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https://www.readbyqxmd.com/read/28077816/incidence-of-atrial-tachyarrhythmias-in-patients-with-early-repolarization-syndrome
#1
Ki Won Hwang, Gi-Byoung Nam, Junhee Han, Yong Giun Kim, Hyung Oh Choi, Jun Kim, Kee-Joon Choi, You-Ho Kim
Atrial tachyarrhythmias (ATAs) occur in a significant proportion of Brugada syndrome (BrS) patients and are often an important cause of inappropriate shocks. The aim of this retrospective study was to evaluate the incidence of ATAs and ATA-induced inappropriate shocks in early repolarization syndrome (ERS) patients as compared to BrS patients.We analyzed data from 20 consecutive patients who were diagnosed with ERS and compared them with patients diagnosed with BrS (n = 31). Clinical and ICD interrogation data were collected and analyzed for all events with ICD shocks...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28062685/development-and-validation-of-the-increment-esbl-predictive-score-for-mortality-in-patients-with-bloodstream-infections-due-to-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae
#2
Zaira Raquel Palacios-Baena, Belén Gutiérrez-Gutiérrez, Marina De Cueto, Pierluigi Viale, Mario Venditti, Alicia Hernández-Torres, Antonio Oliver, Luis Martínez-Martínez, Esther Calbo, Vicente Pintado, Oriol Gasch, Benito Almirante, José Antonio Lepe, Johann Pitout, Murat Akova, Carmen Peña-Miralles, Mitchell J Schwaber, Mario Tumbarello, Evelina Tacconelli, Julia Origüen, Nuria Prim, German Bou, Helen Giamarellou, Joaquín Bermejo, Axel Hamprecht, Federico Pérez, Manuel Almela, Warren Lowman, Po-Ren Hsueh, Carolina Navarro-San Francisco, Julián Torre-Cisneros, Yehuda Carmeli, Robert A Bonomo, David L Paterson, Álvaro Pascual, Jesús Rodríguez-Baño
BACKGROUND: Bloodstream infections (BSIs) due to ESBL-producing Enterobacteriaceae (ESBL-E) are frequent yet outcome prediction rules for clinical use have not been developed. The objective was to define and validate a predictive risk score for 30 day mortality. METHODS: A multinational retrospective cohort study including consecutive episodes of BSI due to ESBL-E was performed; cases were randomly assigned to a derivation cohort (DC) or a validation cohort (VC)...
January 6, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28054228/polymicrobial-pneumococcal-bacteraemia-a-case-control-study
#3
I Grau, C Ardanuy, M H Schulze, J Liñares, R Pallares
Polymicrobial bacteraemia involving Streptococcus pneumoniae and other bacteria (e.g. Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenza, viridans streptococci, Salmonella spp.) occurred in 3.4% of our pneumococcal bacteraemia cases. Compared with 308 controls (monomicrobial bacteraemia), the 77 polymicrobial cases included more males (83 vs 62%, p = 0.001), had serious underlying diseases (100 vs 80%, p < 0.001), abdominal infection (18 vs 5%, p < 0.001), nosocomial infection (33 vs 8%, p < 0...
January 4, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28034575/complete-right-bundle-branch-block-and-qrs-t-discordance-can-be-the-initial-clue-to-detect-s-icd-ineligibility
#4
Motomi Tachibana, Nobuhiro Nishii, Yoshimasa Morimoto, Satoshi Kawada, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito
BACKGROUND: In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG). METHODS: A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously...
December 26, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/28007749/intermuscular-technique-for-implantation-of-the-subcutaneous-implantable-cardioverter-defibrillator-long-term-performance-and-complications
#5
Joachim Winter, Markus Siekiera, Dong-In Shin, Christian Meyer, Patric Kröpil, Harald Clahsen, Stephen O'Connor
AIMS: The subcutaneous cardioverter defibrillator was designed to overcome electrode complications of transvenous defibrillation systems. While largely achieved, pocket complications have increased. Subcutaneous implantation of the pulse generator leaves it prone to erosion, extrusion, discomfort, and poor cosmesis. METHODS AND RESULTS: We use a demonstration electrode and pulse generator with fluoroscopy, prior to prepping and draping, to maximize the left ventricular mass between them...
