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Cardiac rhythm devices

Henrik Staer-Jensen, Kjetil Sunde, Espen Rostrup Nakstad, Jan Eritsland, Geir Øystein Andersen
OBJECTIVES: Haemodynamic monitoring during post arrest care is important to optimise treatment. We compared stroke volume measured by minimally-invasive monitoring devices with or without thermodilution calibration, and transthoracic echocardiography (TTE), and hypothesised that thermodilution calibration would give stroke volume index (SVI) more in agreement with TTE during targeted temperature management (TTM). DESIGN: Comatose out-of-hospital cardiac arrest survivors receiving TTM (33 °C for 24 hrs) underwent haemodynamic monitoring with arterial pulse contour analyses with (PiCCO2®) and without (FloTrac® /Vigileo® monitor® ) transpulmonary thermodilution calibration...
March 16, 2018: Scandinavian Cardiovascular Journal: SCJ
C Vignesh, Madhan Kumar, Ramesh Venkataraman, Senthilkumar Rajagopal, Nagarajan Ramakrishnan, Babu K Abraham
Overdose of cardiovascular medications such as beta blockers and calcium channel blockers cause impaired cardiac contractility, vasoplegia, and/or rhythm disturbances. In addition to conventional management of limiting absorption, increasing elimination and hemodynamic support intravenous (IV) calcium infusion, hyperinsulinemia-euglycemia therapy, glucagon infusion, and IV lipid emulsion have been tried. Extracorporeal circulatory assist device support has been reported as a rescue therapy in overdose refractory to maximal medical therapy...
February 2018: Indian Journal of Critical Care Medicine
Sebastian Voicu, Georgios Sideris, Jean-Guillaume Dillinger, Demetris Yannopoulos, Nicolas Deye, Chantal Kang, Michel Bonneau, Jason Bartos, Antoni Kedra, Sophie Bailliart, Adrien Pasteur-Rousseau, Guy Amah, Philippe Bonnin, Jacques Callebert, Patrick Henry, Bruno Megarbane
Circulatory failure following cardiac arrest (CA) requires catecholamine support and occasionally veno-arterial extracorporeal membrane oxygenation (vaECMO). VaECMO-generated blood flow is continuous and retrograde, increasing ventricular stroke work. Our aim was to assess the benefit of a device generating a pulsatile vaECMO flow synchronized with the heart rhythm lowering systolic vaECMO output on the left ventricular ejection fraction (LVEF) and pulmonary capillary pressure (Pcap) after CA. This experimental randomized study in pigs compared standard nonpulsatile vaECMO (control) with pulsatile synchronized vaECMO (study) group using a pulsatility-generating device...
March 6, 2018: Artificial Organs
Abraham Sonny, Brett J Wakefield, Shiva Sale, Stephanie Mick, Bruce L Wilkoff, Anand R Mehta
With increasing use of cardiovascular implantable electronic devices, the need for lead extractions has increased to an annual volume of more than 10,000 extractions worldwide. This article provides a focused clinical commentary on the perioperative management, identification, and treatment of life-threatening complications associated with lead extractions. In addition, a summary of indications, techniques, and lead extraction complications is provided. Although uncommon, lead extractions are associated with a consistent rate of major procedure-related complications and mortality...
January 10, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Taner Kasar, Pelin Ayyildiz, Gulhan Tunca Sahin, Erkut Ozturk, Selman Gokalp, Sertac Haydin, Alper Guzeltas, Yakup Ergul
BACKGROUND: We aimed to evaluate rhythm abnormalities in cases of congenitally corrected transposition of the great arteries (ccTGA) and associated treatment strategies. PATIENTS AND METHODS: This retrospective cohort study included 65 pediatric patients with ccTGA who were admitted to the clinic between 2009 and 2017. The patients were divided into two groups, and surgical data, Holter electrocardiographic (ECG) recordings, ECG recordings, electrophysiological data, and device implantation data on the two groups were compared...
