Journal of Innovations in Cardiac Rhythm Management最新文献

{"title":"Leadless Pacemaker Implantation in Fontan Patients with Multimodality Imaging: Tips and Tricks.","authors":"Srikant Das, Brian A Boe, Joshua Saef, Kak-Chen Chan, Orhan Kilinc, Steven Bibevski, Todd S Roth","doi":"10.19102/icrm.2024.15082","DOIUrl":"10.19102/icrm.2024.15082","url":null,"abstract":"<p><p>Current leadless pacemaker (LP) systems, which have been developed and used in patients with normal cardiac anatomy, are rare and technically even more challenging to implant in patients with congenital heart diseases, especially with univentricular physiology and Fontan palliation. We report two cases of percutaneous LP implantation in an adult and a child, respectively, highlighting the unconventional approaches, different challenges, and use of multimodality imaging in patients who underwent a Fontan operation.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 8","pages":"5990-5996"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082054","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.2024.15084","DOIUrl":"https://doi.org/10.19102/icrm.2024.15084","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 8","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082055","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":"Feasibility of Single-lead Cardiac Resynchronization and Defibrillation Therapy in an Animal Model.","authors":"Daniel Varela, Amneet Sandhu, Matthew Zipse, Ryan Gerrard Aleong","doi":"10.19102/icrm.2024.15081","DOIUrl":"10.19102/icrm.2024.15081","url":null,"abstract":"<p><p>Conduction system pacing (CSP) has emerged as an alternative to cardiac resynchronization therapy (CRT); however, there is limited experience with CSP using implantable cardiac defibrillator (ICD) leads. The achievement of CSP with an ICD lead may yield comparable results to cardiac resynchronization therapy defibrillator (CRT-D) therapy using fewer leads. We implanted the Biotronik Linox DX \"VDD\"-programmable ICD lead in a swine model to investigate the feasibility of \"single-lead\" CRT-D implantation. With the lead embedded in the basal right ventricular septum, morphologic criteria for CSP were achieved, and successful defibrillation was performed while maintaining atrial sensing. Future work may assure reproducibility of these findings and further determine the feasibility of a single-lead CRT-D.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 8","pages":"5985-5989"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082053","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":"Radiofrequency Catheter Ablation for Atrial Fibrillation: Low-power, Long-duration Versus High-power, Short-duration.","authors":"Luka Petrovic, Bharat K Kantharia","doi":"10.19102/icrm.2024.15086","DOIUrl":"10.19102/icrm.2024.15086","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 8","pages":"5982-5984"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082056","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":"Comparison of Postoperative Continuous Wireless Cardiac Rhythm Monitoring with Traditional Telemetry in Cardiac Surgery Patients: the SMART-TEL Study.","authors":"Julien Pidoux, Emilie Conus, Naomi Blackman, Javier Orrit, Gregory Khatchatourov, Patrick Ruchat, Serban Puricel, Stéphane Cook, Jean-Jacques Goy","doi":"10.19102/icrm.2024.15085","DOIUrl":"10.19102/icrm.2024.15085","url":null,"abstract":"<p><p>Telemetry monitoring (conventional cardiac monitoring system [CCMS]) is a universal method for postoperative arrhythmia detection; however, the clinical challenge of alarm fatigue, primarily associated with noise or cable disconnections, persists. The introduction of wireless continuous cardiac monitoring (WCCM) represents a potential solution to enhance recording fidelity. Patients were simultaneously outfitted with both a monitoring device considered the standard of care and a novel adhesive wireless patch. A 48-h cardiac monitoring session with the two devices occurred after cardiac surgery in a unit equipped with a telemetry system. A total of 53 patients with a mean age of 60 ± 17 years were included in the trial. The number of events detected by the two systems was significantly different at 190 versus 174 for the CCMS and the WCCM system, respectively (<i>P</i> < .05). However, the percentage of agreement was not significantly different at 91% versus 88% (<i>P</i> = .37). Events were classified as follows: pause (2 events, 1%), atrial or premature ventricular contractions (18 events, 11%), atrial flutter or fibrillation (76 events, 45%), bradycardia (12 events, 7%), and tachycardia (61 events, 36%). False alarms were significantly more frequent with the CCMS (n = 21) than with the WCCM system (n = 5; <i>P</i> = .002). The study successfully demonstrated the feasibility and usability of wireless monitoring for patients requiring telemetry. The overall results are compelling, as the WCCM system performed satisfactorily, achieving results comparable to those obtained with the CCMS, even with significantly fewer false alarms.