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https://www.readbyqxmd.com/read/29781854/salvage-of-threatened-cardiovascular-implantable-electronic-devices-case-series-and-review-of-literature
#1
Andrew M Simpson, W Tyler Rockwell, Roger A Freedman, W Bradford Rockwell
BACKGROUND: The treatment of infected or exposed cardiac pacing and defibrillator devices is controversial. The conservative and widely accepted management calls for removal of the device and leads with immediate or delayed replacement of new components in a new site. Lead extraction carries a 2% major complication risk. In this article, we describe our experience with device salvage techniques and review the current literature. METHODS: This is a retrospective case series of consecutive patients with infected, exposed, or at-risk implanted cardiac devices that were treated with aggressive surgical debridement, local pocket irrigation, and revision...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29779529/inhibition-and-restoration-of-crt-pacing-what-is-the-mechanism
#2
Andrzej Ząbek, Barbara Małecka, Maciej Dębski, Krzysztof Boczar, Katarzyna Holcman, Mateusz Ulman, Jacek Lelakowski
The electrocardiogram (ECG) interpretation in patients with cardiac resynchronization therapy (CRT) may be challenging. The difficulty increases if not well-known pacemaker algorithm is turned on. We show a T-wave protection algorithm (LVTP) in a patient with CRT. Accelerated sinus rhythm and intermittent oversensing in left ventricular channel resulted in loss of CRT pacing. The restoration of biventricular pacing occurred when atrial rate decreased. We provide detailed descriptions of the electrocardiogram and intracardiac electrogram...
May 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29779297/cardiac-rhythm-management-devices
#3
Irene Stevenson, Alex Voskoboinik
BACKGROUND: The last decade has seen ongoing evolution and use of cardiac rhythm management devices, including pacemakers, cardiac resynchronisation therapy, implantable cardioverter defibrillators and loop recorders. General practitioners are increasingly involved in follow-up and management of patients with these devices. OBJECTIVE: The aim of this article is to provide an overview of different cardiac rhythm management devices, including their role, implant procedure, post-procedural care, potential complications and follow‑up...
May 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29771730/vagal-mediation-of-low-frequency-heart-rate-variability-during-slow-yogic-breathing
#4
Bryan W Kromenacker, Anna A Sanova, Frank I Marcus, John J B Allen, Richard D Lane
OBJECTIVE: Changes in heart rate variability (HRV) associated with breathing (respiratory sinus arrhythmia [RSA]) are known to be parasympathetically (vagally) mediated when the breathing rate is within the typical frequency range (9-24 breaths/min; high frequency HRV). Slow yogic breathing occurs at rates below this range and increases low frequency HRV power, which may additionally reflect a significant sympathetic component. Yogic breathing techniques are hypothesized to confer health benefits by increasing cardiac vagal control, but increases in low frequency HRV power cannot unambiguously distinguish sympathetic from parasympathetic contributions...
May 16, 2018: Psychosomatic Medicine
https://www.readbyqxmd.com/read/29771311/pathobiology-of-cardiac-dyssynchrony-and-resynchronization-therapy
#5
Uyên Châu Nguyên, Nienke J Verzaal, Frans A van Nieuwenhoven, Kevin Vernooy, Frits W Prinzen
Synchronous ventricular electrical activation is a prerequisite for adequate left ventricular (LV) systolic function. Conduction abnormalities such as left bundle branch block, and ventricular pacing lead to a dyssynchronous electrical activation sequence, which may have deleterious consequences. The present review attempts to connect the various processes involved in the development of 'dyssynchronopathy', and its correction by cardiac resynchronization therapy (CRT). Abnormal electrical impulse conduction leads to abnormal contraction, characterized by regional differences in timing as well as shortening patterns and amount of external work performed...
May 15, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29770365/is-the-epicardial-left-ventricular-lead-implantation-an-alternative-approach-to-percutaneous-attempt-in-patients-with-steinert-disease-a-case-report
#6
Andrea Antonio Papa, Anna Rago, Roberta Petillo, Paola D'Ambrosio, Marianna Scutifero, Marisa DE Feo, Ciro Maiello, Alberto Palladino
Steinert's disease or Myotonic Dystrophy type 1 (DM1) is an autosomal dominant multisystemic disorder characterized by myotonia, muscle and facial weakness, cataracts, cognitive, endocrine and gastrointestinal involvement, and cardiac conduction abnormalities. Although mild myocardial dysfunction may be detected in this syndrome with age, overt myocardial dysfunction with heart failure is not frequent. Cardiac resynchronization therapy is an effective treatment to improve morbidity and reduce mortality in patients with DM1 showing intra-ventricular conduction delay and/or congestive heart failure...