February 24, 2018: Congenital Heart Disease
Pietro Palmisano, Matteo Ziacchi, Mauro Biffi, Renato P Ricci, Maurizio Landolina, Massimo Zoni-Berisso, Eraldo Occhetta, Giampiero Maglia, Gianluca Botto, Luigi Padeletti, Giuseppe Boriani
: The purpose of this two-part consensus document is to provide specific suggestions (based on an extensive literature review) on appropriate pacemaker setting in relation to patients' clinical features. In part 2, criteria for pacemaker choice and programming in atrioventricular blocks and neurally mediate syncope are proposed. The atrioventricular blocks can be paroxysmal or persistent, isolated or associated with sinus node disease. Neurally mediated syncope can be related to carotid sinus syndrome or cardioinhibitory vasovagal syncope...
February 20, 2018: Journal of Cardiovascular Medicine
Matteo Ziacchi, Pietro Palmisano, Mauro Biffi, Renato P Ricci, Maurizio Landolina, Massimo Zoni-Berisso, Eraldo Occhetta, Giampiero Maglia, Gianluca Botto, Luigi Padeletti, Giuseppe Boriani
: Modern pacemakers have an increasing number of programable parameters and specific algorithms designed to optimize pacing therapy in relation to the individual characteristics of patients. When choosing the most appropriate pacemaker type and programing, the following variables must be taken into account: the type of bradyarrhythmia at the time of pacemaker implantation; the cardiac chamber requiring pacing, and the percentage of pacing actually needed to correct the rhythm disorder; the possible association of multiple rhythm disturbances and conduction diseases; the evolution of conduction disorders during follow-up...
April 2018: Journal of Cardiovascular Medicine
Anne-Floor B E Quast, Fleur V Y Tjong, Brendan E Koop, Arthur A M Wilde, Reinoud E Knops, Martin C Burke
Aims: The development of communicating modular cardiac rhythm management systems relies on effective intrabody communication between a subcutaneous implantable cardioverter-defibrillator (S-ICD) and a leadless pacemaker (LP), using conducted communication. Communication success is affected by the LP and S-ICD orientation. This study is designed to evaluate the orientation of the LP and S-ICD in canine subjects and measure success and threshold of intrabody communication. To gain more human insights, we will explore device orientation in LP and S-ICD patients...
February 14, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Habib Rehman Khan, Ines Kralj-Hans, Shouvik Haldar, Toufan Bahrami, Jonathan Clague, Anthony De Souza, Darrel Francis, Wajid Hussain, Julian Jarman, David Gareth Jones, Neeraj Mediratta, Raad Mohiaddin, Tushar Salukhe, Simon Jones, Joanne Lord, Caroline Murphy, Joanna Kelly, Vias Markides, Dhiraj Gupta, Tom Wong
BACKGROUND: Atrial fibrillation is the commonest arrhythmia which raises the risk of heart failure, thromboembolic stroke, morbidity and death. Pharmacological treatments of this condition are focused on heart rate control, rhythm control and reduction in risk of stroke. Selective ablation of cardiac tissues resulting in isolation of areas causing atrial fibrillation is another treatment strategy which can be delivered by two minimally invasive interventions: percutaneous catheter ablation and thoracoscopic surgical ablation...
February 20, 2018: Trials
Marek Grygier, Wojtek Wojakowski, Grzegorz Smolka, Marcin Demkow, Wojtek Wąsek, Danuta Sorysz, Paweł Kralisz, Krzysztof Bartuś, Adam Sukiennik, Radosław Pracoń, Adam Witkowski, Oskar Kowalski, Jacek Legutko
Left atrial appendage (LAA) occlusion devices have the potential to influence the clinical approach to stroke prevention in patients with atrial fibrillation. A number of percutaneous techniques have been proposed, including various intracardiac plugs and also external ligation. Several devices have been already used in Poland. One of them has been evaluated in randomised controlled trials compared with the current standard of care. Others are less well studied but quite commonly used in Europe. It is anticipated that the use of LAA occlusion technologies in clinical practice will expand...
