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Implantable Cardiac Devices

Abraham Speedie, Cinosh Mathew, Ramgopal S Shahi, Rajneesh Calton
INTRODUCTION: The development of implantable technology for cardiac rhythm management remains one of the seminal achievements of the second half of the 20th century. The development of artificial pacemakers for the electrical control of the cardiac rhythm has greatly enhanced the physician's ability to treat cardiac dysrhythmias. An ageing population and the extension of indications will in all probability result in an increasing number of cardiac device implantations. OBJECTIVE OF STUDY: To study mortality and morbidity in patients with permanent pacemaker implantation at a tertiary care hospital in North India...
September 2016: Journal of the Association of Physicians of India
Daniel J Friedman, Haikun Bao, Erica S Spatz, Jeptha P Curtis, James P Daubert, Sana M Al-Khatib
BACKGROUND: -A prolonged PR interval is common among cardiac resynchronization therapy (CRT) candidates; however, the association between PR interval and outcomes is unclear, and data are conflicting. METHODS: -We conducted inverse probability weighted (IPW) analyses of 26,451 CRT eligible (EF≤35, QRS≥120ms) patients from the National Cardiovascular Data Registry ICD Registry to assess the association between a prolonged PR interval (≥230ms), receipt of CRT with defibrillator (CRT-D) versus implantable cardioverter defibrillator (ICD), and outcomes...
October 19, 2016: Circulation
James E Dalen, Joseph S Alpert
A new suspected cause of cryptic strokes is "silent atrial fibrillation". Pacemakers and other implanted devices allow continuous recording of cardiac rhythm for months or years. They have discovered that short periods of atrial fibrillation lasting minutes or hours are frequent and usually are asymptomatic. A meta-analysis of 50 studies involving more than 10,000 patients with a recent stroke found that 7.7% had atrial fibrillation on their admitting EKG. In 3 weeks during and after hospitalization, another 16...
October 15, 2016: American Journal of Medicine
Sven Reek
PURPOSE OF REVIEW: The wearable cardioverter-defibrillator has been available for over a decade. In recent years, the device has been prescribed increasingly for a wide range of indications. The purpose of this review is to describe the technical and clinical aspects of the wearable cardioverter-defibrillator. The available literature on safety, efficacy and cost-effectiveness is reviewed, and indications for use will be discussed. RECENT FINDINGS: The wearable cardioverter-defibrillator has been used successfully in more than 100 000 patients for a variety of indications...
October 15, 2016: Current Opinion in Cardiology
Steven Swiryn, Michael V Orlov, David G Benditt, John P DiMarco, Donald M Lloyd-Jones, Edward Karst, Fujian Qu, Mara T Slawsky, Melanie Turkel, Albert L Waldo
BACKGROUND: The RATE Registry (Registry of Atrial Tachycardia and Atrial Fibrillation Episodes) is a prospective, outcomes-oriented registry designed to document the prevalence of atrial tachycardia and/or fibrillation (AT/AF) of any duration in patients with pacemakers and implantable cardioverter defibrillators (ICDs) and evaluate associations between rigorously adjudicated AT/AF and predefined clinical events, including stroke. The appropriate clinical response to brief episodes of AT/AF remains unclear...
October 18, 2016: Circulation
Ali Vasheghani-Farahani, Masih Tajdini, Seyed Abolfazl Mohsenizadeh, Seyed Mohammad Reza Hosseini
BACKGROUND: Cardiac resynchronization therapy (CRT) is a medical device to help cardiac synchronized contractility by electrical impulses. Improvement of symptoms and left ventricular systolic function, reducing hospital admissions and mortality in patients with moderate to severe heart failure are the main benefits of administration of cardiac resynchronization therapy. CASE REPORT: In this article, we describe a case of heart failure and left bundle branch block (LBBB) who was candidate for cardiac resynchronization therapy; but after managing hyperkalemia, left bundle branch block resolved, ejection fraction increased and cardiac resynchronization therapy implantation was canceled...
May 2016: ARYA Atherosclerosis
Ranjit Kumar Nath, Ajay Raj, C Parvatagouda, Neeraj Pandit
Left ventricular lead placement in the appropriate branch of coronary sinus is the key to successful cardiac resynchronization therapy (CRT) and this step is technically challenging. We describe a case of non-ischemic cardiomyopathy with heart failure, taken up for cardiac resynchronization therapy with defibrillator (CRT-D) implantation. The quadripolar left ventricular lead was impossible to advance into the target lateral branch of the coronary sinus. We made a veno-venous loop, advancing the coronary guidewire through the middle cardiac vein to coronary sinus and then to superior vena cava...