December 2017: Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology
https://www.readbyqxmd.com/read/29761338/-journey-of-the-s%C3%A2-icd-to-first-line-therapy
#7
REVIEW
Elif Kaya, Reza Wakili, Tienush Rassaf
The subcutaneous implantable cardioverter-defibrillator (S-ICD®, Boston Scientific, Marlborough, MA, USA, previously Cameron Health, San Clemente, CA, USA) represents an important milestone in ICD therapy for prevention of sudden cardiac death (SCD). Since the introduction of the S‑ICD in 2010, the device has undergone further development. Based on the unique feature of an entirely extracardiac implantation, the S‑ICD is able to reduce the common perioperative and long-term complications of the usual endovascular implanted ICD systems...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29761336/-syncope-in-children-and-adolescents
#8
REVIEW
Matthias J Müller, Thomas Paul
Syncope is common in children and adolescents. Neurally mediated syncope including pallid and cyanotic breath holding spells, vagovasal syncope and neurocardiogenic syncope is based on a common pathomechanism and accounts for approximately 75% of cases. A potentially life-threatening cardiac cause of syncope may be present in up to 6%. Detailed history, physical examination and 12-lead electrocardiogram (ECG) allow discrimination between benign and serious syncope in the majority of pediatric patients. Tilt-testing can be useful when diagnosis is unclear...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29759833/cardiac-resynchronization-therapy-with-multipoint-left-ventricular-lead-pacing
#9
EDITORIAL
Jeroen J Bax, Victoria Delgado
No abstract text is available yet for this article.
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759832/safety-and-efficacy-of-multipoint-pacing-in-cardiac-resynchronization-therapy-the-multipoint-pacing-trial
#10
Imran Niazi, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Robert Sheppard, Seth J Worley, Niraj Varma, Kwangdeok Lee, Gery Tomassoni
OBJECTIVES: The MultiPoint Pacing (MPP) trial assessed the safety and efficacy of pacing 2 left ventricular sites with a quadripolar lead in patients with heart failure indicated for a CRT-D device. BACKGROUND: Cardiac resynchronization therapy nonresponse is a complex problem where stimulation of multiple left ventricular sites may be a solution. METHODS: Enrolled patients were indicated for a CRT-D system. Bi-ventricular (Bi-V) pacing was activated at implant...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759829/acute-and-3-month-performance-of-a-communicating-leadless-antitachycardia-pacemaker-and-subcutaneous-implantable-defibrillator
#11
Fleur V Y Tjong, Tom F Brouwer, Brendan Koop, Brian Soltis, Allan Shuros, Brian Schmidt, Bryan Swackhamer, Anne-Floor E B Quast, Arthur A M Wilde, Martin C Burke, Reinoud E Knops
OBJECTIVES: The primary objective was to assess the acute and 3-month performance of the modular antitachycardia pacing (ATP)-enabled leadless pacemaker (LP) and subcutaneous implantable cardioverter-defibrillator (S-ICD) system, particularly device-device communication and ATP delivery. BACKGROUND: Transvenous pacemakers and implantable cardioverter-defibrillators (ICDs) have considerable rates of lead complications. We examined the next step in multicomponent leadless cardiac rhythm management: feasibility of pacing (including ATP) by a LP, commanded by an implanted S-ICD through wireless, intrabody, device-device communication...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759782/regional-left-ventricular-electrical-activation-and-peak-contraction-are-closely-related-in-candidates-for-cardiac-resynchronization-therapy
#12
Masih Mafi-Rad, Jetske Van't Sant, Yuri Blaauw, Pieter A Doevendans, Maarten J Cramer, Harry J Crijns, Frits W Prinzen, Mathias Meine, Kevin Vernooy
OBJECTIVES: This study determined the relationship between the timing of left ventricular (LV) electrical activation and peak contraction at potential LV pacing locations in candidates for cardiac resynchronization therapy (CRT). BACKGROUND: Targeting the LV lead to the region of latest electrical activation or the segment of latest peak contraction has both been shown to improve CRT response. Whether these regions correspond within CRT patients is uncertain. METHODS: Twenty-eight consecutive CRT candidates underwent intraprocedural coronary venous electroanatomic mapping using EnSite NavX...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759779/16-years-of-cardiac-resynchronization-pacing-among-congenital-heart-disease-patients-direct-contractility-dp-dt-max-screening-when-the-guidelines-do-not-apply
#13
Peter P Karpawich, Neha Bansal, Sharmeen Samuel, Yamuna Sanil, Kathleen Zelin
OBJECTIVES: The purpose of this study was to use direct cardiac resynchronization therapy (CRT)-paced contractility (dP/dt-max) response as a pre-implantation evaluation among patients with congenital heart disease (CHD) and follow clinical parameters and contractility indexes after CRT implantation. BACKGROUND: Patients with CHD often develop early heart failure with few therapeutic options, leading to heart transplantation (HT). Unfortunately, guidelines for CRT do not apply, and function evaluations by cardiac ultrasound are often inaccurate among CHD anatomies...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759775/real-time-x-mri-guided-left-ventricular-lead-implantation-for-targeted-delivery-of-cardiac-resynchronization-therapy
#14
Jonathan M Behar, Peter Mountney, Daniel Toth, Sabrina Reiml, Maria Panayiotou, Alexander Brost, Bernhard Fahn, Rashed Karim, Simon Claridge, Tom Jackson, Ben Sieniewicz, Nik Patel, Mark O'Neill, Reza Razavi, Kawal Rhode, Christopher Aldo Rinaldi
