Journal of Innovations in Cardiac Rhythm Management最新文献

{"title":"Versatility of Impella^® Ventricular Assist Devices in High-risk Cardiac Patients During Complex Procedures: A Case Series.","authors":"Nagaraj Swaminathan, Madison Hazelwood, Nadine Odo, Mallikarjuna R Devarapalli","doi":"10.19102/icrm.2024.15113","DOIUrl":"10.19102/icrm.2024.15113","url":null,"abstract":"<p><p>High-risk cardiac patients undergoing complex electrophysiology procedures face potential hemodynamic instability, necessitating effective mechanical circulatory support. The catheter-based Impella^® ventricular assist device (Abiomed, Danvers, MA, USA) is crucial to stabilizing hemodynamics by improving the flow of blood from the left ventricle to the aorta. Its automated controller ensures cerebral hemodynamic stability, allowing for bedside adjustments. Herein, we present a case series illustrating the versatility of the Impella^® device in managing patients during complex electrophysiology procedures and highlighting its role in mitigating hemodynamic compromise.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 11","pages":"6080-6083"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failure of Ventricular Fibrillation Sensing During Subcutaneous Implantable Defibrillator Testing: A Twitchy Situation.","authors":"Mussa Saad, Deepti Ranganathan, Sheldon M Singh","doi":"10.19102/icrm.2024.15112","DOIUrl":"10.19102/icrm.2024.15112","url":null,"abstract":"<p><p>Oversensing of extra-cardiac noise may inhibit delivery of subcutaneous cardiac implantable defibrillator (S-ICD) therapy. We report a case of diaphragmatic tetany resulting in the inhibition of S-ICD therapy at the time of defibrillator testing without the use of muscle relaxants. Clinicians should be aware of this phenomenon.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 11","pages":"6085-6087"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Device Therapy in Cardiac Sarcoidosis: Current Review, Challenges, and Future Prospects.","authors":"Mohamed ElRefai, Christina Menexi, Paul R Roberts","doi":"10.19102/icrm.2024.15115","DOIUrl":"10.19102/icrm.2024.15115","url":null,"abstract":"<p><p>Sarcoidosis is a complex disease characterized by inflammatory granulomas that can affect various organs, including the heart. The diagnosis of cardiac sarcoidosis poses challenges, and current criteria involve the use of advanced imaging techniques and histological confirmation. Clinical manifestations of cardiac sarcoidosis vary widely, ranging from heart block to ventricular tachycardia and heart failure. Sudden cardiac death (SCD) is a significant concern, and implantable cardioverter-defibrillators (ICDs) are recommended for preventing SCD in high-risk cases. However, some patients with cardiac sarcoidosis do not meet the current guidelines for ICD implantation, leaving them at risk. Traditional transvenous ICDs are associated with complications, especially in immunosuppressed patients. The subcutaneous implantable cardioverter-defibrillator (S-ICD) offers a potential solution, as it avoids vascular complications and reduces the risk of infections. However, concerns regarding inappropriate shocks and the lack of pacing therapy limit its widespread use. Leadless pacing combined with S-ICD represents a potential novel approach to managing cardiac sarcoidosis patients. Ongoing human clinical trials are expected to shed light on the safety and efficacy of this combined therapy. Cardiac sarcoidosis patients, who have been underserved by traditional device therapies, may benefit from this personalized approach. Further research is needed to guide the management of SCD risk in this population.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 11","pages":"6088-6094"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Cardiac Magnetic Resonance to Predict Response to Cardiac Resynchronization Therapy: A Systematic Review and Meta-analysis.","authors":"Nazima Khatun, Alejandro Sanchez-Nadales, Jonathan Francois, Mohammed Hussein, Muhammed Atere, Yasser Rodriguez, Jose Baez-Escudero, Adam Budzikowski","doi":"10.19102/icrm.2024.15111","DOIUrl":"10.19102/icrm.2024.15111","url":null,"abstract":"<p><p>Cardiac resynchronization therapy (CRT) has revolutionized heart failure (HF) management, offering benefits in morbidity, mortality, and symptom alleviation. However, optimal response rates are not universally achieved, necessitating enhanced patient-selection strategies. Myocardial scar patterns, quantified by delayed-enhancement cardiac magnetic resonance (DE-CMR), have been implicated in CRT outcomes. We conducted a meta-analysis of observational studies assessing CRT responses by performing a systematic literature search using PubMed, Embase, Ovid MEDLINE, Scopus, the Cochrane Library, ScienceDirect, and the Web of Science. Scar burden, left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and left ventricular end-diastolic volume (LVEDV) were evaluated. CRT response rates among ischemic and non-ischemic cardiomyopathy patients were also explored. This meta-analysis incorporated eight studies meeting the eligibility