December 22, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27989789/very-high-rate-programming-in-primary-prevention-patients-with-reduced-ejection-fraction-implanted-with-a-defibrillator-results-from-a-large-multicenter-controlled-study
#6
Nicolas Clementy, Farid Challal, Eloi Marijon, Serge Boveda, Pascal Defaye, Christophe Leclercq, Jean-Claude Deharo, Nicolas Sadoul, Didier Klug, Olivier Piot, Daniel Gras, Pierre Bordachar, Vincent Algalarrondo, Laurent Fauchier, Dominique Babuty
BACKGROUND: Programming implantable cardioverter defibrillators (ICD) with a high-rate therapy strategy has proven to be effective in reducing shocks, and is associated with a reduced mortality. OBJECTIVE: We sought to determine the impact of a very-high-rate cutoff programming strategy on outcomes in patients with a primary indication for an ICD due to reduced left ventricular ejection fraction. METHODS: Using data from the French multicenter DAI-PP registry, this cohort-controlled study compared outcomes in 500 patients programmed with a very-high-rate cutoff (VH-RATE group: monitor zone 170-219 beats per minute, VF zone ≥220 beats per minute with 13±4 detection intervals) with 1,500 matched control patients programmed with 1 or 2 therapy zone...
October 28, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27957764/mechanisms-of-undersensing-by-a-noise-detection-algorithm-that-utilizes-far-field-electrograms-with-near-field-bandpass-filtering
#7
Jayanthi N Koneru, Charles D Swerdlow, Sylvain Ploux, Parikshit S Sharma, Karoly Kaszala, Alex Y Tan, Jose F Huizar, Pugazhendi Vijayaraman, David Kenigsberg, Kenneth A Ellenbogen
BACKGROUND: Implantable cardioverter defibrillators (ICDs) must establish a balance between delivering appropriate shocks for ventricular tachyarrhythmias and withholding inappropriate shocks for lead-related oversensing ("noise"). To improve the specificity of ICD therapy, manufacturers have developed proprietary algorithms that detect lead noise. The SecureSense(TM) RV Lead Noise discrimination (St Jude Medical, St Paul, MN) algorithm is designed to differentiate oversensing due to lead failure from ventricular tachyarrhythmias and withhold therapies in the presence of sustained lead-related oversensing...
December 13, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27956431/salvage-therapy-with-ceftolozane-tazobactam-for-multidrug-resistant-pseudomonas-aeruginosa-infections
#8
Juan José Castón, Álvaro De la Torre, Isabel Ruiz-Camps, M Luisa Sorlí, Vicente Torres, Julián Torre-Cisneros
Infections caused by multidrug-resistant Pseudomonas aeruginosa (MDRPA) present a major problem for therapeutic management. We report our experience in 12 patients with severe MDRPA infections (of which 6 were pneumonias) who received salvage therapy with ceftolozane/tazobactam after inappropriate empirical treatment and/or suboptimal targeted treatment. Although 10 of the 12 patients (83.3%) had septic shock, only 3 patients (25%) died during follow-up. Microbiological cure was observed in 7 patients (58.3%)...
December 12, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27956005/differences-between-access-to-follow-up-care-and-inappropriate-shocks-based-on-insurance-status-of-implantable-cardioverter-defibrillator-recipients
#9
Solomon J Sager, Chris Healy, Archana Ramireddy, Harold Rivner, Juan F Viles Gonzalez, James O Coffey, Natalia Rossin, Ka M Lo, Jeffrey J Goldberger, Robert J Myerburg, Raul D Mitrani
Differences in implantable cardioverter defibrillator (ICD) utilization based on insurance status have been described, but little is known about postimplant follow-up patterns associated with insurance status and outcomes. We collected demographic, clinical, and device data from 119 consecutive patients presenting with ICD shocks. Insurance status was classified as uninsured/Medicaid (uninsured) or private/Health Maintenance Organization /Medicare (insured). Shock frequencies were analyzed before and after a uniform follow-up pattern was implemented regardless of insurance profile...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27943358/intermuscular-two-incisions-technique-for-subcutaneous-implantable-cardioverter-defibrillator-implantation-results-from-a-multicenter-registry
#10
Federico Migliore, Giuseppe Allocca, Vittorio Calzolari, Martino Crosato, Domenico Facchin, Elisabetta Daleffe, Massimo Zecchin, Mauro Fantinel, Sergio Cannas, Rocco Arancio, Procolo Marchese, Francesco Zanon, Alessandro Zorzi, Sabino Iliceto, Emanuele Bertaglia
BACKGROUND: the traditional technique for subcutaneous implantable cardioverter defibrillator (S-ICD) implantation, which involves 3 incisions and a subcutaneous pocket, is associated with possible complications, including inappropriate interventions. The aim of this prospective multicenter study was to evaluate the efficacy and safety of an alternative intermuscular two-incisions technique for S-ICD implantation. METHODS: the study population included 36 consecutive patients [75% male, mean age 44±12 years (range 20-69)] who underwent S-ICD implantation using the intermuscular two-incisions technique...
