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End of life icd

Juan Ruiz-Garcia, Pablo Diez-Villanueva, Ana Ayesta, Vanessa Bruña, Lourdes M Figueiras-Graillet, Laura Gallego-Parra, Francisco Fernández-Avilés, Manuel Martínez-Sellés
BACKGROUND: End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate (DNR) order protocol. METHODS & RESULTS: Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet (Group A), a conventional DNR order (Group B) or the absence of any DNR order (Group C)...
July 2016: Journal of Geriatric Cardiology: JGC
Justin B Josephsen, Eric S Armbrecht, Stephen R Braddock, Catherine C Cibulskis
Care of the child born with trisomy 13 or 18 has evolved over the past few decades, leading to increased healthcare utilization. We hypothesized that there has been an increase in procedures across all intensity types, including major, invasive procedures. We performed a retrospective-cohort study of children with trisomy 13 or 18 from 1990 to 2014 in a quaternary, free-standing children's hospital. Children were identified using ICD-9 billing diagnoses. Procedures were identified during these encounters and categorized by intensity (major, intermediate, or minor)...
September 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Arnulf H Koeppen, Alyssa B Becker, Paul J Feustel, Benjamin B Gelman, Joseph E Mazurkiewicz
Friedreich ataxia (FRDA) is an autosomal recessive disorder with a complex clinical and neuropathological phenotype, but the most frequent cause of death is cardiomyopathy. The principal autopsy findings in FRDA hearts are concentric hypertrophy, enlargement of cardiomyocytes, myofiber necrosis, inflammatory infiltration, scarring, and random accumulation of iron. In addition, the myocardium shows generalized disorganization of intercalated discs (ICD), the Velcro-like end-to-end connections of heart fibers that provide mechanical cohesion and ionic coupling...
August 15, 2016: Journal of the Neurological Sciences
Andrea Campana, Fabrizio Giofrè, Giuseppe Stabile, Matteo Iori, Concetto La Rosa, Corrado Tomasi, Vittorio Calzolari, Gennaro Miracapillo, Pasquale Notarstefano, Valeria Carinci, Leonardo Calò, Carlo Ferretti, Michele Manzo, Maurizio Malacrida, Mauro Biffi
No abstract text is available yet for this article.
October 15, 2016: International Journal of Cardiology
Roland Tilz, Serge Boveda, Jean-Claude Deharo, Dan Dobreanu, Kristina H Haugaa, Nikolaos Dagres
The aim of this EP Wire was to assess the management, indications, and techniques for implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) device replacement in Europe. A total of 24 centres in 14 European countries completed the questionnaire. All centres were members of the European Heart Rhythm Association Electrophysiology Research Network. Replacement procedures were performed by electrophysiologists in 52% of the centres, by cardiologists in 33%, and both in the remaining centres...
June 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Susanne S Pedersen, Charlotte Knudsen, Karen Dilling, Niels C F Sandgaard, Jens Brock Johansen
AIMS: The clinical management and care of patients with an implantable cardioverter defibrillator (ICD) has shifted from face-to-face in-clinic visits to remote monitoring. Reduced interactions between patients and healthcare professionals may impede patients' transition to adapting post-implant. We examined patients' needs and preferences for information provision and care options and overall satisfaction with treatment. METHODS AND RESULTS: Patients implanted with a first-time ICD or defibrillator with cardiac resynchronization therapy (n = 389) within the last 2 years at Odense University Hospital were asked to complete a purpose-designed and standardized set of questionnaires...
June 5, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Paul Erne, Richard Kobza, Markus Lehner, Therese J Resink
AIMS: Battery exchange in pacemaker (PM) or implantable cardioverter defibrillator (ICD) devices may be occasionally problematic because of difficulties in lead disconnection procedures and risk of injuring the fragile leads. This pilot study compares ethanol and dimethyl sulfoxide (DMSO) as solvents to assist removal of leads from PM or ICD device headers in cases of stuck leads or difficulties in untightening device header screws. METHODS AND RESULTS: Of the total number (527) of our patients requiring battery replacement due to end-of-life (EOL) warnings, conventional exchange was not possible in 34 (6...
