, Serge Boveda, Rudolf Duehmke, Kumar Narayanan, Anthony W Chow, Olivier Piot, Didier Klug, Pascal Defaye, Daniel Gras, Jean-Claude Deharo, Paul Milliez, Antoine Da Costa, Pierre Mondoly, Jorge Gonzalez-Panizo, Christophe Leclercq, Patrick Heck, Munmohan Virdee, Nicolas Sadoul, Jean-Yves Le Heuzey, Eloi Marijon
OBJECTIVE: In patients indicated for cardiac resynchronisation therapy (CRT), the choice between a CRT-pacemaker (CRT-P) versus defibrillator (CRT-D) remains controversial and indications in this setting have not been well delineated. Apart from inappropriate therapies, which are inherent to the presence of a defibrillator, whether adding defibrillator to CRT in the primary prevention setting impacts risk of other acute and late device-related complications has not been well studied and may bear relevance for device selection...
March 14, 2018: Heart: Official Journal of the British Cardiac Society
Jim T Vehmeijer, Barbara Jm Mulder, Joris R de Groot
Sudden cardiac death (SCD), mainly caused by ventricular arrhythmias, is one of the leading causes of mortality in adult congenital heart disease (ACHD) patients. An implantable cardioverter defibrillator (ICD) may prevent SCD, but risk stratification remains challenging. In this review, we will address the current guideline recommendations for ICD implantation in ACHD patients, as well as review a recent study in which the discriminative ability for SCD of these guidelines is evaluated. In this study, the guideline recommendations were applied to patients who died of SCD and living controls...
March 13, 2018: Anatolian Journal of Cardiology
Carina Carnlöf, Per Insulander, Mats Jensen-Urstad, Marie Iwarzon, Fredrik Gadler
OBJECTIVES: To explore sex differences regarding indication for atrio-ventricular junction ablation (AVJ), choice of pacing system, complications to pacemaker treatment, long-term outcome, and cause of death after AVJ ablation. DESIGN: 700 patients who had undergone AVJ ablation between January 1990 and December 2010 were included. Data were retrieved from the patients´ medical records and the Swedish Pacemaker and Implantable Cardioverter-Defibrillator Registry...
March 14, 2018: Scandinavian Cardiovascular Journal: SCJ
Rafi Sakhi, Dominic A M J Theuns, Rohit E Bhagwandien, Michelle Michels, Arend F L Schinkel, Tamas Szili-Torok, F Zijlstra, Jolien W Roos-Hesselink, Sing-Chien Yap
PURPOSE: In patients with structural heart disease (SHD) or inherited primary arrhythmia syndrome (IPAS), the occurrence of unexplained syncope or palpitations can be worrisome as they are at increased risk of sudden cardiac death. An implantable loop recorder (ILR) can be a useful diagnostic tool. Our purpose was to compare the diagnostic yield, arrhythmia mechanism, and management in patients with SHD, patients with IPAS, and those without heart disease. METHODS: Retrospective single-center study in consecutive patients who underwent an ILR implantation...
March 13, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Liselotte C R Hensen, Kathleen Goossens, Tomaz Podlesnikar, Joris I Rotmans, J Wouter Jukema, Victoria Delgado, Jeroen J Bax
BACKGROUND: Patients with advanced chronic kidney disease (CKD) have high risk for sudden cardiac death (SCD) and may benefit from implantable cardioverter-defibrillators (ICDs). However, the risk for ICD-related complications is also high in this population. Therefore, there is an unmet need for accurate risk stratification tools to identify patients with CKD at risk for ventricular arrhythmias (VAs), who may benefit from ICD implantation. The aim of this hypothesis-generating study was to investigate the association between left ventricular (LV) mechanical dispersion and LV global longitudinal strain (GLS) measured using two-dimensional speckle-tracking echocardiography and VA and SCD in patients with CKD...
March 10, 2018: Journal of the American Society of Echocardiography
Peter Ofman, Peter Hoffmeister, Danny G Kaloupek, David R Gagnon, Adelqui Peralta, Luc Djousse, J Michael Gaziano, Catherine R Rahilly-Tierney
BACKGROUND: The association between posttraumatic stress disorder (PTSD) and mortality in patients undergoing implantable cardioverter defibrillator (ICD) placement has not been evaluated in US veterans. METHODS AND RESULTS: Retrospective cohort of 25,678 veterans who underwent ICD implant between September 30, 2002 and December 31, 2011. 3,280 of these subjects carried the diagnosis of PTSD prior to ICD implant. Primary outcome was mortality from any cause between the date of ICD implant and the end of follow-up, which was September 30, 2013...