September 2016: Indian Heart Journal
Priccila Zuchinali, Gabriela C Souza, Maurício Pimentel, Diego Chemello, André Zimerman, Vanessa Giaretta, Joyce Salamoni, Bianca Fracasso, Leandro I Zimerman, Luis E Rohde
Importance: The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. Objective: To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Design, Setting, and Participants: Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital...
October 17, 2016: JAMA Internal Medicine
Thomas Sené, Olivier Lidove, Joel Sebbah, Jean-Marc Darondel, Hervé Picard, Laurent Aaron, Olivier Fain, Thierry Zenone, Dominique Joly, Philippe Charron, Jean-Marc Ziza
The incidence and predictive factors of arrhythmias and/or conduction abnormalities (ACAs) requiring cardiac device (CD) implantation are poorly characterized in Fabry disease (FD). The aim of our retrospective study was to determine the prevalence, incidence, and factors associated with ACA requiring CD implantation in a monocentric cohort of patients with confirmed FD who were followed up in a department of internal medicine and reference center for FD.Forty-nine patients (20M, 29F) were included. Nine patients (4M, 5F; 18%) had at least one episode of ACA leading to device therapy...
October 2016: Medicine (Baltimore)
David M Turer, Kelly L Koch, Todd M Koelling, Audrey H Wu, Francis D Pagani, Jonathan W Haft
Centrifugal and axial flow left ventricular assist devices have different hydrodynamic properties that may impact the effectiveness of left ventricular unloading. We sought to determine if patients implanted with the HeartWare HVAD (HW) and HeartMate II (HMII) had a similar degree of hemodynamic support by comparing parameters measured using echocardiography and right heart catheterization. Using our prospectively collected database, we identified 268 patients implanted with the HMII and 93 with the HW. Demographic characteristics were similar between groups...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jaume Miranda-Rius, Eduard Lahor-Soler, Lluís Brunet-Llobet, Xavier Sabaté de la Cruz
Patients with cardiac implantable electrical devices should take special precautions when exposed to electromagnetic fields. Proximity to equipment used in clinical dentistry may cause interference. This study evaluated in vitro the risks associated with different types/makes of cardiac devices and types of dental equipment. Six electronic dental tools were tested on three implantable cardioverter defibrillators and three pacemakers made by different manufacturers. Overall, the risk of interference with the pacemakers was 37% lower than with the implantable cardioverter defibrillators...
October 17, 2016: European Journal of Oral Sciences
Marie Christine Iliou, Jean Christophe Blanchard, Aurélia Lamar-Tanguy, Pascal Cristofini, François Ledru
Large subsets of patients admitted in cardiac rehabilitation centers are having a pacemaker, cardiac resynchronization (CRT) or implantable cardiac defibrillator (ICD). Cardiac rehabilitation for patients, mostly with heart failure, with implanted electronic devices as pacemakers or ICD is a unique opportunity not only to optimize the medical treatment, to increase their exercise capacity and improves their clinical condition but also to supervise the correct functioning of the device. CRT reduces clinical symptoms and increases slightly the exercise capacity...
October 14, 2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Subha Ghosh, Rahul Renapurkar, Subha V Raman
BACKGROUND: The objective of this study was to evaluate patients with known hereditary cardiac conduction and myocardial disease (HCCMD) caused by a lamin A/C gene mutation for skeletal muscle involvement using magnetic resonance imaging (MRI) computed tomography (CT). METHODS: Twenty-one patients with the diagnosis of HCCMD were available for study. Of these 21, 11 had MRI scans of the lower legs. The 11 that had an MRI were compared to a control group of 17 healthy controls...
October 2016: Cardiovascular Diagnosis and Therapy
Nisha Bansal, Adam Szpiro, Frederick Masoudi, Robert T Greenlee, David H Smith, David J Magid, Jerry H Gurwitz, Kristi Reynolds, Grace H Tabada, Sue Hee Sung, Ashveena Dighe, Andrea Cassidy-Bushrow, Romel Garcia-Montilla, Stephen Hammill, John Hayes, Alan Kadish, Param Sharma, Paul Varosy, Humberto Vidaillet, Alan S Go
OBJECTIVE: Patients with chronic kidney disease (CKD) have higher risk of sudden cardiac death; however, they may not receive implantable cardioverter defibrillators (ICDs), in part due to higher risk of complications. We evaluated whether CKD is associated with greater risk of device-delivered shocks/antitachycardia pacing (ATP) therapies among patients receiving a primary prevention ICD. METHODS: We studied participants in the observational Cardiovascular Research Network Longitudinal Study of Implantable Cardioverter Defibrillators...