August 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Federico Migliore, Maria Silvano, Alessandro Zorzi, Emanuele Bertaglia, Mariachiara Siciliano, Loira Leoni, Pietro De Franceschi, Sabino Iliceto, Domenico Corrado
AIMS: This study was designed to prospectively evaluate the risk-benefit ratio of implantable cardioverter defibrillator (ICD) therapy in young patients with cardiomyopathies and channelopathies. METHODS AND RESULTS: The study population included 96 consecutive patients [68 men, median age 27 (22-32) years] with cardiomyopathies, such as arrhythmogenic right ventricular cardiomyopathy (n = 35), dilated cardiomyopathy (n = 17), hypertrophic cardiomyopathy (n = 15), Brugada syndrome (n = 14), idiopathic ventricular fibrillation (n = 5), left ventricular noncompaction (n = 4), long-QT syndrome (n = 4) and short-QT syndrome (n = 2), who were 18-35 years old at the time of ICD implantation...
July 2016: Journal of Cardiovascular Medicine
Jane MacIver, Alana Tibbles, Filio Billia, Heather Ross
BACKGROUND: There is a class I recommendation for implantable cardioverter-defibrillator deactivation discussions to occur between physicians and heart failure patients. Few studies have reported the patient's perspective on the timing of implantable cardioverter-defibrillator deactivation discussions. AIM: To determine patient awareness, preferences and timing of implantable cardioverter-defibrillator deactivation discussions. DESIGN: Grounded theory was used to collect and analyze interview data from 25 heart failure patients with an implantable cardioverter-defibrillator...
2016: SAGE Open Medicine
Giacomo De Luca, Silvia Laura Bosello, Francesca Augusta Gabrielli, Giorgia Berardi, Federico Parisi, Manuela Rucco, Giovanni Canestrari, Francesco Loperfido, Leonarda Galiuto, Filippo Crea, Gianfranco Ferraccioli
BACKGROUND: Arrhythmias are frequent in Systemic Sclerosis (SSc) and portend a bad prognosis, accounting alone for 6% of total deaths. Many of these patients die suddenly, thus prevention and intensified risk-stratification represent unmet medical needs. The major goal of this study was the definition of ECG indexes of poor prognosis. METHODS: We performed a prospective cohort study to define the role of 24h-ECG-Holter as an additional risk-stratification technique in the identification of SSc-patients at high risk of life-threatening arrhythmias and sudden cardiac death (SCD)...
2016: PloS One
Sanjay Mehra, Mihail Gabriel Chelu
A 45-year-old man with nonischemic cardiomyopathy and end-stage renal disease had lived uneventfully with a cardiac resynchronization therapy defibrillator (CRT-D) for 5 years. Less than a month before presenting at our institution, he had undergone stenting of his partially occluded subclavian vein, to relieve stenosis of the ipsilateral arteriovenous fistula that was used for his hemodialysis. The CRT-D subsequently discharged. Device interrogation revealed that electrical noise originating from leads damaged by the stent had caused the inappropriate shock and intermittent electrical discharges thereafter...
February 2016: Texas Heart Institute Journal
Mei Ching Lee, Daniel P Sulmasy, Joseph Gallo, Joan Kub, Mark T Hughes, Stuart Russell, Anela Kellogg, Sharon G Owens, Peter Terry, Marie T Nolan
INTRODUCTION: Many patients with advanced heart failure (HF) experience the life-extending benefits of implantable cardioverter-defibrillators (ICD), but at the end stage of HF, patients may experience shocks with increasing frequency and change the plan for end-of-life (EOL) care including the deactivation of the ICD. This report describes family members' experiences of patients with ICD making decisions at EOL. Understanding the decision-making of patients with ICD at EOL can promote informed decision-making and improve the quality of EOL care...
March 31, 2016: American Journal of Hospice & Palliative Care
Miharu Nakanishi, Taeko Nakashima, Yumi Shindo, Junko Niimura, Atsushi Nishida
BACKGROUND: Dementia-related societies worldwide have called for palliative end-of-life care for those suffering dementia; meanwhile, the Japanese dementia plan was revised on January 2015 to introduce into its objectives the support for end-of-life care via increased social and health care collaboration. OBJECTIVE: The study focus was the use of medical procedures in the last month of life among dementia patients in different care locations in Japan. METHODS: This study was conducted using a retrospective study design...
