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Implantable Cardiac Devices

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https://www.readbyqxmd.com/read/28821963/myocardial-regenerative-therapy-using-a-scaffold-free-skeletal-muscle-derived-cell-sheet-in-patients-with-dilated-cardiomyopathy-even-under-a-left-ventricular-assist-device-a-safety-and-feasibility-study
#1
Yasushi Yoshikawa, Shigeru Miyagawa, Koichi Toda, Atsuhiro Saito, Yasushi Sakata, Yoshiki Sawa
BACKGROUND AND PURPOSE: Despite promising experimental results, clinically, intramyocardial myoblast injection failed to reverse remodeling and it induced arrhythmogenicity. In contrast, scaffold-free skeletal muscle-derived cell (SC) sheets attenuated cardiac dysfunction and arrhythmogenicity via paracrine effects. We report the first clinical trial of SC sheet implantation (SCSI) conducted in four patients with dilated cardiomyopathy (DCM) supported by a left ventricular assist device (LVAD)...
August 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28820968/reduced-activin-receptor-like-kinase-1-activity-promotes-cardiac-fibrosis-in-heart-failure
#2
Kevin J Morine, Xiaoying Qiao, Vikram Paruchuri, Mark J Aronovitz, Emily E Mackey, Lyanne Buiten, Jonathan Levine, Keshan Ughreja, Prerna Nepali, Robert M Blanton, S Paul Oh, Richard H Karas, Navin K Kapur
INTRODUCTION: Activin receptor-like kinase 1 (ALK1) mediates signaling via the transforming growth factor beta-1 (TGFβ1), a pro-fibrogenic cytokine. No studies have defined a role for ALK1 in heart failure. HYPOTHESIS: We tested the hypothesis that reduced ALK1 expression promotes maladaptive cardiac remodeling in heart failure. METHODS AND RESULTS: In patients with advanced heart failure referred for left ventricular (LV) assist device implantation, LV Alk1 mRNA and protein levels were lower than control LV obtained from patients without heart failure...
July 18, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28819983/an-evaluation-of-the-effectiveness-of-a-risk-based-monitoring-approach-implemented-with-clinical-trials-involving-implantable-cardiac-medical-devices
#3
Christopher A Diani, Angie Rock, Phil Moll
Background Risk-based monitoring is a concept endorsed by the Food and Drug Administration to improve clinical trial data quality by focusing monitoring efforts on critical data elements and higher risk investigator sites. BIOTRONIK approached this by implementing a comprehensive strategy that assesses risk and data quality through a combination of operational controls and data surveillance. This publication demonstrates the effectiveness of a data-driven risk assessment methodology when used in conjunction with a tailored monitoring plan...
August 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28819689/beware-of-the-coronary-arteries-with-implantable-cardiac-electronic-devices
#4
REVIEW
S Serge Barold, Benjamin J Pang, Harry G Mond
The transvenous implantation of cardiac devices may sometimes cause serious complications involving the coronary arteries. The left anterior descending artery may be injured during nonapical right ventricular implantation while a right atrial lead may injure the right or circumflex coronary artery. Injury of a left internal mammary graft to a coronary artery may cause myocardial infarction.
August 17, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28815459/a-roadmap-for-reducing-cardiac-device-infections-a-review-of-epidemiology-pathogenesis-and-actionable-risk-factors-to-guide-the-development-of-an-infection-prevention-program-for-the-electrophysiology-laboratory
#5
REVIEW
Westyn Branch-Elliman
PURPOSE OF REVIEW: Cardiovascular implantable electronic device (CIED) infections are highly morbid, common, and costly, and rates are increasing (Sohail et al. Arch Intern Med 171(20):1821-8 2011; Voigt et al. J Am Coll Cardiol 48(3):590-1 2006). Factors that contribute to the development of CIED infections include patient factors (comorbid conditions, self-care, microbiome), procedural details (repeat procedure, contamination during procedure, appropriate pre-procedural prep, and antimicrobial use), environmental and organizational factors (patient safety culture, facility barriers, such as lack of space to store essential supplies, quality of environmental cleaning), and microbial factors (type of organism, virulence of organism)...
August 16, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28812138/-telemetric-follow-up-of-implantable-electronic-cardiac-devices-optimisation-of-care-in-clinical-practice
#6
REVIEW
Ralph Bosch, Ingrid Mutscher
Remote follow-up of patients with implantable electronic cardiac devices (IECD) is a scientifically well-evaluated and technically mature method. Advantages over conventional follow-up include rapid detection of clinically relevant events (i. e. arrhythmias) and of technical problems. Additionally, telemetric follow-up of IECDs has a high degree of acceptance among both patients as well as health care professionals and carries the potential to reduce health care costs. The implementation of a remote follow-up programme is associated with organisational, infrastructural and legal aspects, which are reviewed...
