Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
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Multicenter Study
Feasibility of percutaneous implantation of transapical endocardial left ventricular pacing electrode for cardiac resynchronization therapy.
Failure of coronary sinus lead implantation for resynchronization therapy requires alternative approaches. For such events we have developed a transapical implantation technique as a feasible alternative. We report the outcome of this technique and its evolution from a minithoracotomy to a percutaneous approach. ⋯ Twelve patients have >1 year follow-up; all have sustained and significant improvement in LV dimensions (diastolic Δ4.2 ± 2.9, systolic Δ7.2 ± 5.8 mm), ejection fraction (Δ9.5 ± 9.6%), and functional status (Δ1.1 ± 0.3). Transapical placement of LV endocardial pacing lead is an effective alternative strategy for cardiac resynchronization. A closed-chest, percutaneous approach is feasible and should offer even less invasive intervention.
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Comparative Study
Syncope in the emergency department: comparison of standardized admission criteria with clinical practice.
Syncope is a major health care problem that accounts for many emergency department (ED) and hospital admissions. This study was conducted to investigate the short-term risk of serious events in patients presenting to the ED with syncope and to compare guideline-based admission criteria with those adopted in clinical practice. ⋯ There are significant numbers of inappropriate discharges and admissions in patients presenting with syncope. The standardized guideline-based criteria integrated in the new Faint-Algorithm provide promise but require further prospective evaluation.