Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Feb 2012
Randomized Controlled Trial Comparative StudyComparison of the efficacy of two surgical alternatives for cardiac resynchronization therapy: trans-apical versus epicardial left ventricular pacing.
Epicardial pacing lead implantation is the currently preferred surgical alternative for left ventricular (LV) lead placement. For endocardial LV pacing, we developed a fundamentally new surgical method. The trans-apical lead implantation is a minimally invasive technique that provides access to any LV segments. The aim of this prospective randomized study was to compare the outcome of patients undergoing either trans-apical endocardial or epicardial LV pacing. ⋯ Our data suggest that trans-apical endocardial LV lead implantation is an alternative to epicardial LV pacing.
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Pacing Clin Electrophysiol · Feb 2012
Case ReportsDeath and near death from cardiac arrest during the Boston Marathon.
The Boston Marathon has been run for 115 years during which there were three sudden cardiac arrests. The most recent was a near death avoided by rapid cardiopulmonary resuscitation (CPR) and defibrillation. Awareness of the dangers of participating in a marathon, the risk factors associated with sudden death during competition, and the life-saving importance of rapid CPR and defibrillation are essential for participants and event organizers. ⋯ Prevention or reduction of life-threatening cardiac incidents during marathon races might be achieved if participants of advanced age or with a history of coronary artery disease seek medical clearance prior to entering an event. Those with coronary risk factors should have a discussion with their physician. Availability of trained personnel and defibrillators are important considerations in marathon planning.
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Pacing Clin Electrophysiol · Jan 2012
Safety aspects of deep sedation during catheter ablation of atrial fibrillation.
The combination of intravenous propofol and midazolam is frequently used to provide unconscious sedation during catheter ablation of atrial fibrillation (AF), but only a very few reports are available on the influence of prolonged propofol infusion on arterial blood gas, blood pressure, and anesthesia-associated complications during ablation of AF. The purpose of this study was to assess tolerance and safety of unconscious sedation with intravenous propofol and midazolam during catheter ablation of AF. ⋯ Unconscious sedation with propofol and midazolam in AF ablation procedures lasting 3-5 hours did not result in severe changes of vital parameters or serum electrolytes. Anesthesia-associated problems were not observed. Propofol and midazolam can be safely used during catheter ablation of AF.
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Pacing Clin Electrophysiol · Jan 2012
Accurate guidance of a catheter by ultrasound imaging and identification of a catheter tip by pulsed-wave Doppler.
With the advent of numerous minimally invasive medical procedures, accurate catheter guidance has become imperative. We introduce and test an approach for catheter guidance by ultrasound imaging and pulsed-wave (PW) Doppler. ⋯ Although early in the development process, these quantitative in vitro results show promise for catheter guidance with ultrasound imaging and tip identification by PW Doppler.