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https://www.readbyqxmd.com/read/28229483/venous-hemodialysis-catheters-and-cardiac-implantable-electronic-devices-avoiding-a-high-risk-combination
#1
EDITORIAL
Theodore F Saad, Henry L Weiner
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection...
February 23, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28229272/prophylactic-implantable-cardioverter-defibrillator-in-heart-failure-the-growing-evidence-for-all-or-primum-non-nocere-for-some
#2
REVIEW
Khang-Li Looi, Nigel Lever, Anthony Tang, Sharad Agarwal
Heart failure (HF) is a common health problem and has reached epidemic in many western countries. Despite the current era of HF treatment, the risk of sudden cardiac death (SCD) in HF remains significant. Implantable cardioverter defibrillator (ICD) support has been shown to reduce the risk of SCD in patients with HF and impaired left ventricular function. Prophylactic ICD implantation in HF patients seems a logical step to reduce mortality through a reduction in SCD. However, ICD implantation is an invasive procedure, and both short- and long-term complications can occur...
February 23, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28229201/-sudden-cardiac-death-epidemiology-pathophysiology-and-risk-stratification
#3
B Rudic, E Tülümen, V Liebe, J Kuschyk, I Akin, M Borggrefe
Sudden cardiac death (SCD) remains a major public health burden despite revolutionary progress in the last three decades in the treatment of ventricular tachyarrhythmia with the use of implantable cardioverter defibrillator (ICD) therapy. Survivors of sudden cardiac arrest are at high risk for recurrent tachyarrhythmia events. Early recognition of low left ventricular ejection fractions (≤35%) as a strong predictor of mortality and the causal association between ventricular tachyarrhythmia and SCD has led to a significant development of not only pharmacological antiarrhythmic therapy but also device-based prevention of SCD...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28229200/-current-impact-of-cardiac-implantable-electronic-devices
#4
J Kuschyk, B Rudic, M Borggrefe, I Akin
Sudden cardiac death and chronic heart failure are among the main contributors to persisting high mortality rates in Germany. In addition to removal of causal factors and guideline-conform pharmacological therapy, therapy with cardiac implantable electronic devices (CIED) is of undisputed importance. Subcutaneous defibrillators have the advantage that they do not have intracardiac electrodes but still have the same efficacy and safety. For patients with a wide QRS complex and reduced ejection fraction, cardiac resynchronization has led to a reduction of morbidity and mortality...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28229198/-catheter-ablation-of-ventricular-tachycardia-what-have-we-achieved
#5
T Konrad, B A Hoffmann, T Rostock
The role of catheter ablation in patients with ventricular tachycardia (VT) has evolved over the last two decades into an established treatment option. In patients with idiopathic VT catheter ablation is the gold standard treatment option with high effectiveness and low risk of complications. Due to the high risk of side effects the use of antiarrhythmic drugs is only indicated in exceptional cases. In patients with structural heart diseases, such as ischemic and dilated cardiomyopathy, VT is the most frequent cause of death...
