Pacing and clinical electrophysiology : PACE
-
Pacing Clin Electrophysiol · Apr 2014
Clinical TrialThe prevalence and contents of advance directives in patients with pacemakers.
Little is known about the use of advance directives (ADs) in patients who have implantable cardiac pacemakers (PMs). ⋯ More than half of the patients with PMs in our study had executed an AD, but only one patient specifically mentioned her PM in her AD. These results suggest that patients with PMs should be encouraged to execute ADs and specifically address end-of-life device management in their ADs. Doing so may prevent end-of-life ethical dilemmas related to PM management.
-
Pacing Clin Electrophysiol · Apr 2014
Comparative StudyComparison of ICD implantation in obese and nonobese patients.
Implantable defibrillator (ICD) therapy improves mortality in patients at risk for sudden cardiac death. Obese patients pose challenges during ICD implantation and may have an increased risk of procedure-related complications. The comparison of acute procedural success and safety of ICD implantation in obese and nonobese patients has not been previously reported. ⋯ Acute success and safety of ICD implantation is similar in both obese and nonobese patients. This finding extended to patients treated with a CRT-ICD and among patients with extreme obesity. Obesity should probably not be a factor in determining whether a patient is a candidate for ICD implantation.
-
Pacing Clin Electrophysiol · Apr 2014
Clinical TrialThe benefit of a second burst antitachycardia sequence for fast ventricular tachycardia in patients with implantable cardioverter defibrillators.
In patients with implantable cardioverter defibrillators (ICDs), an empirical burst of antitachycardia pacing (ATP) is moderately effective in terminating fast ventricular tachycardias (FVTs). It is unknown whether, in the case of failure of a first burst, a second burst attempt increases the efficacy of the intervention, without increasing morbidity. Our aim was to evaluate the safety and efficacy of a strategy of programming successive ATP sequences for FVT episodes. ⋯ The addition of a second burst pacing attempt increases the effectiveness of ATP for FVT and, therefore, reduces the need for high-energy shocks.