December 10, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27943348/the-design-of-the-understanding-outcomes-with-the-s-icd-in-primary-prevention-patients-with-low-ef-study-untouched
#11
Michael R Gold, Reinoud Knops, Martin C Burke, Pier D Lambiase, Andrea M Russo, Maria Grazia Bongiorni, Jean-Claude Deharo, Johan Aasbo, Mikhael F El Chami, Michael Husby, Nathan Carter, Lucas Boersma
AIMS: The UNTOUCHED study will assess the safety and efficacy of the subcutaneous implantable cardioverter defibrillator (S-ICD) in the most common cohort of patients receiving ICDs. The primary goal is to evaluate the inappropriate shock (IAS) free rate in primary prevention patients with a reduced ejection fraction and compare with a historical control of transvenous ICD patients with similar programming. METHODS AND RESULTS: The UNTOUCHED Study is a global, multi-center, prospective, non-randomized study of patients undergoing denovo S-ICD implantation for primary prevention of sudden cardiac death with a left ventricular ejection fraction ≤ 35%...
December 10, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27943296/safety-of-the-wearable-cardioverter-defibrillator-wcd-in-patients-with-implanted-pacemakers
#12
Joern Schmitt, Guezine Abaci, V Johnson, Damir Erkapic, Christopher Gemein, Ritvan Chasan, Kay Weipert, Christian W Hamm, Helmut U Klein
BACKGROUND: The wearable cardioverter defibrillator (WCD) is an important approach for better risk stratification, applied to patients considered to be at high risk of sudden arrhythmic death. Patients with implanted pacemakers may also become candidates for use of the WCD. However, there is a potential risk that pacemaker signals may mislead the WCD detection algorithm and cause inappropriate WCD shock delivery. The aim of the study was to test the impact of different types of pacing, various RV lead positions and pacing modes for potential misleading of the WCD detection algorithm...
December 10, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27941395/optimal-implantable-cardioverter-defibrillator-programming
#13
Bindi K Shah
Optimal programming of implantable cardioverter defibrillators (ICDs) is essential to appropriately treat ventricular tachyarrhythmias and to avoid unnecessary and inappropriate shocks. There have been a series of large clinical trials evaluating tailored programming of ICDs. We reviewed the clinical trials evaluating ICD therapies and detection, as well as the consensus statement on ICD programming. In so doing, we found that prolonged ICD detection times, higher rate cutoffs, and antitachycardia pacing programming decreases inappropriate and painful therapies in a primary prevention population...
November 17, 2016: Cardiology in Review
https://www.readbyqxmd.com/read/27941299/long-term-efficacy-of-implantable-cardioverter-defibrillator-in-repaired-tetralogy-of-fallot%C3%A3-role-of-anti-tachycardia-pacing
#14
Ryuta Henmi, Koichiro Ejima, Daigo Yagishita, Yuji Iwanami, Tomomi Nishimura, Daiji Takeuchi, Keiko Toyohara, Morio Shoda, Nobuhisa Hagiwara
BACKGROUND: Tetralogy of Fallot (TOF) is one of the common congenital heart diseases (CHD) in implantable cardioverter defibrillator (ICD) recipients, but few studies have reported the long-term outcomes of and the anti-tachycardia pacing (ATP) efficacy in repaired TOF.Methods and Results:Twenty-one repaired TOF patients with an ICD implanted between April 2003 and March 2015 were investigated retrospectively. ICD therapy and clinical outcome were analyzed. Mean patient age was 39±11 years; 62% were male; and mean age at repair surgery was 9...