February 22, 2017: Herz
https://www.readbyqxmd.com/read/28227376/electrocardiogram-reconstruction-from-high-resolution-voltage-optical-mapping
#6
Ilija Uzelac, Conner Herndon, James Farmer, Flavio Fenton, Ilija Uzelac, Conner Herndon, James Farmer, Flavio Fenton, Ilija Uzelac, Conner Herndon, James Farmer, Flavio Fenton
Electrocardiogram recordings during opucal mapping experiments in heart tissue are commonly used tu monitor the health of the preparation and to obtain dominant frequencies during arrhythmic and defibrillatory studies. However the use of ECG reconstructed from optical mapping is seldom used and to date it has not been strictly validated. In this manuscript we present the first detailed validation and comparison of Optical Mapping ECG, or OM-ECG, with standard ECG recordings by calculating the electrostatic potential in space as a function of the voltage measured optically and describe the different approximations that can be used to obtain unipolar or bipolar ECG recordings...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227089/low-energy-defibrillation-research-using-a-rabbit-ventricular-model-optimizing-the-potential-gradient-distribution-using-multiple-epicardial-electrodes
#7
Jianfei Wang, Lian Jin, Xiaomei Wu, Biao Song, Li Qian, Weiqi Wang, Jianfei Wang, Lian Jin, Xiaomei Wu, Biao Song, Li Qian, Weiqi Wang, Xiaomei Wu, Li Qian, Biao Song, Jianfei Wang, Weiqi Wang, Lian Jin
Cardiac potential gradient distribution directly affects defibrillation efficacy, and the electrode configuration that ensures optimal distribution is yet to be determined. In this study, a rabbit ventricular finite element conductor model containing blood perfusion in ventricular cavities was developed. The electric field was solved on the model by using 95% myocardial volume potential gradient higher than 5 V/cm as the successful defibrillation threshold (DFT). Multiple epicardial electrodes (MEE) protocols and a SCAN protocol were used to identify the optimum defibrillation method...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226465/in-silico-pre-clinical-trials-for-implantable-cardioverter-defibrillators
#8
Zhihao Jiang, Houssam Abbas, Kuk Jin Jang, Marco Beccani, Jackson Liang, Sanjay Dixit, Rahul Mangharam, Zhihao Jiang, Houssam Abbas, Kuk Jin Jang, Marco Beccani, Jackson Liang, Sanjay Dixit, Rahul Mangharam, Jackson Liang, Marco Beccani, Sanjay Dixit, Rahul Mangharam, Houssam Abbas, Zhihao Jiang, Kuk Jin Jang
Regulatory authorities require that the safety and efficacy of a new high-risk medical device be proven in a Clinical Trial (CT), in which the effects of the device on a group of patients are compared to the effects of the current standard of care. Phase III trials can run for several years, cost millions of dollars, and expose patients to an unproven device. In this paper, we demonstrate how to use a large group of synthetic patients based on computer modeling to improve the planning of a CT so as to increase the chances of a successful trial for implantable cardioverter defibrillators (ICDs)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225684/assessing-the-risks-associated-with-mri-in-patients-with-a-pacemaker-or-defibrillator
#9
Robert J Russo, Heather S Costa, Patricia D Silva, Jeffrey L Anderson, Aysha Arshad, Robert W W Biederman, Noel G Boyle, Jennifer V Frabizzio, Ulrika Birgersdotter-Green, Steven L Higgins, Rachel Lampert, Christian E Machado, Edward T Martin, Andrew L Rivard, Jason C Rubenstein, Raymond H M Schaerf, Jennifer D Schwartz, Dipan J Shah, Gery F Tomassoni, Gail T Tominaga, Allison E Tonkin, Seth Uretsky, Steven D Wolff
Background The presence of a cardiovascular implantable electronic device has long been a contraindication for the performance of magnetic resonance imaging (MRI). We established a prospective registry to determine the risks associated with MRI at a magnetic field strength of 1.5 tesla for patients who had a pacemaker or implantable cardioverter-defibrillator (ICD) that was "non-MRI-conditional" (i.e., not approved by the Food and Drug Administration for MRI scanning). Methods Patients in the registry were referred for clinically indicated nonthoracic MRI at a field strength of 1...
23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28225475/stretching-exercises-improve-vascular-endothelial-dysfunction-through-attenuation-of-oxidative-stress-in-chronic-heart-failure-patients-with-an-implantable-cardioverter-defibrillator
#10
Michitaka Kato, Takashi Masuda, Michio Ogano, Kazuki Hotta, Hisato Takagi, Shinya Tanaka, Yumi Kamada, Ayako Akiyama, Daisuke Kamekawa, Ryosuke Shimizu, Minoru Tabata, Jun Tanabe, Takuya Umemoto
PURPOSE: Endurance training improves oxidative stress and vascular endothelial dysfunction in patients with chronic heart failure (CHF). However, patients with CHF and an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D) often avoid endurance training for fear of ICD shock. Recent studies have reported that stretching exercises enhance antioxidant activity and improve vascular responses. Therefore, we aimed to assess the effects of 4 weeks of stretching exercises on oxidative stress and vascular endothelial function in patients with CHF with an ICD or CRT-D...
