Pacing and clinical electrophysiology : PACE
-
Pacing Clin Electrophysiol · Sep 2013
Comparative Study Controlled Clinical TrialA comparison of steep and shallow needle trajectories in blind axillary vein puncture.
Previously developed techniques for pacemaker lead introduction usually require some form of image guidance to facilitate the axillary vein puncture process. The existing blind vein puncture methods have not gained widespread acceptance. We aimed to investigate whether our blind vein puncture approach is effective and safe. ⋯ Our shallow needle puncture technique does not require any extra equipment. In addition, this method is effective and safe and may be used as the initial attempt for venous access during pacemaker implantation.
-
Pacing Clin Electrophysiol · Sep 2013
Postoperative junctional ectopic tachycardia: risk factors for occurrence in the modern surgical era.
Postoperative (PO) junctional ectopic tachycardia (JET) can be a life-threatening arrhythmia that follows surgical repair of congenital heart disease (CHD) and results in PO morbidity. ⋯ JET occurred more commonly following OHS associated with prolonged surgical times and PO use of inotropic medications. In contrast to previous reports, our results suggest that mechanical injury to the atrioventricular node area is not strongly associated with JET.
-
Pacing Clin Electrophysiol · Sep 2013
Axillary vein puncture without contrast venography for pacemaker and defibrillator leads implantation.
Axillary vein puncture has been demonstrated to be an effective method for pacemaker and defibrillator leads implantation, without the complications encountered with the standard intrathoracic approach. ⋯ Our approach of axillary venipunture using fluoroscopic landmark, without contrast venography, is simple, safe, and effective.
-
Patients with preexisting mild cognitive impairment or dementia may be at increased risk for developing cardiac device complications due to an impaired ability to follow postimplant care instructions. We sought to determine whether rates of infection, lead dislodgement, or appropriate or inappropriate implantable cardioverter defibrillator (ICD) shocks are increased in this population. ⋯ Patients with cognitive impairment and standard device indications are not at increased risk for device complications and therapy but their survival is much lower than in matched controls. The cause of this lower survival is unknown but may be related to the underlying neurological disease. Presence of cognitive impairment should therefore be considered when contemplating implantation of a cardiac device.