October 14, 2016: Heart: Official Journal of the British Cardiac Society
Claudia Schaarschmidt, Christof Kolb
The subcutaneous implantable defibrillator (S-ICD) has become an established tool for the prevention of sudden cardiac death. Based on its detection properties, the S‑ICD is essentially dependent on correct morphology discrimination of the QRS complex and avoidance of potential T‑wave sensing. We report on a patient who experienced multiple inappropriate S‑ICD shocks due to T‑wave oversensing in the setting of new onset of right bundle branch block. Strategies for the optimisation of the device programming are discussed...
October 13, 2016: Herzschrittmachertherapie & Elektrophysiologie
Newton B Wiggins, Daniel T Chong, Penny L Houghtaling, Ayman A Hussein, Walid Saliba, Joseph F Sabik, Oussama Wazni, Bruce L Wilkoff, Khaldoun G Tarakji
AIMS: The incidence, indications, and risk factors for cardiac implantable electronic device (CIED) implantation after cardiac surgery in an era with an aging population are not well described. There are limited data about the survival of these patients compared with a non-device group. We aimed to evaluate the incidence, indications, and risk factors for postoperative CIED implantation. We also assessed survival of these patients compared with a non-device group. METHODS: We included all patients without prior CIED implantation who underwent cardiac surgery at our institution from 1996 to 2008...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Tatsuya Nishikawa, Masashi Fujino, Ikutaro Nakajima, Yasuhide Asaumi, Yu Kataoka, Toshihisa Anzai, Kengo Kusano, Teruo Noguchi, Yoichi Goto, Kunihiro Nishimura, Yoshihiro Miyamoto, Keisuke Kiso, Satoshi Yasuda
AIMS: The prognostic impact of chronic total coronary occlusion (CTO) on implantable cardioverter-defibrillator (ICD) recipients remains unclear. METHODS AND RESULTS: Eighty-four consecutive patients with ischaemic heart disease who received ICD therapy for primary or secondary prevention were analysed. We investigated all-cause mortality and major adverse cardiac events (MACEs) including cardiac death, appropriate device therapy, hospitalization for heart failure, and ventricular assist device implantation...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Erin A Fender, Ammar M Killu, Bryan C Cannon, Paul A Friedman, Christopher J Mcleod, David O Hodge, Craig S Broberg, Charles A Henrikson, Yong-Mei Cha
AIMS: Patients with congenital heart disease (CHD) are at increased risk for intracardiac device malfunction and infection that may necessitate extraction; however, the risk of extraction is poorly understood. This study addresses the safety of extraction in patients with structural heart disease and previous cardiac surgery. METHODS: This retrospective study included 40 CHD and 80 matched control patients, who underwent transvenous lead extractions between 2001 and 2014...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Matteo Ziacchi, Pietro Palmisano, Ernesto Ammendola, Gabriele Dell'era, Federico Guerra, Stefano Aquilani, Vittorio Aspromonte, Giuseppe Boriani, Michele Accogli, Giuseppe Del Giorno, Eraldo Occhetta, Alessandro Capucci, Renato Pietro Ricci, Giampiero Maglia, Mauro Biffi
AIM: The aim of this multicentre, observational, transversal study was to evaluate pacemaker (PM) choice and setting in a large number of patients, in order to understand their relationship with the patients' clinical characteristics. METHODS AND RESULTS: The study enrolled a total of 1858 patients (71 ± 14 years, 54% male), consecutively evaluated during scheduled PM follow-up visits in 7 Italian cardiac arrhythmia centres. To evaluate the appropriateness of PM choice in relation to the patients' clinical characteristics, we analysed their rhythm disorders at the time of device implantation and the characteristics of the devices implanted...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Lisa A Gottlieb, Anniek Lubberding, Anders Peter Larsen, Morten B Thomsen
Potassium Channel Interacting Protein 2 (KChIP2) is suggested to be responsible for the circadian rhythm in repolarization duration, ventricular arrhythmias, and sudden cardiac death. We investigated the hypothesis that there is no circadian rhythm in QT interval in the absence of KChIP2. Implanted telemetric devices recorded electrocardiogram continuously for 5 days in conscious wild-type mice (WT, n = 9) and KChIP2(-/-) mice (n = 9) in light:dark periods and in complete darkness. QT intervals were determined from all RR intervals and corrected for heart rate (QT100 = QT/(RR/100)(1/2))...
October 13, 2016: Chronobiology International
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