August 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28811391/cardiac-implantable-electronic-device-lead-extraction-using-the-lead-locking-device-system-keeping-it-simple-safe-and-inexpensive-with-mechanical-tools-and-local-anesthesia
#7
Antonis S Manolis, Georgios Georgiopoulos, Sofia Metaxa, Spyridon Koulouris, Dimitris Tsiachris
OBJECTIVE: We have previously reported our successful approach for percutaneous cardiac implantable electronic device (CIED) lead extraction using inexpensive tools, which we have continued over the years. Herein we report the results of the systematic use of a unique stylet, the lead-locking device (LLD), which securely locks the entire lead lumen, aided with non-powered telescoping sheaths in 54 patients to extract 98 CIED leads. METHODS: This prospective observational clinical study included 38 men and 16 women aged 68...
August 11, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28804785/periprocedural-antibiotic-prophylaxis-for-cardiac-implantable-electrical-device-procedures-results-from-a-heart-rhythm-society-survey
#8
Anuj Basil, Steven A Lubitz, Peter A Noseworthy, Matthew R Reynolds, Howard Gold, David Yassa, Daniel Kramer
No abstract text is available yet for this article.
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/28801537/closure-of-secundum-atrial-septal-defects-with-the-amplatzer-septal-occluder-a-prospective-multicenter-post-approval-study
#9
Daniel R Turner, Carl Y Owada, Charlie J Sang, Muhammad Khan, D Scott Lim
BACKGROUND: Prospective data on the medium-term safety and effectiveness of the AMPLATZER Septal Occluder in clinical practice are not available. The objective of this study was to prospectively evaluate the risk of hemodynamic compromise and obtain medium-term survival data on patients implanted with the AMPLATZER Septal Occluder for percutaneous closure of secundum atrial septal defects. METHODS AND RESULTS: Subjects were enrolled prospectively at 50 US sites and followed for 2 years...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28800149/atrial-fibrillation-variability-on-long-term-monitoring-of-implantable-cardiac-rhythm-management-devices
#10
Rachel M Kaplan, Paul D Ziegler, Jodi Koehler, Taya V Glotzer, Rod S Passman
BACKGROUND: Atrial fibrillation (AF) burden and duration are predictors of thromboembolic events. The random nature of these measures may affect clinical decision making. The objective of this study was to determine temporal changes in AF burden as detected by continuous monitoring. HYPOTHESIS: AF burden changes over time when detected by continuous monitoring. METHODS: A post hoc analysis of patients enrolled in the TRENDS (A Prospective Study of the Clinical Significance of Atrial Arrhythmias Detected by Implanted Device Diagnostics) study with ≥1 stroke risk factor(s) who were implanted with a dual-chamber cardiac rhythm management device (CRMD) and had AF burden data available for ≥2 years was performed...
August 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28799694/patient-with-a-total-artificial-heart-maintained-on-outpatient-dialysis-while-listed-for-combined-organ-transplant-a-single-center-experience
#11
Ramy M Hanna, Huma Hasnain, Mohammad Kamgar, Mina Hanna, Raffi Minasian, James Wilson
Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care...
August 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28790277/-management-of-right-heart-failure-after-cardiac-surgery
#12
Takeo Fujino, Akira Shiose
Perioperative right heart failure(RHF) is an important problem, especially in the field of heart failure surgery. Right ventricular performance is determined by the combination of preload, contractility, heart rate, rhythm and afterload. Many factors influence on these parameters in the perioperative period, and the deterioration of one of them can cause RHF. Recently, we often encounter perioperative RHF after left ventricular assist device (LVAD) implantation, and prompt LVAD pump speed optimization and treatment for RHF is required to avoid complications and hemodynamic deterioration...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28789600/cardiac-surgery-score-casus-improves-outcome-prediction-in-patients-treated-with-extracorporal-life-support-ecls
#13
Britt Hofmann, Moriz J Gmelin, Dietrich Metz, Christoph Raspé, Andreas Wienke, Hendrik Treede, Andreas Simm
INTRODUCTION: The often-unexpected necessity of extracorporeal life support (ECLS) implies that information on patients and end-organ functions at time of implantation is scarce. However, there is a need for early prognostic indicators and a score predicting the outcome. Therefore, we evaluated established laboratory parameters and widely used intensive care scores - cardiac surgery score (CASUS) and sequential organ failure assessment (SOFA) after ECLS implantation. METHODS: In this retrospective analysis, 90 consecutive adult patients with veno-arterial ECLS were included...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28781823/inappropriate-shock-in-a-subcutaneous-cardiac-defibrillator-due-to-residual-air
#14
Shawn Lee, Nektarios Souvaliotis, Davendra Mehta, Ranjit Suri
Inappropriate shock due to residual air in subcutaneous implantable cardiac defibrillators is not a well-known complication. Obtaining overpenetrated X-rays, recognizing electrocardiogram findings, limiting blunt finger dissection, and switching to sense at another vector are techniques which might lead to avoidance of unnecessary wound exploration or device removal.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28781240/outcomes-in-patients-with-contained-ruptures-of-the-aortic-annulus-after-transcatheter-aortic-valve-implantation-with-balloon-expandable-devices
#15
Philipp Breitbart, Jan Minners, Gregor Pache, Jochen Reinöhl, Nicolaj Christopher Hansson, Bjarne L Nørgaard, Franz-Josef Neumann, Philipp Ruile
AIMS: To evaluate incidence and long-term outcomes of patients with contained ruptures of the aortic annulus (CR) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: From May 2012 to June 2017 a total of 1030 patients underwent post- TAVI computed tomography angiography (CTA) at three centers in Germany and Denmark. CR were identified in 12 patients (1.2%, 80.7+5.0 years, STS-Score 4.1+1.4%). All 12 patients had received a balloon-expandable valve...
