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https://www.readbyqxmd.com/read/29149500/ep-radiofrequency-generators-significant-offsets-between-selected-and-delivered-power
#1
Felix Bourier, Bernhard Schwarz, Amir Brkic, Lara Wolf, Verena Semmler, Marc Kottmaier, Elena Risse, Marta Telishevska, Stephanie Brooks, Sarah Lengauer, Marielouise Kornmayer, Katharina Koch-Büttner, Florian Berger, Gabriele Hessling, Isabel Deisenhofer, Tilko Reents
INTRODUCTION: For radiofrequency ablation, the EP Shuttle®, Ampere®, and SmartAblate® generator models are most frequently used in clinical practice. The aim of this study was to assess the correlation between selected and delivered RF power for different generators. METHODS AND RESULTS: In an experimental setup, ablation catheters were connected to the EP Shuttle®, Ampere®, and SmartAblate® generators. The power delivered by the generators was measured using a current converter and an oscilloscope...
November 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29138937/effects-of-propofol-sedation-on-pacing-thresholds-results-from-an-observational-cohort-study
#2
Jakob Lüker, Arian Sultan, Tobias Plenge, Samuel Lee, Jan-Hendrik van den Bruck, Daniel Steven
BACKGROUND: Propofol is one of the most commonly used intravenous anaesthetic drugs for surgical procedures. The use of propofol for sedation is also common practice during endoscopic procedures, electrophysiology studies, and ablation procedures, as well as pacemaker and defibrillator implantation. It was found that propofol alters the electrophysiologic properties of the heart and its conduction system. The effects of propofol on pacing thresholds are unknown and could have implications for pacemaker (PM) and defibrillator (ICD) implantation procedures, as well as sedation and anaesthesia in PM and ICD patients in general...
November 14, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29090490/the-effect-of-an-ultra-low-framerate-and-antiscatter-grid-less-radiation-protocol-for-cardiac-device-implantations
#3
Philipp Attanasio, Tobias Schreiber, Abdul Parwani, Philipp Lacour, Burkert Pieske, Wilhelm Haverkamp, Florian Blaschke, Martin Huemer
BACKGROUND AND AIMS: Antiscatter grids improve image contrast by absorbing scattered X-ray beams. By removing the antiscatter grid patient dose can be reduced as more X-ray beams reach the image receptor. Additionally there is a trend towards ultra low framerates for radiation dose reduction during various EP procedures. As for most cardiac device implantations (CIED) image quality demands are usually modest, the purpose of this study was to assess the safety and efficacy of an ultra-low frame rate and scatter grid-less radiation protocol...
November 1, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29072996/wide-qrs-tachycardia-in-a-patient-with-pre-excitation-what-are-the-pathways-involved-pacing-manoeuvres-to-characterize-a-unique-pathway
#4
Krishna Kumar Mohanan Nair, Anees Thajudeen, Narayanan Namboodiri, Ajitkumar Valaparambil
A 30year old patient presented to us with recurrent episodes of palpitation and documented tachycardia. In all his presentations a wide QRS tachycardia was recorded. The baseline ECG showed pre excitation. The 12 lead ECG of the tachycardia and the baseline ECG is shown in Fig. 1A. During EP study the patient had baseline pre excitation and the HV interval was 16 ms. A duo-decapolar halo (HL) catheter was used to map right atrium and a decapolar coronary sinus (CS) catheter was used to map coronary sinus...
March 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29046320/mortality-and-cerebrovascular-events-following-heart-rhythm-disorder-management-procedures
#5
Justin Z Lee, Jayna Ling, Nancy N Diehl, David O Hodge, Deepak Padmanabhan, Ammar M Killu, Malini Madhavan, Peter A Noseworthy, Suraj Kapa, Christopher J McLeod, Yong-Mei Cha, Abhishek J Deshmukh, Komandoor Srivathsan, Fred M Kusumoto, Win-Kuang Shen, Paul A Friedman, Thomas M Munger, Samuel J Asirvatham, Douglas L Packer, Siva K Mulpuru
Background -Recognition of rates and causes of hard, patient-centered outcomes of death and cerebrovascular event (CVE) after heart rhythm disorder management (HRDM) procedures is an essential step for development of quality improvement programs in electrophysiology laboratories. Our primary aim was to assess and characterize death and CVE (stroke or transient ischemic attack) after HRDM procedures over a 17-year period. Methods -We performed a retrospective cohort study of all patients undergoing HRDM procedures between January 2000 and November 2016 at the Mayo Clinic...
