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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Indications for cardiovascular implantable electronic devices continue to evolve, which has led to an increasing requirement for transvenous lead extraction. We explore the indications, complications, and success rates involved in the removal of pacemaker and implantable cardioverter-defibrillator (ICD) leads in a high-volume centre, over 20 years. ⋯ Pacing and ICD leads can be safely extracted with mechanical techniques. The presence of device infection appears to be the major predictor of procedural complications.
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Observational Study
Evaluation of the current prognostic role of heart diseases in the history of patients with syncope.
Pivotal studies showed that the 1-year mortality was consistently higher in cardiogenic than in non-cardiogenic syncope 10 years later, further studies questioned these evidences, showing that the risk of death was only predicted by underlying heart disease and not from the syncope itself. Accordingly, nearly all the prognostic scales now include cardiovascular variables, but their definition is often neither unique nor precise and it might lead to an excessive hospitalization. ⋯ We recommend that emergency department physicians adopt a strict definition of heart diseases considered at risk to promptly identify all patients at risk for serious events, while avoiding an excessive hospitalization.
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An association between obstructive sleep apnoea (OSA) and atrial fibrillation (AF) has been established. However, studies on the role of OSA in AF recurrence after catheter ablation have yielded conflicting results, and the effect of OSA treatment by continuous positive airway pressure (CPAP) on the success rate of AF catheter ablation is indeterminate. The aim of this meta-analysis was to investigate the rate of AF recurrence after catheter ablation in patients with AF with or without OSA and to evaluate the relationship between CPAP therapy and AF recurrence. ⋯ Obstructive sleep apnoea was associated with AF recurrence after catheter ablation. The efficacy of catheter ablation for AF was similar between patients without OSA and patients with OSA undergoing CPAP treatment.