Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Oct 2013
Randomized Controlled Trial Multicenter StudyEnd-of-life care in patients with implantable cardioverter defibrillators: a MADIT-II substudy.
Implantable cardioverter defibrillator (ICD)-delivered shocks can cause substantial distress, warranting consideration of ICD deactivation at end of life. This study was designed to describe the patterns of end-of-life management in patients with ICDs. ⋯ In patients with terminal conditions who are at risk for imminent death, active management of the patient's ICD, including timely discussions regarding ICD deactivation, may reduce the risk of ICD shocks during the end of life.
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Pacing Clin Electrophysiol · Oct 2013
Randomized Controlled TrialProphylactic high-dose oral-N-acetylcysteine does not prevent atrial fibrillation after heart surgery: a prospective double blind placebo-controlled randomized clinical trial.
Postoperative atrial fibrillation (POAF) following cardiac surgery is a frequent complication with multifactorial etiologies. Recently inflammation due to enhanced oxidative stress has been implicated in its pathogenesis. N-acetylcysteine (NAC) is a promising and novel antioxidant agent. The purpose of this study was to evaluate the efficacy of high-dose oral-NAC for prevention of POAF. ⋯ Prophylactic high-dose oral-NAC begun 2 days before open heart surgery and continued for 5 days, and had no significant effect on the incidence of POAF, in-hospital stay, and postoperative morbidity or mortality.
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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.
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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.
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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.