Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Jul 2012
Clinical TrialEvolution in transvenous extraction of pacemaker and implantable cardioverter defibrillator leads using a mechanical dilator sheath.
With developing technology, transvenous lead extraction (TLE) has undergone an explosive evolution due to incremental problems related to lead infection and malfunction. ⋯ Our experience confirms that the hand-powered Evolution system is an effective extraction tool for chronically implanted PM/ICD leads. Randomized controlled studies are required to evaluate success and complication rates in comparison to other techniques.
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Pacing Clin Electrophysiol · Jun 2012
Multicenter Study Clinical TrialMulticenter experience with transvenous lead extraction of active fixation coronary sinus leads.
Active fixation coronary sinus (CS) leads limit dislodgement and represent an attractive option to the implanter. Although extraction of passive fixation CS leads is a common and frequently uncomplicated procedure, data regarding extraction of chronically implanted active fixation CS leads are limited. ⋯ Although TLE of active fixation CS leads can be a safe procedure in select patients and experienced hands, powered sheaths and aggressive techniques are frequently required for successful removal despite relatively short implant durations. This raises significant concern regarding future TLE of active fixation CS leads with longer implant durations.
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Pacing Clin Electrophysiol · Jun 2012
Case ReportsInduction of ventricular tachycardia by alternate current due to an insufficiently grounded electrical system.
Detection of electromagnetic interference followed by inappropriate therapy by implantable cardioverter-defibrillators (ICDs) has been well documented in several case reports as well as in follow-up studies. This is a report of a case where electromagnetic interference induced ventricular tachycardia, with appropriate detection and treatment by the patient's ICD.
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Pacing Clin Electrophysiol · May 2012
Case ReportsVentricular tachycardia from remote blunt chest trauma: combined epicardial-endocardial right ventricular substrate characterization.
Ventricular tachycardia as a late complication of blunt chest trauma has never been reported. We present a case of combined endocardial and epicardial delineation of the right ventricular arrhythmogenic substrate, where other causes of cardiomyopathy were excluded. The epicardial scar was more extensive than endocardial scar, and the central isthmus was likely intramural. A history of blunt chest trauma should be considered in patients with right ventricular cardiomyopathy.
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Pacing Clin Electrophysiol · May 2012
The use of advance directives among patients with implantable cardioverter defibrillators.
We aimed to determine the prevalence of advance directives (ADs) among patients with implantable cardioverter defibrillators (ICDs) and of ADs that addressed ICD management at the end of life. ⋯ About one-third of patients with ICDs had an AD, but only a couple ADs mentioned the ICD. These results suggest that clinicians should not only encourage patients with ICDs to complete an AD, but also encourage them to address ICD management specifically. Not addressing ICD management in an AD may result in ethical dilemmas during end-of-life care.