February 14, 2018: Kardiologia Polska
Serge Boveda, Radoslaw Lenarczyk, Stefano Fumagalli, Roland Tilz, Kinga Goscinska-Bis, Maciej Kempa, Pascal Defaye, Christelle Marquié, Alessandro Capucci, Laura Ueberham, Nikolaos Dagres
The purpose of this European Heart Rhythm Association (EHRA) prospective snapshot survey is to provide an overview of the factors influencing patient selection for the implantation of a particular type of device: subcutaneous implantable cardioverter-defibrillator (S-ICD) or transvenous implantable cardioverter-defibrillator (TV-ICD), across a broad range of tertiary European centres. A specially designed electronic questionnaire was sent via the internet to tertiary reference centres routinely implanting both TV-ICDs and S-ICDs...
February 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Emin Evren Özcan, Bülent Görenek
Although various cardiac monitoring methods were developed to detect subclinical arrhythmias, guidelines do not address in detail the management of subclinical atrial fibrillation and tachyarrhythmias. The European Heart Rhythm Association recently published a consensus document that addresses the clinical importance, implications, and management of device-detected subclinical atrial tachyarrhythmias. This paper comprehensively reviews the diagnostic tools to detect subclinical atrial arrhythmias and discusses the pathophysiologic link between devicedetected subclinical atrial fibrillation and stroke...
February 2018: Anatolian Journal of Cardiology
Jolien Haesen, Ward Eertmans, Cornelia Genbrugge, Ingrid Meex, Jelle Demeestere, Margot Vander Laenen, Willem Boer, Dieter Mesotten, Jo Dens, Frank Jans, Ludovic Ernon, Cathy De Deyne
AIMS: We aimed to validate retrospectively the accuracy of simplified electroencephalography (EEG) monitoring derived from the bispectral index (BIS) monitor in post-cardiac arrest (CA) patients. METHODS: Successfully resuscitated CA patients were transferred to the Catherization Lab followed by percutaneous coronary intervention when indicated. On arrival at the coronary care unit, bilateral BIS monitoring was started and continued up to 72 h. Raw simplified EEG tracings were extracted from the BIS monitor at a time point coinciding with the registration of standard EEG monitoring...
February 1, 2018: Resuscitation
Adam Wojtaszczyk, Guido Caluori, Martin Pešl, Katarina Melajova, Zdeněk Stárek
Atrial fibrillation (AF) is one of the most important problems in modern cardiology. Thermal ablation therapies, especially radiofrequency ablation (RF), are currently "gold standard" to treat symptomatic AF by localized tissue necrosis. Despite the improvements in reestablishing sinus rhythm using available methods, both success rate and safety are limited by the thermal nature of procedures. Thus, while keeping the technique in clinical practice, safer and more versatile methods of removing abnormal tissue are being investigated...
February 5, 2018: Journal of Cardiovascular Electrophysiology
Hideyuki Hasebe
BACKGROUND Left bundle branch block (LBBB) is associated with atrial fibrillation (AF) and systolic heart failure, which can be treated with cardiac resynchronization therapy (CRT) that includes an implantable cardiac device (ICD). However, in some patients, LBBB may vary with heart rate, and during episodes of AF in LBBB, aberrant ventricular conduction, or wide QRS complex tachycardia (Ashman beats) can occur. This report is a case of LBBB treated with pharmacologic CRT, without the use of an ICD. CASE REPORT A 68-year-old man presented with persistent AF and systolic heart failure...
