Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Nov 2004
Endocardial pacemaker implantation in infants weighing < or = 10 kilograms.
Epicardial pacemaker implantation is the most common approach for small children requiring pacemaker implantation, though it is not free from complications. This article reviews the experience with endocardial pacemaker implantation, as an alternative approach, in children < or =10 kg at two centers. Thirty-nine children, median age 3.8 months (2 days-35 months), weight 4.6 kg (2.3-10 kg) underwent endocardial permanent pacing (VVI/R in 38, DDDR in 1). ⋯ Infective endocarditis on the lead, 9 months postimplant required removal of the system in one patient. The subclavian vein was found to be asymptomatically thrombosed in four patients. Endocardial permanent pacing is feasible and effective in children < or = 10 kg and an acceptable alternative to epicardial pacing.
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Pacing Clin Electrophysiol · Nov 2004
Case ReportsExtraction of a defibrillator lead through an inferior vena cava filter.
We report an extraction of a chronic, previously cut and abandoned, active-fixation implantable cardioverter-defibrillator lead through an inferior vena cava filter. A long workstation sheath that crossed the filter was used, allowing the lead and all hardware to be withdrawn through a single opening in the filter.
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Pacing Clin Electrophysiol · Sep 2004
Electrophysiological mechanisms and catheter ablation of complex atrial arrhythmias from crista terminalis:.
Paroxysmal atrial fibrillation (PAF) can be initiated by ectopic activation from the crista terminalis. The crista terminalis conduction gap is also a critical isthmus in atrial reentrant arrhythmias like upper and lower loop reentry. The aim of this study was to investigate the mechanism and results of catheter ablation for complex atrial arrhythmias originating from the crista terminalis using the noncontact mapping system (NCM). ⋯ During a mean follow-up of 9 +/- 5 months (range 5-18 months), five patients were free of AF without antiarrhythmic drugs, and one patient did not have AF or atrial flutter using propafenone. NCM demonstrated the mechanism of crista terminalis ectopy-initiating AF and associated typical/atypical atrial flutter. Catheter ablation of crista terminalis ectopy and substrate for the reentry guided by NCM successfully eliminated these atrial arrhythmias.
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Pacing Clin Electrophysiol · Aug 2004
Immediate and 1-year survival of out-of-hospital cardiac arrest victims in southern New Jersey: 1995-2000.
Most studies report the out-of-hospital cardiac arrest (OHCA) survival to hospital discharge. One-year survival and neurological outcomes in southern New Jersey in 1996-2000 were analyzed using a retrospective data review. There were 1,597 cases of OHCA. ⋯ One-year survival of OHCA victims without neurological deficits is low. In southern New Jersey the survival rate did not improve over the 5-year study. Not only initial (prehospital) mortality, but also "delayed" (in-hospital mortality) increases with increase of response time.