2016: Journal of Alzheimer's Disease: JAD
İlyas Atar, Uğur Bal, Çağatay Ertan, Bülent Özin, Haldun Müderrisoğlu
Presence of a cardiac pacemaker or implantable cardioverter defibrillator (ICD) is a relative contraindication to magnetic resonance imaging (MRI). Biventricular ICDs are often used in the treatment of advanced heart failure; however, reports on experience with biventricular ICDs are lacking in the literature. In this case report, we describe a pacemaker-dependent patient with a biventricular ICD on whom an MRI of the lumbar spine was performed without having realized the presence of the ICD.
January 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
M Motaz Baibars, M Chadi Alraies, Amjad Kabach, Marc Pritzker
No abstract text is available yet for this article.
February 2016: Cleveland Clinic Journal of Medicine
Hanyang Shen, Cecilia Magnusson, Dheeraj Rai, Michael Lundberg, Félice Lê-Scherban, Christina Dalman, Brian K Lee
IMPORTANCE: Depression is a common cause of morbidity and disability worldwide. Parental depression is associated with early-life child neurodevelopmental, behavioral, emotional, mental, and social problems. More studies are needed to explore the link between parental depression and long-term child outcomes. OBJECTIVE: To examine the associations of parental depression with child school performance at the end of compulsory education (approximately age 16 years)...
March 2016: JAMA Psychiatry
Sara E Wordingham, Colleen K McIlvennan, J Nicholas Dionne-Odom, Keith M Swetz
Care for patients with advanced cardiac disease continues to evolve in a complex milieu of therapeutic options, advanced technological interventions, and efforts at improving patient-centered care and shared decision-making. Despite improvements in quality of life and survival with these interventions, optimal supportive care across the advanced illness trajectory remains diverse and heterogeneous. Herein, we outline challenges in prognostication, communication, and caregiving in advanced heart failure and review the unique needs of patients who experience frequent hospitalizations, require chronic home inotropic support, and who have implantable cardioverter-defibrillators and mechanical circulatory support in situ, to name a few...
February 2016: Current Heart Failure Reports
Faisal M Merchant, Tammie Quest, Angel R Leon, Mikhael F El-Chami
Although implantable cardioverter-defibrillators (ICDs) are frequently viewed as a lifelong commitment in that patients are routinely scheduled for generator exchange (GE) at end of battery life, several considerations should prompt a reevaluation of risks and benefits before GE. Compared with initial ICD implant, patients receiving replacement devices are older, and have more comorbidities and shorter life expectancy, all of which may limit the benefit of ICD therapy following GE. Additionally, GE is associated with significant complications, including infection, which may increase the risk of mortality...
February 2, 2016: Journal of the American College of Cardiology
Piotr Futyma, Marian Futyma, Piotr Kułakowski
BACKGROUND: The use of an implantable cardioverter defibrillator (ICD) is a widely used and effective therapy, which reduces the risk of cardiac death in many cardiac diseases, both implanted for secondary and primary prevention. However, recurrent arrhythmias and ICD discharges have adverse prognostic significance. Additional parameters that would identify patients who are at increased risk of arrhythmias and appropriate ICD interventions would be of clinical value. Modern ICDs are relatively complex devices with a number of functions, including the possibility to perform noninvasive programmed stimulation (NIPS) with an implanted electrode located in the right ventricle...
2016: Trials
Alessandro Zorzi, Francesco Peruzza, Federica Stella, Alvise Del Monte, Federico Migliore, Nicola Gasparetto, Luigi Badano, Sabino Iliceto, Domenico Corrado
BACKGROUND: in-hospital life-threatening ventricular arrhythmias (LT-VA) may complicate the course of cardiovascular patients. We aimed to assess the incidence, circumstances, determinants, and outcome of in-hospital LT-VA in order to help clinicians in prescribing appropriate levels of monitoring. METHODS: the study population consisted of all 10,741 consecutive patients (65 ± 15 years, 67.7% males) admitted to a cardiology department in 2009-2014. Terminally ill patients and those with primary arrhythmia diagnosis were excluded...
April 2016: Resuscitation
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