March 13, 2018: Clinical Cardiology
Lidija Poposka, Vladimir Boskov, Dejan Risteski, Jane Taleski, Filip Janusevski, Elizabeta Srbinovska, Ljubica Georgievska-Ismail
INTRODUCTION: Although strict selection criteria are used to select patients for cardiac resynchronisation therapy, up to 30% of patients do not have a positive clinical response. PATIENTS: A total of 102 consecutive patients who had biventricular pacemaker/defibrillator (CRT-P or CRT-D) implanted were enrolled in this prospective observational study. RESULTS: During the average follow-up period of 24.3 months 5 patients died and 17 (16.7%) patients were hospitalised with the symptoms of heart failure; 75 (73...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Alessandro Proclemer, Massimo Zecchin, Antonio D'Onofrio, Giuseppe Boriani, Domenico Facchin, Luca Rebellato, Marco Ghidina, Giulia Bianco, Emanuela Bernardelli, Elsa Pucher, Dario Gregori
BACKGROUND: The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2016 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers. METHODS: The registry collects prospectively national PM and ICD implantation activity on the basis of European cards...
February 2018: Giornale Italiano di Cardiologia
Sami Viskin
Terror-Mori-Ex-Abrupto is the Latin term for "fear of dropping dead." Based on frequent email consultations I receive from patients with "suspected Brugada syndrome" (BrS), it seems that a terrifying anticipation of dying is more dominant among asymptomatic patients with BrS than in other arrhythmogenic diseases. The tragic death of a young British man that went viral over Facebook, led >10,000 British citizens to petition their Parliament, requesting that all patients with asymptomatic BrS be given the choice of an implantable defibrillator (ICD) even in the absence of markers indicating increased risk Already, 1 in 2 patients undergoing ICD implantation for BrS are asymptomatic and 1 in 5 are not only free of symptoms, but do not even have the Brugada electrocardiogram (ECG) spontaneously...
March 12, 2018: Circulation
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
April 2018: Therapeutic Advances in Cardiovascular Disease
Ji Yan, Shu Zhang, Dejia Huang, Xiaolin Xue, Jing Xu, Qianmin Tao, Weize Zhang, Zheng Zhang, Wei Hua, Yanchun Liang, Baopeng Tang, Wei Xu, Geng Xu, Xuejun Ren, Jingfeng Wang, Tao Guo, Shaobin Jia, Yugang Dong, Hong Jiang, Guosheng Fu, Liguang Zhu, Lin Chen, Fuli Tian, Feng Ling, Jianmei Li, Xiaoyong Qi, Yinglu Hao, Yutang Wang, Liangrong Zheng, Xiaoqun Pu, Farong Shen, Guangping Li, Hui Li, Fang Peng
In this trial, long-term therapeutic effects and clinical improvements in Chinese chronic heart failure patients optimized by QuickOpt or echocardiography were compared for atrioventricular (AV) and interventricular (VV) delay optimizations after cardiac resynchronization therapy (CRT) with pacing (CRT-P) or with pacing and defibrillator (CRT-D) therapy. One hundred and ninety-six subjects (50%) had dilated cardiomyopathy, 108 (27.6%) had ischemic heart disease and 112 (28.6%) were hypertensive and were randomized into QuickOpt (198) or echocardiographic optimization (control) (194) groups at ≤2-weeks post-implantation...
March 9, 2018: Scientific Reports
Abdulcebbar Şipal, Serdar Bozyel, Müjdat Aktaş, Emir Derviş, Tayyar Akbulut, Onur Argan, Umut Çelikyurt, Dilek Ural, Tayfun Şahin, Ayşen Ağır, Ahmet Vural
OBJECTIVE: Failure to select the optimal left ventricular (LV) segment for lead implantation is one of the most important causes of unresponsiveness to the cardiac resynchronization therapy (CRT). In our study, we aimed to investigate the echocardiographic and clinical benefits of LV lead implantation guided by an intraoperative 12-lead surface electrocardiogram (ECG) in patients with multiple target veins. METHODS: We included 80 [42 (62.5%) male] heart failure patients who successfully underwent CRT defibrillator (CRT-D) implantation...
March 2018: Anatolian Journal of Cardiology
Amartya Kundu, Aditya Vaze, Partha Sardar, Ahmed Nagy, Wilbert S Aronow, Naomi F Botkin
PURPOSE OF REVIEW: Variant angina, which is characterized by recurrent chest pain and transient ECG changes along with angiographic evidence of coronary artery spasm, generally has a favorable prognosis. However, episodes of ischemia caused by vasospasm may lead to potentially life-threatening ventricular arrhythmias and cardiac arrest, even in patients with no history of prior cardiac disease. This review describes the epidemiology, pathogenesis, clinical spectrum, and management of variant angina, as well as outcomes in patients who present with aborted sudden cardiac death (ASCD)...
March 8, 2018: Current Cardiology Reports
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