December 9, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27940933/management-of-functional-sprint-fidelis-leads-at-cardiac-resynchronization-therapy-defibrillator-generator-replacement-a-novel-option-for-preventing-inappropriate-shocks-from-lead-failure-in-fragile-patients-with-high-risk-of-sudden-death
#15
Dennis W X Zhu, Matthew M Chu, Chad M House
BACKGROUND: In patients with a functional Sprint Fidelis lead at generator replacement, the manufacturer recommended to either continue to use the existing lead or replace it with a new lead. For those patients who continue to use a functional Fidelis lead, the risk of inappropriate shocks remains present if the lead fails in the future. OBJECTIVE: We evaluated the feasibility of an alternative approach at the time of cardiac resynchronization therapy-defibrillator (CRT-D) generator replacement in patients with a functional bipolar left ventricular (LV) lead for prevention of inappropriate shocks from future Fidelis lead failure...
December 8, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27940454/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#16
J W Simmons, M F Powell
Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27922468/optimal-implantable-cardioverter-defibrillator-programming
#17
Bindi K Shah
Optimal programming of implantable cardioverter defibrillators (ICDs) is essential to appropriately treat ventricular tachyarrhythmias and to avoid unnecessary and inappropriate shocks. There have been a series of large clinical trials evaluating tailored programming of ICDs. We reviewed the clinical trials evaluating ICD therapies and detection, and the consensus statement on ICD programming. In doing so, we found that prolonged ICD detection times, higher rate cutoffs, and antitachycardia pacing (ATP) programming decreases inappropriate and painful therapies in a primary prevention population...
January 2017: Cardiology in Review
https://www.readbyqxmd.com/read/27909501/-two-for-the-price-of-one-a-single-lead-implantable-cardioverter-defibrillator-system-with-a-floating-atrial-dipole
#18
REVIEW
Nicole E Worden Md, Musab Alqasrawi Md, Siva M Krothapalli Md, Alexander Mazur Md
In patients known to be a high risk for sudden cardiac arrest, implantable cardioverter defibrillators (ICD) are a proven therapy to reduce risk of death. However, in patients without conventional indications for pacing, the optimal strategy for type of device, dual- versus single-chamber, remains debatable. The benefit of prophylactic pacing in this category of patients has never been documented. Although available atrial electrograms in a dual chamber system improve interpretation of stored arrhythmia events, allow monitoring of atrial fibrillation and may potentially reduce the risk of inappropriate shocks by enhancing automated arrhythmia discrimination, the use of dual-chamber ICDs has a number of disadvantages...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908173/pacemaker-and-icd-oversensing-induced-by-movements-near-the-mri-scanner-bore
#19
E Mattei, F Censi, G Calcagnini, R Falsaperla, E Genovese, A Napolitano, V Cannatà
PURPOSE: The effect of the movement near the MRI scanner bore for people with a pacemaker (PM) or an implantable cardioverter defibrillator (ICD) is experimentally evaluated and discussed. METHODS: The authors performed in vitro measurements on a saline-filled human-shaped phantom (male, 170 cm height), equipped first with an MR-conditional PM (bicameral configuration, DDD programming), then with an MR-conditional ICD (biventricular configuration, detection algorithms enable but shock delivery disable)...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27905927/characteristics-and-outcomes-of-diabetic-patients-with-an-implantable-cardioverter-defibrillator-in-a-real-world-setting-results-from-the-israeli-icd-registry
#20
Hillel Steiner, Michael Geist, Ilan Goldenberg, Mahmoud Suleiman, Michael Glikson, Alexander Tenenbaum, Moshe Swissa, Enrique Z Fisman, Gregory Golovchiner, Boris Strasberg, Alon Barsheshet
AIMS: There are limited data regarding the effect of diabetes mellitus (DM) on the risks of both appropriate and inappropriate implantable cardioverter defibrillator (ICD) therapy. The present study was designed to compare the outcome of appropriate and inappropriate ICD therapy in patients with or without DM. METHODS AND RESULTS: The risk of a first appropriate ICD therapy for ventricular tachyarrhythmias (including anti tachycardia pacing and shock) was compared between 764 DM and 1346 non-DM patients enrolled in the national Israeli ICD registry...
December 1, 2016: Cardiovascular Diabetology
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