August 8, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28777391/design-and-numerical-evaluation-of-an-axial-partial-assist-blood-pump-for-chinese-and-other-heart-failure-patients
#16
Guang-Mao Liu, Dong-Hai Jin, Jian-Ye Zhou, Xi-Hang Jiang, Han-Song Sun, Yan Zhang, Hai-Bo Chen, Sheng-Shou Hu, Xing-Min Gui
A fully implantable axial left ventricular assist device LAP31 was developed for Chinese or other heart failure patients who need partial support. Based on the 5-Lpm total cardiac blood output of Chinese without heart failure disease, the design point of LAP31 was set to a flow rate of 3 Lpm with 100-mmHg pressure head. To achieve the required pressure head and good hemolytic performance, a structure that includes a spindly rotor hub and a diffuser with splitter and cantilevered main blades was developed. Computational fluid dynamics (CFD) was used to analyze the hydraulic and hemodynamic performance of LAP31...
August 2, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28776823/mri-of-patients-with-implanted-cardiac-devices
#17
REVIEW
Bobby Kalb, Julia H Indik, Peter Ott, Diego R Martin
Cardiac implanted electronic devices (CIEDs) have historically been regarded as a contraindication for performing magnetic resonance imaging (MRI), limiting the availability of this exam for large numbers of patients who may have otherwise benefited from the unique diagnostic capabilities of MRI. Interactions between CIEDs and the magnetic field associated with MRI systems have been documented, and include potential effects on CIED function, lead heating, and force/torque on the generator. Several device manufacturers have developed "MR-Conditional" CIEDs with specific hardware and software design changes to optimize the device for the MR environment...
August 4, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28772056/right-ventricular-temporal-assist-device-for-cardiac-recompensation
#18
Isabell Yan, Hanno Grahn, Stefan Blankenberg, Dirk Westermann
In this case report, we discuss treatment of a 66-year-old patient with right heart failure due to chronic left heart failure caused by ischemic cardiomyopathy. We decided to manage this patient by implanting a temporary right ventricular assist device (Impella RP®) as a novel therapeutic option for acute on chronic right heart decompensation.
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28772036/implantation-of-a-left-ventricular-assist-device-to-provide-long-term-support-for-end-stage-duchenne-muscular-dystrophy-associated-cardiomyopathy
#19
Douglas Stoller, Faris Araj, Alpesh Amin, Catherine Fitzsimmons, Robert Morlend, Jennifer T Thibodeau, Claudio Ramaciotti, Mark H Drazner, Dan M Meyer, Pradeep P A Mammen
A young man with Duchenne muscular dystrophy presented to the UT Southwestern Neuromuscular Cardiomyopathy Clinic with advanced heart failure. Despite maximal medical therapy, his cardiac function continued to decline requiring initiation of inotrope therapy. Given the patient's clinical deterioration, a left ventricular assist device (LVAD) was implanted as destination therapy after undergoing a multidisciplinary assessment. The patient tolerated the surgical implantation of the LVAD without any significant complications, and he has had a relatively unremarkable course 38 months post-LVAD implantation...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28769025/delayed-pacemaker-generator-pocket-and-lead-primary-infection-due-to-burkholderia-cepacia
#20
Fatma Ben Abid, Hussam Al-Saoub, Faraj Howadi, Ahmed AlBishawi, Maliha Thapur
BACKGROUND Recently, the use of cardiac implantable electrophysiological devices (CIEDs) has increased. Advances in medical technology, an increasingly aging population, increases in clinical indications, and expanded medical insurance coverage for these devices have all contributed to this trend. Infection is considered to be one of the most serious complications of CIEDs and carries a significant risk of morbidity and mortality. Although infection with Staphylococcus sp. accounts for the majority of cases, other bacteria have been implicated as causative agents of infection of CIEDs...
August 3, 2017: American Journal of Case Reports
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