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 8","pages":"5997-6003"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082052","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":"Trends in Atrial Fibrillation and Ablation Therapy During the Coronavirus Disease 2019 Pandemic.","authors":"Anmol Johal, Joseph Heaton, Abbas Alshami, Ndausung Udongwo, Steven Imburgio, Anton Mararenko, Brett Sealove, Jesus Almendral, Jeffrey Selan, Riple Hansalia","doi":"10.19102/icrm.2024.15074","DOIUrl":"10.19102/icrm.2024.15074","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic affected many aspects of health care and continues to have an impact as waves of COVID-19 cases re-emerge. Many procedures were negatively impacted by the pandemic, and management was primarily focused on limiting exposure to the virus. We present an analysis of the National Inpatient Sample (NIS) to delineate how COVID-19 affected atrial fibrillation (AF) ablation. The NIS was analyzed from 2017-2020 in order to determine the pre- and intra-pandemic impacts on AF ablation procedures. Admissions were identified using the International Classification of Diseases, 10th Revision, Clinical Modification codes with a primary diagnosis of AF (ICD-10 CM code I48.0, I48.1, I48.2, or I48.91). Admissions were also assessed for the use of cardiac ablation therapy. Comorbidity diagnoses were identified using the Elixhauser comorbidity software (Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Rockville, MD, USA); additional ICD-10 codes for diagnoses and procedures used are also provided. The primary outcome of our study was the trend in ablation therapy during AF admissions. Secondary outcomes included health care disparities, inpatient mortality, and length of stay. Ablation therapy was used in 18,885 admissions in 2020, compared to the preceding 3-year average of 20,103 (adjusted Wald test, <i>P</i> = .002). Multivariate logistic regression revealed a greater likelihood of undergoing ablation therapy (odds ratio, 1.24; 95% confidence interval, 1.10-1.40; <i>P</i> < .001) among 2020 admissions compared to 2017 admissions. Inpatient mortality increased in 2020 compared to the preceding average; however, the difference was not significant. The procedural volume of ablation for AF saw a decrease in 2020; however, surprisingly, more patients were likely to undergo ablation during 2020.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 7","pages":"5955-5962"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621178","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":"Effects of Irradiation During Computed Tomography Scanning on the Function of Implantable Cardioverter-defibrillators.","authors":"Yusaku Nishikawa, Naoki Fujimoto, Tomoaki Kurata, Takashi Sasou, Akio Yamazaki, Yasutaka Ichikawa, Hajime Sakuma, Kaoru Dohi","doi":"10.19102/icrm.2024.15073","DOIUrl":"10.19102/icrm.2024.15073","url":null,"abstract":"<p><p>The effect of irradiation during computed tomography (CT) imaging on implantable cardioverter-defibrillators (ICDs) has not been fully evaluated in various settings. The purposes of this study were to evaluate the occurrence of electromagnetic interference (EMI) during CT irradiation in various clinically available ICDs with phantom experiments and to determine the potential risks related to irradiation during CT imaging. Five types of clinically available ICDs from five manufacturers were tested. An ICD was combined with an electrocardiogram (ECG) simulator, mounted in a chest phantom, and subjected to CT imaging. Each ICD was irradiated at the maximal power level (tube voltage, 135 kVp; tube current, 510 mA; rotation time, 1.5 s). EMI was defined as oversensing, ventricular tachycardia/ventricular fibrillation (VT/VF) detection, noise, or shock delivery during CT imaging. For ICDs in which EMI was observed, EMI was then evaluated under 144 different irradiation conditions (tube voltage [four patterns from 80-135 kVp], tube current [six patterns from 50-550 mA], and rotation time [six patterns from 0.35-1.5 s]). Testing was also performed during irradiation at the typical doses in three clinical settings and in two settings with inappropriate irradiation of ICDs due to incorrect setup. Among the five ICDs, a shock was delivered by one ICD manufactured by Medtronic (Minneapolis, MN, USA) due to oversensing during irradiation, which occurred at the maximal power level. No oversensing was observed in other ICDs. In the malfunctioned ICD, oversensing was observed in 134 of 144 irradiation patterns, even at a low power in the ICD. The VF-detection criterion was fulfilled in 20 of 134 tests and was significantly associated with tube voltage, tube current, ration time, and tube voltage × rotation time interaction. Although oversensing was observed in three clinical settings (typical chest CT, CT coronary angiography after coronary artery bypass graft, and dynamic assessment for pleural tumors) and one situation during an incorrect scan range on the chest for head perfusion CT, they were not recognized as tachycardia beats. Oversensing was observed when scans were incorrectly set over the ICD during bolus tracking of contrast-enhanced CT. Maximal power CT imaging induced VT/VF detection and shock delivery in one model of ICD placed in a chest phantom. VT/VF detection was observed when tube voltages were high and irradiation times were longer. Oversensing can occur during inappropriate CT imaging, particularly when slices are positioned over the ICD.