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Dual defibrillation

Marcin Michalak, Andrzej Cacko, Agnieszka Kapłon-Cieślicka, Monika Budnik, Przemysław Stolarz, Grzegorz Opolski, Marcin Grabowski
BACKGROUND: Single-lead for implantable cardioverter-defibrillator (ICD) with floating atrial sensing dipole is a new diagnostic tool with the potential advantage in terms of arrhythmia discrimination. We sought to determine whether right heart size and dipole position influence atrial sensing. METHODS: Atrial sensing amplitude (AS) was measured during implantation (PP, periprocedural), predischarge (IHFU, in-hospital follow-up) and 3-6 months after the procedure (AFU, ambulatory follow-up)...
October 17, 2016: Cardiology Journal
Mateusz Tajstra, Elżbieta Gadula-Gacek, Anna Kurek, Elżbieta Adamowicz-Czoch, Dawid Olszowski, Mateusz Ostręga, Aneta Ciślak, Łukasz Pyka, Michał Hawranek, Andrzej Lekston, Lech Poloński, Mariusz Gąsior
BACKGROUND: Current real-life information from all-comers registries from middle and east Europe about the incidence and type of complications during long-term follow-up of patients with cardioverters-defibrillators (ICD) and cardiac resynchronization devices-defibrillators (CRT-D) is still insufficient. The aim of the study was to assess the incidence and determinants of short- and long-term complications related to implantable ICD and CRT-D. METHODS: We studied 1,105 recipients hospitalized in our center in 2009-2013, followed for a mean of 2...
October 13, 2016: Cardiology Journal
Eran Leshem, Mahmoud Suleiman, Avishag Laish-Farkash, Yuval Konstantino, Michael Glikson, Alon Barsheshet, Ilan Goldenberg, Yoav Michowitz
AIMS: Dual-coil leads were traditionally considered standard of care due to lower defibrillation thresholds (DFT). Higher complication rates during extraction with parallel progression in implantable cardioverter defibrillator (ICD) technology raised questions on dual coil necessity. Prior substudies found no significant outcome difference between dual and single coils, although using higher rates of DFT testing then currently practiced. We evaluated the temporal trends in implantation rates of single- vs...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
W Amara, S Naccache, C Akret, S Cheggour, S M'Zoughi, G Galuscan, A Dompnier
INTRODUCTION: Management of antiplatelet therapy at the time of device implantation remains controversial. This study aimed to assess the risk of bleeding complications in patients receiving ticagrelor at the time of cardiac device surgery. METHODS: We performed a multicentre (n=4), retrospective study from January 2015 to January 2016. The survey included all patients (pts) treated with ticagrelor before undergoing pacemaker, implantable cardioverter-defibrillator (ICD) implantation or generator replacement...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Laurent Fauchier, Christine Alonso, Frédéric Anselme, Hugues Blangy, Pierre Bordachar, Serge Boveda, Nicolas Clementy, Pascal Defaye, Jean-Claude Deharo, Patrick Friocourt, Daniel Gras, Franck Halimi, Didier Klug, Jacques Mansourati, Benjamin Obadia, Jean-Luc Pasquié, Dominique Pavin, Nicolas Sadoul, Jérôme Taieb, Olivier Piot, Olivier Hanon
Despite the increasingly high rate of implantation of pacemakers (PM) and cardioverter-defibrillators (ICD) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety, and effectiveness of the conventional pacing, ICD and cardiac resynchronization therapy (CRT) in elderly patients. Although peri-procedural risk may be slightly higher in the elderly, the procedure of implantation of PMs and ICDs is still relatively safe in this age group...