March 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28225377/inappropriate-shocks-and-power-delivery-using-adult-automatic-external-defibrillator-pads-in-a-pediatric-patient
#11
Shai Tejman-Yarden, Uriel Katz, Marina Rubinstein, Yehuda Attias, Reem Yahia, David Mishali, Michael Glikson
The use of automatic external defibrillators (AEDs) during pulseless resuscitations is considered safe and reliable, and was established as part of the guidelines in out-of-hospital events. Based on extensive studies, the use of the standard AED is now indicated in every age group with a preference of pediatric pad application for small children and babies. If unavailable, adult pads are recommended. We report a case of 2 inappropriate AED shocks that were delivered to a neonate during a pulseless resuscitation after application of adult pads...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224629/clinical-performance-of-magnetic-resonance-imaging-conditional-and-non-conditional-cardiac-implantable-electronic-devices
#12
Anand D Shah, Adarsh U Patel, Andrea Knezevic, Michael H Hoskins, David S Hirsh, Faisal M Merchant, Mikhael F El Chami, David B Delurgio, Anshul M Patel, Angel R Leon, Jonathan J Langberg, Michael S Lloyd
OBJECTIVES: This study compared risks associated with magnetic resonance imaging (MRI) in patients with non-MRI conditional and MRI conditional pacing and defibrillator systems with particular attention to clinically actionable outcomes. BACKGROUND: While recipients of new MRI conditional pacemaker and defibrillator systems may undergo MRI scanning with very low risk, safety and regulatory concerns persist regarding such scanning in recipients of non- MRI conditional systems...
February 22, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28223004/sudden-cardiac-death-among-hemodialysis-patients
#13
Melissa S Makar, Patrick H Pun
Hemodialysis patients carry a large burden of cardiovascular disease; most onerous is the high risk for sudden cardiac death. Defining sudden cardiac death among hemodialysis patients and understanding its pathogenesis are challenging, but inferences from the existing literature reveal differences between sudden cardiac death among hemodialysis patients and the general population. Vascular calcifications and left ventricular hypertrophy may play a role in the pathophysiology of sudden cardiac death, whereas traditional cardiovascular risk factors seem to have a more muted effect...
February 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28222965/ventricular-arrhythmias-and-sudden-death-in-tetralogy-of-fallot
#14
REVIEW
Philippe Maury, Frederic Sacher, Anne Rollin, Pierre Mondoly, Alexandre Duparc, Katja Zeppenfeld, Sebastien Hascoet
Malignant ventricular arrhythmias and sudden cardiac death may late happen in repaired tetralogy of Fallot, although probably less frequently than previously thought, especially with the advent of new surgical techniques/management. Ventricular tachycardias are caused by reentry around the surgical scars/patches and valves. Many predictive factors have been proposed, which suffer from poor accuracy. There is currently no recommended indication for prophylactic implantable cardioverter defibrillator implantation-except maybe in the case of multiple risk factors-while radiofrequncy ablation may be proposed in secondary prevention with or even without a back-up implantable cardioverter defibrillator in selected cases...
February 17, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28220942/crt-induced-ventricular-tachyarrhythmia-what-s-the-mechanism
#15
Sanoj Chacko, Enes Gul, Chris Simpson, Adrian Baranchuk
A 56-year-old woman with non-ischemic dilated cardiomyopathy and severe left ventricular systolic dysfunction received cardiac resynchronization defibrillator therapy (CRT-D; St Jude Medical Quadra Assura, CA, USA), for primary prevention and management of heart failure. This article is protected by copyright. All rights reserved.
