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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
#1
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/28205160/non-fermentative-gram-negative-rods-bacteremia-in-children-with-cancer-a-14-year-single-center-experience
#2
D Averbuch, C Avaky, M Harit, P Stepensky, I Fried, T Ben-Ami, V Temper, Y Peled, H Troen, R Masarwa, W Abu Ahmad, M Weintraub, S Revel-Vilk, D Engelhard
PURPOSE: Data on non-fermentative Gram-negative rods (NFGNR) bacteremia in children with malignancies are limited. The aim of this study was to present clinical picture, antimicrobial susceptibility pattern, risk factors for resistance and outcome in NFGNR bacteremia in children with cancer. METHODS: All episodes of NFGNR bacteremia occurring during 2001-2014 in children with cancer in a tertiary-care hospital were retrospectively analyzed. Pseudomonas and Acinetobacter spp...
February 15, 2017: Infection
https://www.readbyqxmd.com/read/28196927/healthcare-utilization-and-expenditures-associated-with-appropriate-and-inappropriate-implantable-defibrillator-shocks
#3
Mintu P Turakhia, Steven Zweibel, Andrea L Swain, Sarah A Mollenkopf, Matthew R Reynolds
BACKGROUND: In patients with implantable cardioverter-defibrillators, healthcare utilization (HCU) and expenditures related to shocks have not been quantified. METHODS AND RESULTS: We performed a retrospective cohort study of patients with implantable cardioverter-defibrillators identified from commercial and Medicare supplemental claims databases linked to adjudicated shock events from remote monitoring data. A shock event was defined as ≥1 spontaneous shocks delivered by an implanted device...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28191986/studies-of-learned-helplessness-in-honey-bees-apis-mellifera-ligustica
#4
Christopher W Dinges, Christopher A Varnon, Lisa D Cota, Stephen Slykerman, Charles I Abramson
The current study reports 2 experiments investigating learned helplessness in the honey bee (Apis mellifera ligustica). In Experiment 1, we used a traditional escape method but found the bees' activity levels too high to observe changes due to treatment conditions. The bees were not able to learn in this traditional escape procedure; thus, such procedures may be inappropriate to study learned helplessness in honey bees. In Experiment 2, we used an alternative punishment, or passive avoidance, method to investigate learned helplessness...
February 13, 2017: Journal of Experimental Psychology. Animal Learning and Cognition
https://www.readbyqxmd.com/read/28188473/outpatient-treatment-with-the-wearable-cardioverter-defibrillator-clinical-experience-in-two-dutch-centres
#5
A F B E Quast, V F van Dijk, A A M Wilde, R E Knops, L V A Boersma
INTRODUCTION: The latest European Society of Cardiology Guidelines recommend consideration of a wearable cardioverter-defibrillator (WCD) for patients with a poor left ventricular ejection fraction (LVEF) who are at risk of sudden arrhythmic death but are not eligible for an implantable defibrillator. For these patients a WCD can be an alternative to long-term hospitalisation. PURPOSE: To evaluate the use of WCD therapy in these patient groups in two Dutch centres...
February 10, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28164835/a-quick-reference-on-hyponatremia
#6
REVIEW
Julien Guillaumin, Stephen P DiBartola
The article focuses on causes of hyponatremia, including hypovolemia, diabetes mellitus and others. Hypovolemia is a major cause of hyponatremia in veterinary medicine. Hypovolemia causes a decrease in effective circulating volume, triggering antidiuretic hormone (ADH) secretion and free water retention, and develops after gastrointestinal losses, renal losses, hemorrhagic shock, hypoadrenocorticism, and other causes of hypovolemia. The article reviews the clinical approach to diagnosing the cause of hyponatremia in critically ill patients, including recognition of the syndrome of inappropriate ADH secretion (SIADH)...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28150095/risk-of-ventricular-tachyarrhythmias-following-improvement-of-left-ventricular-ejection-fraction-in-patients-with-implantable-cardiac-defibrillators-implanted-for-primary-prevention-of-sudden-cardiac-death
#7
Jayasree Pillarisetti, Rakesh Gopinathannair, Matthew J Haney, Bassem Abazid, Wasiq Rawasia, Madhu Yeruva Reddy, Niveditha Adabala, Sudharani Bommana, Martin Emert, Dhanunjaya Lakkireddy
PURPOSE: In patients who undergo implantable cardiac defibrillator (ICD) implantation for primary prevention of sudden cardiac death (SCD), data is unclear whether their ICD generator needs to be replaced at end of life if their left ventricular ejection fraction (EF) improves. Despite improvement in EF, the underlying scar may represent a potential substrate for ventricular arrhythmias. METHODS: Data on 280 patients who underwent ICD implantation for primary prevention of SCD was obtained from two centers...
February 1, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28127641/assessment-of-linezolid-prescriptions-in-three-french-hospitals
#8
C Dentan, E Forestier, M Roustit, S Boisset, S Chanoine, O Epaulard, P Pavese
The use of linezolid to treat gram-positive cocci infections is increasing in France. Linezolid is approved in pneumonia and complicated skin and soft tissue infections. Overuse and misuse of linezolid can favor the emergence and spreading of linezolid-resistant strains. We aimed to assess the appropriateness of linezolid use in French hospitals. This is a multicenter, retrospective study conducted in three tertiary care hospitals. Appropriateness of linezolid indications and adequacy (composite score concerning dosage, route of administration and blood monitoring) were assessed...
January 26, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28122311/sirt1-inhibits-releases-of-hmgb1-and-hsp70-from-human-umbilical-vein-endothelial-cells-caused-by-il-6-and-the-serum-from-a-preeclampsia-patient-and-protects-the-cells-from-death
#9
Yongxiang Yin, Yaling Feng, Hua Zhao, Ziyu Zhao, Hua Yua, Jianjuan Xu, Haisha Che
Preeclampsia (PE), a pregnancy-specific disorder, is associated with inappropriate maternal inflammatory response, oxidative stress, and vascular endothelial cell dysfunction and damage. Releases of high mobility group box-1 (HMGB1) and heat-shock protein 70 (HSP70) into serum are considered to participate in the pathogenesis of PE. The deacetylase, sirtuin 1 (SIRT1), has protective effects against inflammation, apoptosis, and oxidative stress in various pathological conditions. We established a PE mouse model by injection of phosphatidylserine/dioleoyl-phosphatidycholine compounds, followed by measurement of the SIRT1 protein level in the placenta via Western blotting and the serum HMGB1 and HSP70 concentrations via enzyme-linked immunosorbent assay (ELISA)...
January 22, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28092204/impact-of-combination-therapy-and-early-de-escalation-on-outcome-of-ventilator-associated-pneumonia-caused-by-pseudomonas-aeruginosa
#10
Laurène Deconinck, Agnès Meybeck, Pierre Patoz, Nicolas Van Grunderbeeck, Nicolas Boussekey, Arnaud Chiche, Pierre-Yves Delannoy, Hugues Georges, Olivier Leroy
BACKGROUND: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in patients with VAP caused by P. aeruginosa. METHODS: Between 1994 and 2014, all 100 patients with VAP caused by P...
January 16, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28077816/incidence-of-atrial-tachyarrhythmias-in-patients-with-early-repolarization-syndrome
#11
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...
February 7, 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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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, USA) algorithm is designed to differentiate oversensing due to lead failure from ventricular tachyarrhythmias and withhold therapies in the presence of sustained lead-related oversensing...
February 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27956431/salvage-therapy-with-ceftolozane-tazobactam-for-multidrug-resistant-pseudomonas-aeruginosa-infections
#18
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
#19
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
#20
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
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