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Inappropriate shock

Teresa Oloriz, Francesca Baratto, Nicola Trevisi, Melania Barbaro, Caterina Bisceglia, Giuseppe D'Angelo, Miki Yamase, Gabriele Paglino, Andrea Radinovic, Paolo Della Bella
BACKGROUND: Catheter ablation of ventricular tachycardia (VT) is effective to prevent arrhythmia episode-related implantable cardioverter defibrillator shocks. However, recurrences in noninducible patients at programmed ventricular stimulation (PVS) are substantial. METHODS AND RESULTS: From May 2013 to September 2015, 218 PVSs were performed 6 days (5-7) after ablation (186 noninvasive programmed stimulations and 32 invasive PVS) in 210 consecutive patients (ischemic, 48%; median left ventricular ejection fraction, 37%; syncope, 35% with trauma associated 6%), while patients were awake and under β-blocker therapy...
March 2018: Circulation. Arrhythmia and Electrophysiology
Tirtsah Toledano, Alon Vitenshtein, Noam Stern-Ginossar, Einat Seidel, Ofer Mandelboim
Recognition of the human stress-induced ligand MHC class I polypeptide-related sequence A (MICA) by the receptor NKG2D expressed on NK cells leads to NK cell-mediated killing of the target cells. Hence, the expression of MICA must be tightly regulated, and its cell surface expression needs to be quickly downregulated to avoid inappropriate activation of immune cells. In this article, we describe a transcript variant of human MICA that has not yet been studied, which contains a 3' untranslated region of 119 nt instead of 174...
March 14, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
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
Maureen Campion, Gail Scully
Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections...
January 1, 2018: Journal of Intensive Care Medicine
B A Mulder, A H Maass, Y Blaauw
No abstract text is available yet for this article.
March 12, 2018: Netherlands Heart Journal
Cindy You, Shishir Sharma, Aakash Bavishi, Christopher A Groh, Yazan Alia, Basil Saour, Rod Passman
BACKGROUND: Hemodialysis (HD) patients have a high risk of sudden death but limited vascular access and high complication rates from transvenous implantable cardioverter-defibrillators (ICDs). Subcutaneous ICDs (S-ICD) may be an alternative, but dynamic ECG changes may result in inappropriate shocks. This study aims to define the screen failure rate for S-ICD in patients pre- and post-HD. METHODS: ECG waveforms were obtained using electrodes mimicking the S-ICD sensing vectors in an unselected test group of chronic HD patients and a control group of ICD-eligible non-dialysis patients...
March 10, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Georgios Karaolanis, Dimitrios Moris, C Cameron McCoy, Diamantis I Tsilimigras, Sotirios Georgopoulos, Chris Bakoyiannis
The evaluation and management of patients with abdominal vascular trauma or injury requires immediate and effective decision-making in these unfavorable circumstances. The majority of these patients arrive at trauma centers in profound shock, secondary to massive blood loss, which is often unrelenting. Moreover, ischemia, compartment syndrome, thrombosis, and embolization may also be life threatening and require immediate intervention. To minimize the risk of these potentially lethal complications, early understanding of the disease process and emergent therapeutic intervention are necessary...
2018: Frontiers in Surgery
Mehdi Slim, Yassine Guedri, Elies Neffati, Afef Lagren, Mahmoud Cheikh Bouhlel, Rym Gribaa, Fehmi Remadi, Essia Boughzela
INTRODUCTION: Sudden cardiac death (SCD) is a public health problem. In most cases, it is the consequence of ventricular arrhythmias. The only treatment of proven effectiveness is the implantable cardioverter defibrillator (ICD). AIM: To describe indications for ICD implantation according to the underlying heart disease and report it's short and long-term results. METHODS: We report a retrospective and descriptive study involving 90 patients implanted with an ICD in our facility collected between January 2003 and December 2014...