September 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Mark L Brown, Charles D Swerdlow
Ensuring sensing and detection of ventricular tachycardia (VT) and ventricular fibrillation (VF) was a prerequisite for the clinical trials that established the survival benefit of implantable cardioverter defibrillators (ICDs). However, for decades, a high incidence of unnecessary shocks limited patients' and physicians' acceptance of ICD therapy. Oversensing, misclassification of supraventricular tachycardia (SVT) as VT, and self-terminating VT accounted for the vast majority of unnecessary shocks. Medtronic ICDs utilize sensitive baseline settings with minimal blanking periods to ensure accurate sensing of VF, VT, and SVT electrograms...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Carsten W Israel, Tatsiana Burmistrava
Optimal implantable cardioverter-defibrillator (ICD) programming can reduce the incidence of inappropriate shock therapy and improve prognosis in patients with an ICD. Only after results from randomized trials became available was the "safety first" feeling overcome that mandated early shock therapy, waived the use of antitachycardia pacing and forced shock therapy after a time of 30 s expired, even if tachycardia discriminators would have withheld the therapy. The strong evidence to limit ICD therapy to longer ventricular tachycardia (VT) should not result in individually dangerous ICD programming, particularly in patients with a high risk of slow VT (known monomorphic VT, post VT ablation, during treatment with amiodarone, very dilated left ventricle)...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Simon Pecha, Yalin Yildirim, Nils Gosau, Muhammet Ali Aydin, Stephan Willems, Hendrik Treede, Hermann Reichenspurner, Samer Hakmi
OBJECTIVES: Lead extraction in patients with multiple or old leads of an implantable cardioverter defibrillator (ICD) is challenging. As adhesions are common at the side of the shock coils, we investigated success and procedural complication rates of laser lead extraction procedures in single- and dual-coil leads. METHODS: Between January 2001 and June 2013, 41 single- and 145 dual-coil ICD leads were extracted from 171 patients using laser sheaths. Procedural data, success rates and complications were collected into a database and retrospectively analysed...
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
Jan Zdarek, Carsten W Israel
Modern implantable cardioverter/defibrillator (ICD) systems offer a multitude of algorithms to optimize performance in sensing and tachycardia detection even in difficult circumstances (e. g., ventricular tachycardia during supraventricular tachycardia, fine ventricular fibrillation with intermittent undersensing), to reliably discriminate sustained ventricular tachyarrhythmia from noise, nonsustained and supraventricular tachyarrhythmia, and to limit shock therapy only to those arrhythmias that definitely need to be treated by a shock...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Daniel J Friedman, Craig S Parzynski, Paul D Varosy, Jordan M Prutkin, Kristen K Patton, Ali Mithani, Andrea M Russo, Jeptha P Curtis, Sana M Al-Khatib
Importance: Trends and in-hospital outcomes associated with early adoption of the subcutaneous implantable cardioverter defibrillator (S-ICD) in the United States have not been described. Objectives: To describe early use of the S-ICD in the United States and to compare in-hospital outcomes among patients undergoing S-ICD vs transvenous (TV)-ICD implantation. Design, Setting, and Participants: A retrospective analysis of 393 734 ICD implants reported to the National Cardiovascular Data Registry ICD Registry, a nationally representative US ICD registry, between September 28, 2012 (US Food and Drug Administration S-ICD approval date), and March 31, 2015, was conducted...
September 7, 2016: JAMA Cardiology
Thomas Brüggemann, Daniel Dahlke, Amin Chebbo, Ilka Neumann
Implantable cardioverter-defibrillators (ICD) have to reliably sense, detect, and treat malignant ventricular tachyarrhythmias. Inappropriate treatment of non life-threatening tachyarrhythmias should be avoided. This article outlines the functionality of ICDs developed and manufactured by BIOTRONIK. Proper sensing is achieved by an automatic sensitivity control which can be individually tailored to solve special under- and oversensing situations. The programming of detection zones for ventricular fibrillation (VF), ventricular tachycardia (VT), and zones to monitor other tachyarrhythmias is outlined...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Masayasu Komatsu, Jun Takahashi, Koji Fukuda, Yusuke Takagi, Takashi Shiroto, Makoto Nakano, Masateru Kondo, Ryuji Tsuburaya, Kiyotaka Hao, Kensuke Nishimiya, Taro Nihei, Yasuharu Matsumoto, Kenta Ito, Yasuhiko Sakata, Satoshi Miyata, Hiroaki Shimokawa
BACKGROUND: Optimal therapy for patients resuscitated from out-of-hospital cardiac arrest (OHCA) who are not found to have structural heart disease remains to be established, especially regarding the use of implantable cardioverter-defibrillators. Coronary artery spasm (CAS) and lethal ventricular arrhythmias are important causes of OHCA. METHODS AND RESULTS: In 47 consecutive OHCA survivors without structural heart disease who had fully recovered (M/F 44/3, 43±13 years...