February 2, 2018: American Journal of Case Reports
Massimo Zecchin, Jessica Artico, Gaetano Morea, Mara Severgnini, Elisabetta Bianco, Antonio De Luca, Anna Zorzin Fantasia, Luca Salvatore, Vittorino Milan, Matteo Lucarelli, Roberta Dissegna, Antonio Cannatà, Gianfranco Sinagra
AIM: During radiotherapy, in patients with implantable cardioverter-defibrillators (ICDs) malfunctions are considered more likely if doses more than 2 Gy reach the ICD site; however, most malfunctions occur with high-energy (>10 MV) radiations, and the risk is less defined using 6-MV linear accelerators. The purpose of the study is to experimentally evaluate the occurrence of malfunctions in ICDs radiated with a 6-MV linear accelerator at increasing photon doses. METHODS: Thirty-two ICDs from all manufacturers (31 explanted and one demo) were evaluated; all devices with a sufficient battery charge underwent multiple radiations with a 6-MV photon beam reaching a cumulative dose at ICD site of 0...
January 30, 2018: Journal of Cardiovascular Medicine
Pattara Rattanawong, Sikarin Upala, Tanawan Riangwiwat, Veeravich Jaruvongvanich, Anawin Sanguankeo, Wasawat Vutthikraivit, Eugene H Chung
PURPOSE: Recent studies suggest that atrial fibrillation (AF) is associated with increased cardiovascular risk and mortality including sudden cardiac death (SCD). According to the Cardiovascular Heath Study cohort, the incident rate of SCD was higher in the AF population (2.9 per 1000 per year) compared with non-AF controls (1.3 per 1000 per year). In this study, we performed a systematic review and meta-analysis to explore the association between AF and SCD. METHODS: We comprehensively searched the databases of MEDLINE and EMBASE from inception to January 2017...
January 13, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Benedict M Wiles, Caroline A Illingworth, Michael Lg Couzins, Paul R Roberts, Stephen P Harden
OBJECTIVE: At our tertiary cardiothoracic centre, cardiac MRI and thoracic CT scans are performed in patients with implanted LINQ devices. The degree of foreign body artefact associated with the LINQ device, and its clinical importance, has not previously been assessed. A case series review was therefore performed with a simultaneous review of patient safety and data loss events, secondary to the MRI environment. METHODS: A local database search identified LINQ device patients who underwent thoracic CT or cardiac MRI scans between March 2014 and December 2016...
February 1, 2018: British Journal of Radiology
Kristina Hermann Haugaa, Tatjana S Potpara, Serge Boveda, Jean-Calude Deharo, Jian Chen, Dan Dobreanu, Stefano Fumagalli, Radoslaw Lenarczyk, Antonio Hernandez Madrid, Torben Bjerregaard Larsen, Elena Sciarrafia, Milos Taborsky, Roland Richard Tilz, Paolo Pieragnoli, Andrzej Przybylski, Nikolaos Dagres
The purpose of this patient survey was to analyse the knowledge, experiences, and attitudes regarding cardiac implantable electronic devices (CIED) in patients with pacemakers, implantable cardioverter-defibrillators (ICDs), or cardiac resynchronization devices. Of the 1644 patients with CIEDs from seven European countries, 88% were over 50 years of age. Most patients (90%) knew what device they were implanted with and felt sufficiently informed about the indications for therapy. As many as 42% of patients needed additional information on the battery replacement and limitations in physical activity...
December 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Elisa Pelissero, Marco Giuggia, Maria Chiara Todaro, Giuseppe Trapani, Benedetta Giordano, Gaetano Senatore
BACKGROUND: We evaluated long-term safety and efficacy of concomitant left atrial appendage (LAA) closure and atrial fibrillation (AF) ablation. METHODS: From February 2013 to June 2017, all patients referred for AF ablation and LAA closure (group 1) were enrolled in the study and compared with a matched control group undergoing AF ablation only (group 2). Pulmonary vein isolation was achieved in all cases with radiofrequency or cryoballoon. LAA was occluded with Watchman or Amplatzer Cardiac Plug or Amulet (ACP) devices...
December 2017: Giornale Italiano di Cardiologia
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