October 18, 2017: Circulation
https://www.readbyqxmd.com/read/29040554/frailty-syndrome-an-emerging-clinical-problem-in-the-everyday-management-of-clinical-arrhythmias-the-results-of-the-european-heart-rhythm-association-survey
#6
Stefano Fumagalli, Tatjana S Potpara, Torben Bjerregaard Larsen, Kristina H Haugaa, Dan Dobreanu, Alessandro Proclemer, Nikolaos Dagres
The age of patients presenting with complex arrhythmias is increasing. Frailty is a multifaceted syndrome characterized by an increased vulnerability to stressors and a decreased ability to maintain homeostasis. The prevalence of frailty is associated with age. The aims of this European Heart Rhythm Association (EHRA) EP Wire survey were to evaluate the proportion of patients with frailty and its influence on the clinical management of arrhythmias. A total of 41 centres-members of the EHRA Electrophysiology Research Network-in 14 European countries completed the web-based questionnaire in June 2017...
November 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29016753/clinical-impact-safety-and-accuracy-of-the-remotely-monitored-implantable-loop-recorder-medtronic-reveal-linqtm
#7
Massimiliano Maines, Alessandro Zorzi, Giancarlo Tomasi, Carlo Angheben, Domenico Catanzariti, Lucio Piffer, Maurizio Del Greco
Aims: Implantable loop recorders (ILR) are indicated in a variety of clinical situations when extended cardiac rhythm monitoring is needed. We aimed to assess the clinical impact, safety, and accuracy of the new Medtronic Reveal LINQTM ILR that can be inserted outside the electrophysiology (EP) laboratory and remotely monitored. Methods and results: All 154 consecutive patients (100 males, 63 ± 15 year-old) who received the Reveal LINQTM ILR during the period July 2014-June 2016 were enrolled...
July 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28874934/emergency-physician-performed-transesophageal-echocardiography-in-simulated-cardiac-arrest
#8
Don V Byars, Jordan Tozer, John M Joyce, Michael J Vitto, Lindsay Taylor, Turan Kayagil, Matt Jones, Matthew Bishop, Barry Knapp, David Evans
INTRODUCTION: Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28866284/intracardiac-electrocardiographic-assessment-of-precordial-taser-shocks-in-human-subjects-a-pilot-study
#9
Jason P Stopyra, James E Winslow, David M Fitzgerald, William P Bozeman
BACKGROUND: Case reports of cardiac arrest in temporal proximity to Conducted Electrical Weapon(CEW) exposure raise legitimate concerns about this as a rare possibility. In this pilot study, we respectfully navigate the oversight and regulatory hurdles and demonstrate the intra-shock electrocardiographic effects of an intentional transcardiac CEW discharge using subcutaneous probes placed directly across the precordium of patients with a previously implanted intracardiac EKG sensing lead...
August 24, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28851517/an-integrative-appraisal-of-mechano-electric-feedback-mechanisms-in-the-heart
#10
Viviane Timmermann, Lars A Dejgaard, Kristina H Haugaa, Andrew G Edwards, Joakim Sundnes, Andrew D McCulloch, Samuel T Wall
Mechanically-induced alterations in cardiac electrophysiology are referred to as mechano-electric feedback (MEF), and play an important role in electrical regulation of cardiac performance. The influence of mechanical stress and strain on electrophysiology has been investigated at all levels, however the role of MEF in arrhythmia remains poorly understood. During the normal contraction of the heart, mechano-sensitive processes are an implicit component of cardiac activity. Under abnormal mechanical events, stretch-activated mechanisms may contribute to local or global changes in electrophysiology (EP)...
August 26, 2017: Progress in Biophysics and Molecular Biology
https://www.readbyqxmd.com/read/28845235/cardiac-electrophysiology-under-mri-guidance-an-emerging-technology
#11
Henry Chubb, Steven E Williams, John Whitaker, James L Harrison, Reza Razavi, Mark O'Neill
MR-guidance of electrophysiological (EP) procedures offers the potential for enhanced arrhythmia substrate assessment, improved procedural guidance and real-time assessment of ablation lesion formation. Accurate device tracking techniques, using both active and passive methods, have been developed to offer an interface similar to electroanatomic mapping platforms, and MR-compatible EP equipment continues to be developed. Progress to clinical implementation of these technically complex fields has been relatively slow over the last 10 years, but recent developments have led to successful clinical experience...