September 2016: Circulation. Arrhythmia and Electrophysiology
Hideo Okamura, Paul A Friedman, Yuko Inoue, Takashi Noda, Takeshi Aiba, Satoshi Yasuda, Hisao Ogawa, Shiro Kamakura, Kengo Kusano, Raul E Espinosa
BACKGROUND: Single-coil defibrillator leads have gained favor because of their potential ease of extraction. However, a high defibrillation threshold remains a concern in patients with hypertrophic cardiomyopathy (HCM), and in many cases, dual-coil leads have been used for this patient group. There is little data on using single-coil leads for HCM patients. METHODS AND RESULTS: We evaluated 20 patients with HCM who received an implantable cardioverter-defibrillator (ICD) on the left side in combination with a dual-coil lead...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Charles D Deakin, Richard E Kerber
No abstract text is available yet for this article.
August 23, 2016: Resuscitation
José M Porres-Aracama, José Luis Cerezuela, Francisco García-Urra, Oscar Luque-Lezcano, Vicente Herrero
In patients with permanent atrial fibrillation (AF) and implantable cardioverter-defibrillator (ICD) implant indication, a single-chamber device is the choice because AF does not provide interesting information for the treatment. It is very unusual to find patients with permanent AF that coexist with atrial tachycardia with various degree of Atrioventricular block.
August 2016: Clinical Case Reports
A Schmutz, P Quaas, S Grundmann
A 32-year-old woman at 32 weeks gestation presented with cardiac arrest due to ventricular tachycardia following acute chest pain at home. After immediate defibrillation with return of spontaneous circulation (ROSC), an ST segment elevation myocardial infarction due to coronary artery dissection was confirmed. Two drug-eluting stents were implanted and she was placed on dual antiplatelet therapy (DAPT). The echocardiogram showed akinesis of the apex and anterior wall. The patients risk for stent thrombosis was considered high and therefore DAPT was continued until cesarean section at 35 weeks gestation...
September 2016: Der Anaesthesist
Haran Burri
This case describes a tachycardia with a 1:1 atrioventricular relationship that was effectively terminated with antitachycardia pacing by the implantable cardioverter defibrillator. The differential diagnosis and clues that allow the reader to establish the correct diagnosis are discussed. The case also serves to analyse technical features of Boston Scientific dual-chamber defibrillators.
September 2016: Herzschrittmachertherapie & Elektrophysiologie
S Serge Barold, F Van Heuverswyn
A patient with a dual chamber implantable cardioverter-defibrillator developed a defective atrial lead whereupon the generated false atrial signals were repeatedly interpreted as atrial tachycardia/atrial fibrillation (AF) by the atrial upper rate algorithm coupled with rare episodes of noise reversion. This unusual response highlights the limitations of the upper atrial rate triggers of device diagnosis of supraventricular tachyarrhythmias. The converse may occur with a very fine AF or with a very sensitive sensitivity setting (e...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Rodney C Sena, Samuel Eldrich, Richard M Pescatore, Anthony Mazzarelli, Richard G Byrne
BACKGROUND: Current guidelines for the treatment of adult patients in cardiac arrest are supplied by the American Heart Association through basic life support and advanced cardiovascular life support (ACLS) provider courses. When treatments defined by the ACLS guidelines are unsuccessful in terminating a lethal dysrhythmia, the use of alternative strategies may prove useful. In this case, two defibrillators were used to deliver a greater than normal energy waveform over an extended time interval to return a patient to a normal sinus rhythm...
September 2016: Journal of Emergency Medicine
Elliot M Ross, Theodore T Redman, Stephen A Harper, Julian G Mapp, David A Wampler, David A Miramontes
STUDY OBJECTIVES: The goal of our study is to determine if prehospital dual defibrillation (DD) is associated with better neurologically intact survival in out-of-hospital cardiac arrest. METHODS: This study is a retrospective cohort analysis of prospectively collected Quality Assurance/Quality Improvement data from a large urban fire based EMS system out-of-hospital cardiac arrest (OHCA) database between Jan 2013 and Dec 2015. Our inclusion criteria were administration of DD or at least four conventional 200J defibrillations for cases of recurrent and refractory ventricular fibrillation (VF)...
September 2016: Resuscitation
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