February 21, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28220241/-icd-in-elderly-patients
#16
Carsten W Israel
Treatment with an implantable cardioverter-defibrillator (ICD) represents a prognostic but not symptomatic therapy. It should therefore be restricted to patients where an improvement of prognosis is possible and reasonable. ICD implantation should only be performed in patients with a life expectancy of at least 1 year at reasonable quality of life. The decision in which patient improvement of prognosis is no longer a desirable target is problematic, both medically and ethically. It is not entirely clear in which elderly patient an ICD therapy can convey prognostic benefit despite comorbidity and competitive life-threatening diseases, as it is unclear how old age should be defined...
February 20, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28220232/targeted-temperature-management-after-intraoperative-cardiac-arrest-a-multicenter-retrospective-study
#17
Anne-Laure Constant, Nicolas Mongardon, Quentin Morelot, Nicolas Pichon, David Grimaldi, Lauriane Bordenave, Alexis Soummer, Bertrand Sauneuf, Sybille Merceron, Sylvie Ricome, Benoit Misset, Cedric Bruel, David Schnell, Julie Boisramé-Helms, Etienne Dubuisson, Jennifer Brunet, Sigismond Lasocki, Pierrick Cronier, Belaid Bouhemad, Serge Carreira, Emmanuelle Begot, Benoit Vandenbunder, Gilles Dhonneur, Philippe Jullien, Matthieu Resche-Rigon, Jean-Pierre Bedos, Claire Montlahuc, Stephane Legriel
PURPOSE: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS: Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28219565/epicardial-implantable-cardioverter-defibrillator-in-a-2-month-old-infant
#18
Koichi Sughimoto, Yuta Tsuchida, Hidenori Hayashi, Shinzo Torii, Tadashi Kitamura, Tetsuya Horai, Kagami Miyaji
We describe the implantation of an implantable cardioverter defibrillator (ICD) in a 2-month-old infant with frequent sustained ventricular tachycardia (VT) refractory to antiarrhythmic agents. An epicardial ICD shock coil lead and pacing leads were placed, as was a cumbersome device console that was stored in a pocket between the left external and internal oblique muscles. These methods were safe and feasible even for such a small infant, and possible adverse events were avoided.
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28217234/inappropriate-shocks-from-a-subcutaneous-implantable-cardioverter-defibrillator-due-to-oversensing-during-periods-of-rate-related-bundle-branch-block
#19
Maria João Sousa, Tim Betts
The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel technology with proven efficacy in sudden cardiac death prevention; however, there is a lack of long-term safety data. We describe the case of a 55-year-old female patient implanted with an S-ICD due to idiopathic ventricular fibrillation, who subsequently presented with inappropriate shocks leading to ventricular fibrillation that was successfully terminated by another shock. Inappropriate shocks were due to intermittent T wave oversensing during periods of rate-dependent right bundle branch block...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28217231/successful-intermuscular-implantation-of-subcutaneous-implantable-cardioverter-defibrillator-in-a-japanese-patient-with-pectus-excavatum
#20
Yusuke Kondo, Marehiko Ueda, Joachim Winter, Miyo Nakano, Masahiro Nakano, Masayuki Ishimura, Kazuo Miyazawa, Kaoru Tateno, Yoshio Kobayashi
The entirely subcutaneous implantable cardioverter-defibrillator (ICD) system was developed to provide a life-saving defibrillation therapy that does not affect the heart and vasculature. The subcutaneous ICD is preferred over the transvenous ICD for patients with a history of recurrent infection presenting major life-threatening rhythms. In this case report, we describe the first successful intermuscular implantation of a completely subcutaneous ICD in a Japanese patient with pectus excavatum. There were no associated complications with the device implantation or lead positioning...
February 2017: Journal of Arrhythmia
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