April 2017: La Tunisie Médicale
Liang Zhang, DaLong Wan, LeLe Zhang, ShiGuo Xu, HaiYang Xie, ShengZhang Lin
RATIONALE: Currently, percutaneous catheter drainage (PCD) is regarded as the first-line treatment modality of pyogenic liver abscess. Severe complications associated with PCD were uncommon. Hepatic rupture is an uncommon but life-threatening liver trauma with high mortality. Its management is challenging because a delay in the diagnosis may lead to fatal hemorrhagic shock. To our knowledge, PCD-associated hepatic rupture has never been reported. PATIENT CONCERNS: We report herein a rare case of PCD-associated hepatic rupture...
January 2018: Medicine (Baltimore)
Shu C Chang, Kristen K Patton, Melissa R Robinson, Jeanne E Poole, Jordan M Prutkin
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires pre-implant screening to ensure appropriate sensing and reduce risk of inappropriate shocks. Screening can be performed using either an ICD programmer or a 12 lead ECG machine. It is unclear whether differences in signal filtering and digital sampling change the screening success rate. METHODS: Subjects were recruited if they had a transvenous single lead ICD without pacing requirements or were candidates for a new ICD...
February 24, 2018: Pacing and Clinical Electrophysiology: PACE
K P Letsas, S Xydonas, N Karamichalakis, M Efremidis, D Manolatos, G Bazoukis, D Asvestas, K Vlachos, S Georgopoulos, A Saplaouras, J Winter, A Sideris
BACKGROUND: The conventional technique for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation has been associated with pocket complications. The aim of this study was to evaluate the efficacy and safety of an alternative intermuscular technique for S‑ICD implantation. METHODS: S-ICDs were implanted in ten consecutive patients (ten males, mean age: 46.8 ± 14.7 years). The pocket for the pulse generator was made above the serratus anterior muscular fascia and beneath the latissimus dorsi muscle by detaching the fibrous tissue between the muscles...
February 21, 2018: Herz
Anand D Shah, Mike A Morris, David S Hirsh, Megan Warnock, Yijian Huang, Mike Mollerus, Faisal M Merchant, Anshul M Patel, David B Delurgio, Adarsh U Patel, Michael H Hoskins, Mikhael F El Chami, Angel R Leon, Jonathan J Langberg, Michael S Lloyd
BACKGROUND: Recommendations regarding performance of MRI in non-MRI conditional pacemaker and defibrillator recipients are evolving. Previous studies suggest low adverse event rates with MRI in non-conditional CIED recipients, but low power limits optimal characterization of risk. OBJECTIVE: In order to improve power, a systematic review and meta-analysis was performed to characterize the clinical risk associated with MRI in CIED recipients. METHODS: PUBMED and CINAHL indexed articles from 1990-2017 were queried...
February 16, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Shozo Konishi, Hitoshi Minamiguchi, Kentaro Ozu, Hiroya Mizuno, Shungo Hikoso, Osamu Yamaguchi, Yasushi Sakata
Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are susceptible to T-wave oversensing (TWOS) caused by high rate-dependent QRS-T morphology changes. We experienced an inappropriate S-ICD shock due to TWOS, which could not be predicted by routine exercise testing. A newly available high-pass filter might be effective for avoiding this.
February 2018: Clinical Case Reports
Yuka Taguchi, Toshiyuki Ishikawa, Katsumi Matsumoto, Yutaka Ogino, Hirooki Matsushita, Kohei Iguchi, Junya Hosoda
A 17-year-old woman was resuscitated from cardiac arrest due to ventricular fibrillation and was diagnosed with concealed long QT syndrome. She underwent subcutaneous implantable cardiac defibrillator (S-ICD) implantation at our hospital. The device electrogram immediately after implantation was normal. Four days after implantation, she received an inappropriate shock. The device interrogation revealed a continuous baseline shift and frequent oversensing for low amplitude signals, followed by a shock. A chest radiograph in the orthogonal view showed entrapped subcutaneous air surrounding the distal electrode...