OBJECTIVES: This study sought to test the feasibility of a purpose-built, integrated software platform to process, analyze, and overlay cardiac magnetic resonance (CMR) data in real time within a combined cardiac catheter laboratory and magnetic resonance imaging scanner suite (X-MRI) to guide left ventricular (LV) lead implantation. BACKGROUND: Suboptimal LV lead position is a major determinant of poor cardiac resynchronization therapy (CRT) response, and the optimal site is highly patient specific...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759631/idiopathic-lead-migration-concept-and-variants-of-an-uncommon-cause-of-cardiac-implantable-electronic-device-dysfunction
#15
José L Morales, Santiago Nava, Manlio F Márquez, Jorge González, Jorge Gómez-Flores, Luis Colín, Marco A Martínez-Ríos, Pedro Iturralde
OBJECTIVES: This cumulative case study was performed to properly address the possible mechanisms, forms, and consequences of "twiddler's," "reel," and "ratchet" syndromes. BACKGROUND: Twiddler's, reel, and ratchet syndromes are rare entities responsible for lead displacement of cardiac implantable electronic devices (CIED). METHODS: From 2007 to 2012, 1,472 CIED were implanted at our center. Eighty-nine cases were reviewed for failure of pacing circuit integrity...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759615/enhancing-response-in-the-cardiac-resynchronization-therapy-patient-the-3b-perspective-bench-bits-and-bedside
#16
REVIEW
Angelo Auricchio, Frits W Prinzen
Cardiac resynchronization therapy (CRT) is an established nonpharmacological treatment for patients with heart failure (HF), reduced left ventricular (LV) ejection fraction, and a wide QRS complex. Although the therapy was developed 30 years ago and approved by the Food and Drug Administration in 2001, attempts to improve it have never stopped. Such improvements have been facilitated by combining knowledge from bench (basic science), bits (computer modeling), and bedside (clinical studies); these issues are addressed in the present review...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29755632/is-there-always-a-need-for-permanent-pacemaker-replacement-after-device-infection-a-tale-of-two-patients
#17
Munish Sharma, Daniel A N Mascarenhas
There has been an increase in number of cardiac implantable electronic devices (CIEDs) implantation and with this we have witnessed increased rates of CIED infection mainly in elderly population. It is important to assess conditions that may not reliably improve with cardiac pacing or those who lack adequate beneficial effect from permanent pacing before contemplating implantation or reimplantation of these devices. Sometimes, the initial cardiac pathology may revert obviating the need for reimplantation as in the two cases that we have discussed below...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29754959/human-induced-pluripotent-stem-cell-derived-cardiac-cell-sheets-expressing-genetically-encoded-voltage-indicator-for-pharmacological-and-arrhythmia-studies
#18
Naim Shaheen, Assad Shiti, Irit Huber, Rami Shinnawi, Gil Arbel, Amira Gepstein, Noga Setter, Idit Goldfracht, Amit Gruber, Snizhanna V Chorna, Lior Gepstein
Fulfilling the potential of human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes for studying conduction and arrhythmogenesis requires development of multicellular models and methods for long-term repeated tissue phenotyping. We generated confluent hiPSC-derived cardiac cell sheets (hiPSC-CCSs), expressing the genetically encoded voltage indicator ArcLight. ArcLight-based optical mapping allowed generation of activation and action-potential duration (APD) maps, which were validated by mapping the same hiPSC-CCSs with the voltage-sensitive dye, Di-4-ANBDQBS...
May 7, 2018: Stem Cell Reports
https://www.readbyqxmd.com/read/29752679/wavelet-promoted-sparsity-for-non-invasive-reconstruction-of-electrical-activity-of-the-heart
#19
Matthijs Cluitmans, Joël Karel, Pietro Bonizzi, Paul Volders, Ronald Westra, Ralf Peeters
We investigated a novel sparsity-based regularization method in the wavelet domain of the inverse problem of electrocardiography that aims at preserving the spatiotemporal characteristics of heart-surface potentials. In three normal, anesthetized dogs, electrodes were implanted around the epicardium and body-surface electrodes were attached to the torso. Potential recordings were obtained simultaneously on the body surface and on the epicardium. A CT scan was used to digitize a homogeneous geometry which consisted of the body-surface electrodes and the epicardial surface...
May 12, 2018: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29752526/application-of-the-bogossian-formula-for-evaluation-of-the-qt-interval-in-pacemaker-patients-with-stimulated-left-bundle-branch-block
#20
K F Weipert, H Bogossian, P Conzen, G Frommeyer, C Gemein, I Helmig, R Chasan, L Eckardt, M Seyfarth, B Lemke, M Zarse, C W Hamm, J Schmitt, D Erkapic
BACKGROUND: The presence of left bundle branch block (LBBB) represents a particular challenge in properly measuring the QT interval. Here we demonstrate the applicability of the "Bogossian formula" in pacemaker patients with LBBB due to apical or nonapical right ventricular (RV) pacing and preserved left ventricular function. METHODS: A total of 163 patients with a cardiac one- or two-chamber pacemaker were included in this prospective, multicentre observational study...
May 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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