criteria. CRT responders exhibited a significantly lower scar burden (-11.7%; 95% confidence interval, 6.6%-16.8%) compared to non-responders, supporting the predictive value of scar quantification (<i>I</i> ² = 95.25%; <i>P</i> < .001). Responders demonstrated an increased mean LVEF (from 25.2% to 31.9%), while non-responders showed modest changes (from 23.3% to 24.4%). Responders experienced a decrease in mean LVESV from 158.8 to 132.8 mL, contrasting with a more stable mean LVESV value in non-responders (reduction from 160.9 to 157.6 mL). Responders experienced a reduced mean LVEDV from 219.4 to 196.7 mL, while non-responders showed more minimal changes (from 213.4 to 210.6 mL). Limited data suggested a CRT response rate of 34.7% in ischemic cardiomyopathy; non-ischemic data were insufficient. In conclusion, DE-CMR, assessing the scar burden, emerges as a valuable tool for predicting the CRT response. A lower scar burden correlates with improved responses, supporting the role of DE-CMR in refining patient selection for CRT. This meta-analysis contributes insights into personalized CRT strategies, emphasizing the potential of imaging modalities to enhance therapeutic outcomes in HF patients. Further research is warranted to solidify these findings and refine clinical applications.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 11","pages":"6095-6106"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time Technical Support Using a Remote Technology During Cardiac Implantable Electronic Device Follow-up: A Preliminary Multicenter Experience in Clinical Practice.","authors":"Valter Bianchi, Maria Silvia Negroni, Domenico Pecora, Giovanni Bisignani, Giuseppe Damiano Sanna, Stefano Nardi, Manuela Azzara, Carmelo La Greca, Concetta Torchia, Gavino Casu, Luigi Argenziano, Monica Campari, Sergio Valsecchi, Antonio D'Onofrio","doi":"10.19102/icrm.2024.15114","DOIUrl":"10.19102/icrm.2024.15114","url":null,"abstract":"<p><p>Industry-employed allied professionals (IEAPs) provide technical assistance to physicians during cardiac implantable electronic device (CIED) implantation, programming, troubleshooting, and follow-up. The Heart Connect™ application (Boston Scientific Inc., Marlborough, MA, USA) is a data-sharing system that enables remote access and display sharing of the CIED Programmer. This report aims to describe the preliminary experience of remote IEAP support through the application during CIED follow-up in clinical practice. The application was downloaded on the programmer, and network connections were established and tested at six Italian centers. Staff members were trained and online meetings were scheduled with IEAPs during consecutive CIED follow-up visits. Data and user feedback were collected. A total of 20 operators received training, and online meetings were conducted during 208 patient visits. Of these, 202 (97%) visits were successfully completed with remote support, without the need for additional medical or technical assistance. The connection quality, audio, and video were rated as good or excellent in ≥95% of sessions. The average duration of online meetings ranged from 6-16 min, depending on the supported session type. Comprehensive CIED checks and tests were performed during the visits, leading to the identification of relevant conditions or programming changes in 29% of visits. All operators found the application to be user-friendly and effective. Overall, satisfaction with the remote support service was rated high in 80% of responses, particularly for managing unscheduled CIED follow-up visits. In conclusion, remote support during CIED follow-up appears to be feasible, effective, and well accepted. It offers a viable alternative to traditional on-site IEAP support for both scheduled and unscheduled follow-up visits.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 11","pages":"6070-6078"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter from the Editor in Chief.","authors":"Devi Nair","doi":"10.19102/icrm.2024.15106","DOIUrl":"https://doi.org/10.19102/icrm.2024.15106","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges to Contemporary Wide Complex Tachycardia Criteria: A Single-center Case Series of 1:1 Atrial Flutter.","authors":"Garrett M Snipes, Jacob N Blackwell, Prashant D Bhave","doi":"10.19102/icrm.2024.15102","DOIUrl":"10.19102/icrm.2024.15102","url":null,"abstract":"<p><p>Atrial flutter with 1:1 atrioventricular conduction is a rare cause of wide complex tachycardia, which presents a diagnostic challenge. This report describes a series of eight cases of 1:1 atrial flutter compiled during 2018-2022. The cases in this report include patients without class 1 anti-arrhythmic use or pre-excitation.