February 14, 2018: International Heart Journal
Robert Larbig, Markus Bettin, Lukas J Motloch, Alicia Fischer, Niklas Bode, Gerrit Frommeyer, Florian Reinke, Andreas Loeher, Lars Eckardt, Julia Köbe
Inappropriate shocks are a feared complication after implantable cardioverter-defibrillator (ICD) implantation and have a tremendous impact on quality of life. Inappropriate shocks in patients with subcutaneous ICD (S-ICD®, Boston Scientific, Marlborough, MA, USA) have various underlying causes. This review summarizes the current literature on this topic and lists possible treatment options.
February 12, 2018: Herzschrittmachertherapie & Elektrophysiologie
Nitin Kulkarni, Mark S Link
Use of implantable cardioverter-defibrillators as a primary prevention therapy has been shown to reduce mortality in patients after cardiac arrest and also with left ventricular systolic dysfunction. Yet, inappropriate shocks are variably reported and associated with a reduction in quality of life. Inappropriate shocks are the result of environmental causes leading to electromagnetic interference and inappropriate sensing of external noise, device-related causes from inappropriate sensing of physiologic or pathologic signals, and supraventricular arrhythmias...
March 2018: Cardiac Electrophysiology Clinics
Stephanie A Goldstein, Martin J LaPage, Brynn E Dechert, Gerald A Serwer, Sunkyung Yu, Ray E Lowery, David J Bradley
OBJECTIVE: Inappropriate implantable cardioverter defibrillator (ICD) shocks in children and patients with congenital heart disease (CHD) remain a major complication of device therapy, occurring in as many as 50% of children with ICDs. New generation devices include algorithms designed to minimize inappropriate shocks. This study aimed to evaluate the effect of new generation ICDs on the incidence of inappropriate shocks in the pediatric and CHD population. DESIGN: Retrospective study of patients with CHD or under age 25 receiving ICDs between 2000 and 2015...
January 25, 2018: Congenital Heart Disease
Alexandra D Forrest, Jakyung Bang, Robert E Featherstone, Jonathan H Bloom, Matthew S Luminais, Rebecca V Zhang, Christopher R Gajewski, Mary F McMullen, Yuling Liang, Steven J Siegel
Schizophrenia is a disabling psychiatric disease characterized by symptoms including hallucinations, delusions, social withdrawal, loss of pleasure, and inappropriate affect. Although schizophrenia is marked by dysfunction in dopaminergic and glutamatergic signaling, it is not presently clear how these dysfunctions give rise to symptoms. The aberrant salience hypothesis of schizophrenia argues that abnormal attribution of motivational salience to stimuli is one of the main contributors to both positive and negative symptoms of schizophrenia...
January 19, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Dino Dvorak, Basma Radwan, Fraser T Sparks, Zoe Nicole Talbot, André A Fenton
Behavior is used to assess memory and cognitive deficits in animals like Fmr1-null mice that model Fragile X Syndrome, but behavior is a proxy for unknown neural events that define cognitive variables like recollection. We identified an electrophysiological signature of recollection in mouse dorsal Cornu Ammonis 1 (CA1) hippocampus. During a shocked-place avoidance task, slow gamma (SG) (30-50 Hz) dominates mid-frequency gamma (MG) (70-90 Hz) oscillations 2-3 s before successful avoidance, but not failures...
January 18, 2018: PLoS Biology
Joseph Doran, Max Ward, Brittany Ward, Boris Paskhover, Michael Umanoff, Antonios Mammis
OBJECTIVES: The objectives of this study are to utilize the MAUDE data base to enhance our understanding of the complication profile for Occipital Nerve Stimulation, a therapy for which the current level of evidence is limited. Additionally, it is our objective to describe a systematic approach to processing the MAUDE data, which addresses its flaws and enhances its utility. METHODS: From the FDA website, we accessed adverse events reports from the MAUDE data base for devices used in Occipital Nerve Stimulation between June 30, 2007 and June 30, 2017...
January 18, 2018: Neuromodulation: Journal of the International Neuromodulation Society
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