June 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28766834/transseptal-puncture-using-surgical-electrocautery-in-children-and-adults-with-and-without-complex-congenital-heart-disease
#12
Srinath T Gowda, Athar M Qureshi, Daniel Turner, Nitin Madan, Justin Weigand, Richard Lorber, Harinder R Singh
BACKGROUND: Atrial transseptal puncture (TSP) for cardiac catheterization procedures remain challenging in children and adults with complex congenital heart disease (CHD). OBJECTIVES: We sought to evaluate our experience using radiofrequency (RF) current via surgical electrocautery needle for TSP to facilitate diagnostic and interventional procedures. METHODS: Retrospective chart review of all patients (pts) who underwent TSP using RF energy (10-25 W) via surgical electrocautery from three centers from January 2011 to January 2017 were evaluated...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28762918/-noninvasive-electrophysiological-mapping-in-patients-with-complete-left-bundle-branch-block-and-different-modes-of-biventricular-pacing
#13
S V Zubarev, M P Chmelevsky, M A Budanova, M A Trukshina, T A Lyubimtseva, V K Lebedeva, D S Lebedev
OBJECTIVE: to investigate possibilities of noninvasive electrophysiological mapping (NEM) during biventricular (BiV) pacing and to compare the results with data of 12 lead ECG and tissue Doppler echocardiography (TDI). MATERIAL AND METHODS: The study included 25 patients with complete left bundle branch block (LBBB) and implanted cardiac resynchronization therapy (CRT) system. Twenty-two patients were CRT responders, three other patients did not demonstrate a clear effect...
May 2017: Kardiologiia
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#14
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
October 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28641381/supraventricular-tachyarrhythmias-in-patients-with-a-persistent-left-superior-vena-cava
#15
Jongmin Hwang, Hyoung-Seob Park, Jun Kim, Jeong Su Kim, Jong Sung Park, Ki-Hun Kim, Myung Hwan Bae, Sang-Hee Lee, Young Soo Lee, Seongwook Han, Dae-Kyeong Kim, Tae-Joon Cha, Dong Gu Shin, Byung Chun Jung, Yoon-Nyun Kim
Aims: A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results: From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed...
June 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28630564/cathrob-a-highly-compact-and-versatile-remote-catheter-navigation-system
#16
Laura Cercenelli, Barbara Bortolani, Emanuela Marcelli
Several remote catheter navigation systems have been developed and are now commercially available. However, these systems typically require specialized catheters or equipment, as well as time-consuming operations for the system set-up. In this paper, we present CathROB, a highly compact and versatile robotic system for remote navigation of standard tip-steerable electrophysiology (EP) catheters. Key features of CathROB include an extremely compact design that minimizes encumbrance and time for system set-up in a standard cath lab, a force-sensing mechanism, an intuitive command interface, and functions for automatic catheter navigation and repositioning...
2017: Applied Bionics and Biomechanics
https://www.readbyqxmd.com/read/28593399/mri-use-for-atrial-tissue-characterization-in-arrhythmias-and-for-ep-procedure-guidance
#17
Ehud J Schmidt, Henry R Halperin
We review the utilization of magnetic resonance imaging methods for classifying atrial tissue properties that act as a substrate for common cardiac arrhythmias, such as atrial fibrillation. We then review state-of-the-art methods for mapping this substrate as a predicate for treatment, as well as methods used to ablate the electrical pathways that cause arrhythmia and restore patients to sinus rhythm.
June 7, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28541499/hypertension-and-cardiac-arrhythmias-executive-summary-of-a-consensus-document-from-the-european-heart-rhythm-association-ehra-and-esc-council-on-hypertension-endorsed-by-the-heart-rhythm-society-hrs-asia-pacific-heart-rhythm-society-aphrs-and-sociedad-latinoamericana
#18
Gregory Y H Lip, Antonio Coca, Thomas Kahan, Giuseppe Boriani, Antonis S Manolis, Michael Hecht Olsen, Ali Oto, Tatjana S Potpara, Jan Steffel, Francisco Marín, Márcio Jansen de Oliveira Figueiredo, Giovanni de Simone, Wendy S Tzou, Chern En Chiang, Bryan Williams
Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD, or HF. In addition, high doses of thiazide diuretics commonly used to treat HTN, may result in electrolyte abnormalities (e...
October 1, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28507742/mark-e-josephson-the-boston-years
#19
Peter Zimetbaum
Mark Josephson came to Beth Israel Hospital from the University of Pennsylvania in 1992, having firmly established a reputation as a master clinician, scientist and educator. He had built one of the premier electrophysiology (EP) services in the world in Pennsylvania and had become Chief of Cardiology there by the age of 35. In those days, Beth Israel was well known for its interventional cardiology and cardiac imaging but had not yet committed to the development of a modern EP section. The buzz surrounding Mark's arrival predicted an outspoken, larger than life and irreverent character who would profoundly change the place...
April 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/28507738/mark-e-josephson-clinical-investigator
#20
EDITORIAL
John M Miller
Mark E Josephson entered the world of clinical cardiac electrophysiology (EP) almost at its inception (1972); with so much to learn and so many directions one could take, he dived into the field with unbridled enthusiasm and an uncommon - perhaps almost unique - aptitude for asking questions and finding ways to answer them. Few aspects of EP escaped his indelible influence. In this short paper, I will attempt to touch on some of the high points of his astounding career as a clinical investigator.
April 2017: Arrhythmia & Electrophysiology Review
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