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"6041-6046"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid Sinus Massage During Head-up Tilt Testing Can Predict the Test Outcome: Implications for Its Use as a Screening Tool in Patients with Unexplained Syncope.","authors":"Atul Prakash, Julie Truong, Adeniyi Adelakun, Ravnit Singh","doi":"10.19102/icrm.2024.15101","DOIUrl":"10.19102/icrm.2024.15101","url":null,"abstract":"<p><p>Head-up tilt testing (HUT) has been used for decades in the work-up of patients presenting with syncope and a suspected reflex etiology. Different protocols have been used with varying sensitivity and specificity. The standard protocols are relatively long, with various maneuvers employed to elicit a response and potentially abbreviate the test. The role of carotid sinus massage (CSM) as a provocative maneuver has not been well studied. The objective of this study was to assess whether CSM could predict the outcome of HUT. Fifty consecutive patients who had been referred for head-up tilt table testing were prospectively enrolled in the study. All patients underwent an identical protocol that involved provocation with CSM both initially in the supine posture and at the end of 30 min of HUT. Seventeen out of 50 (34%) patients ultimately had a positive tilt table test result. Fifteen of these 17 patients had a significant vasodepressor response (symptomatic blood pressure drop of >20 mmHg) without significant bradycardia (heart rate of <50 bpm) during the initial CSM in the supine posture. Of the 33 patients with a negative tilt table result, none had a vasodepressor response to CSM. The sensitivity of CSM in detecting a patient who would ultimately have a positive tilt table test was 88.24% (95% confidence interval [CI], 63.56%-98.54%), while the specificity was 100% (95% CI, 89.42%-100.00%). CSM performed in the supine posture at the beginning of a tilt table test was highly sensitive and specific for the outcome of the test after completion of the entire protocol. Based on these findings, CSM may obviate the need for completion of the protocol for diagnostic reasons.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"6047-6051"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Snaring via a Femoral Approach to Facilitate Transvenous Lead Extraction of an Infected Right Ventricular Lead Jailed by a Bioprosthetic Tricuspid Valve.","authors":"Sapan Bhuta, Sena Colak, Aleena I Arif, Muhammad R Afzal","doi":"10.19102/icrm.2024.15105","DOIUrl":"10.19102/icrm.2024.15105","url":null,"abstract":"<p><p>An 85-year-old woman presented with <i>Corynebacterium</i> bacteremia complicated by infective endocarditis with vegetations on the prosthetic mitral valve and right ventricular (RV) lead. The patient had a single-chamber permanent pacemaker with two RV leads, one of which was previously trapped or \"jailed\" after a bioprosthetic tricuspid valve replacement. Complete transvenous lead extraction including the chronically retained jailed RV lead was achieved via laser extraction assisted by concomitant traction from a superior left subclavian and inferior right femoral venous approach.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"6066-6069"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Direct Oral Anticoagulants Versus Warfarin in Atrial Fibrillation Patients with Chronic Liver Disease: A Systematic Review and Meta-analysis.","authors":"Syed Muhammad IbnE Ali Jaffari, Fnu Karishma, Syeda Urooba Shah, Robish Kishore, Avinash Kumar, Fnu Kajal, Maira Khalid, Avesh Kumar, Huda Anum, Zarmina Ali, Rimsha Irfan, Muhammad Ahsan Naseer Khan, Abdul Rehman Saleem, Hamza Islam, Rabia Islam","doi":"10.19102/icrm.2024.15103","DOIUrl":"10.19102/icrm.2024.15103","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is a prevalent cardiac arrhythmia. Direct oral anticoagulants (DOACs), with superior efficacy and safety, have emerged as a promising alternative to warfarin. This systematic review and meta-analysis aimed to compare the safety and efficacy of DOACs and warfarin in patients with AF and chronic liver disease (CLD). A systematic search was undertaken in PubMed, the Cochrane Library, and Google Scholar to identify studies comparing the effectiveness of DOACs and warfarin in patients diagnosed with AF and CLD. Subsequent analyses were carried out using the random-effects model. This meta-analysis included eight studies involving 20,684 participants; baseline characteristics indicated a prevalent male presence (56.7%), with an average age of 61.63 ± 9 years. Primary outcomes demonstrated that DOACs were associated with significantly reduced all-cause mortality (relative risk [RR], 0.73; 95% confidence interval [CI], 0.56-0.95; <i>I</i> ² = 84%; <i>P</i> = .02) and ischemic stroke risk (RR, 0.62; 95% CI, 0.45-0.86; <i>I</i> ² = 61%; <i>P</i> = .004). Secondary outcomes revealed a significantly reduced risk of major bleeding with DOACs compared to warfarin, while gastrointestinal bleeding showed a non-significant decrease. Intracranial hemorrhage risk was significantly lower with DOACs compared to warfarin. DOACs demonstrate superior safety and efficacy compared to warfarin, evidenced by reduced rates of all-cause death, ischemic stroke, severe bleeding, and cerebral hemorrhage. Further randomized controlled trials are essential to enhance the evidence base for DOACs across diverse patient populations.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"6052-6061"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}