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
-
Comparative Study
ICD-implantation guidelines versus clinical practice: a prospective study of out-of-hospital cardiac arrest survivors.
The aim of this study was prospectively to compare clinical practice of implantable cardioverter defibrillator (ICD) use with current guidelines in out-of-hospital cardiac arrest (OHCA) survivors. ⋯ In at least 21% of OHCA survivors, insufficient diagnostic procedures concerning the indication for ICD implantation were performed or no ICD was implanted when indicated, despite clear guidelines. In particular, there was no proof of ischaemia prior to revascularization and no confirmation of the absence of ischaemia and EPS thereafter. Clinicians should be guided better in evaluating pts after OHCA concerning the indication for ICD implantation, especially when a transient of reversible condition was present or when treatment was sufficiently established safely to refrain from ICD implantation.
-
Case Reports
Pneumopericardium and pneumothorax contralateral to venous access site after permanent pacemaker implantation.
A 77-year-old female underwent implantation of a left-sided dual chamber permanent pacemaker for symptomatic bradycardia with active fixation leads. Eight hours after the procedure, the patient complained of shortness of breath and was found to have a 30% right pneumothorax on chest X-ray. ⋯ The helix was abutting a bulla in the right lung, the likely cause for pneumothorax and pneumopericardium. The atrial lead was explanted without incident.
-
To evaluate the incidence and the strategy of management of syncope admitted urgently to a general hospital. ⋯ Great inter-hospital and inter-department heterogeneity in the incidence and management of syncope was observed in general hospitals. As a consequence, we were unable to describe a uniform strategy for the management of syncope in everyday practice.
-
Twiddler's syndrome is a well-known complication of pacemaker treatment. It was first described by Bayliss et al. when a patient manipulated and rotated the pulse generator in the pocket so many turns that it resulted in lead dislodgment, diaphragmatic stimulation and loss of capture. In this case report we present a patient who managed to rotate her dual chamber pulse generator so quickly after implantation that exit block occurred within 17 h. She had wound the two leads as far as their tips in a perfect formation around the pulse generator.