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 7","pages":"5936-5944"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621175","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":"Flecainide Toxicity in a Patient with a Functioning Pacemaker.","authors":"Sneha Chebrolu, Jonathan Mayl, Prashant Bhave","doi":"10.19102/icrm.2024.15075","DOIUrl":"10.19102/icrm.2024.15075","url":null,"abstract":"<p><p>Flecainide is a class Ic anti-arrhythmic that demonstrates use dependence, meaning the medication has an increased effect on the myocardium at high heart rates. Flecainide toxicity can be identified by wide QRS complexes on an electrocardiogram (ECG). We discuss a case of a 75-year-old patient with a pacemaker who presented with concern for flecainide toxicity. The patient had several risk factors known to increase the likelihood for toxicity, including structural heart disease and acute kidney injury. The initial ECG showed tachycardia with wide QRS complexes. The patient had a pacemaker set in a tracking mode (DDD) that resulted in rapid ventricular pacing with failure to mode switch. However, with modification to the VVI mode, the patient experienced tachycardia resolution with an improvement in QRS complexes. This case emphasizes the use dependence of flecainide and illustrates the utility of pacing mode in the management of flecainide toxicity in patients with pacemakers.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 7","pages":"5951-5954"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621176","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":"Utility of an Externalized Temporary Transvenous Implantable Cardioverter-defibrillator System in the Setting of Ventricular Tachycardia Storm and Concurrent Device Infection Requiring Extraction.","authors":"Ronuk M Modi, Marianna Lozano Cruz Marquez, Shu Yang, Robert N D'Angelo, Timothy R Maher, Bahij Kreidieh, Nicholas O Palmeri, Hans F Stabenau, Dana Goldense, Emily Wacks, Patricia Tung, Andre d'Avila, Jonathan Waks, Peter Zimetbaum, Andrew H Locke","doi":"10.19102/icrm.2024.15071","DOIUrl":"10.19102/icrm.2024.15071","url":null,"abstract":"<p><p>With the expanding use of cardiac implantable electronic device (CIED) therapy, intravascular device infections are becoming more common. In the case of transvenous implantable cardioverter-defibrillator (ICD) infections requiring extraction for bacterial clearance, there remains no standard method to deliver temporary ICD therapy following device removal. We present a case of persistent bacteremia complicated by monomorphic ventricular tachycardia (VT) electrical storm where biventricular ICD system extraction was performed and a temporary transvenous dual-coil lead with an externalized ICD generator was used to treat VT episodes prior to the re-implantation of a new permanent system. This case demonstrates the utility of a temporary externalized transvenous ICD system in the successful detection and pace-termination of VT, thereby reducing episodes of painful and potentially harmful external defibrillator shocks during the treatment of CIED infection.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 7","pages":"5930-5934"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621179","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":"ChatGPT for Patients: A Comprehensive Study on Atrial Fibrillation Awareness.","authors":"Rahul Vyas, Arpita Pawa, Chanza Shaikh, Anaiya Singh, Hetvi Shah, Shubhika Jain, Vijaywant Brar","doi":"10.19102/icrm.2024.15072","DOIUrl":"10.19102/icrm.2024.15072","url":null,"abstract":"<p><p>Due to the intricate nature of atrial fibrillation (AF), the diagnostic process often gives rise to a spectrum of concerns and inquiries. A 20-question survey on AF, covering general concerns, diagnosis, treatment, and post-diagnosis inquiries, was conducted via Google Forms (Google LLC, Mountain View, CA, USA). The questions were input into the Chat Generative Pre-trained Transformer (ChatGPT) system (OpenAI LP, San Francisco, CA, USA) in November 2023, and the responses were meticulously collated within the same Google Forms. The survey, involving 30 experienced physicians, including 22 cardiologists and 8 hospitalists, practicing for an average of 18 years, assessed artificial intelligence (AI)-generated responses to 20 medical queries. Out of 600 evaluations, \"excellent\" responses were most common (29.50%), followed by \"very good\" (26%), \"good\" (19.50%), and \"fair\" (17.3%). The least common response was \"poor\" (7.67%). Questions were categorized into \"general concerns,\" \"diagnosis-related,\" \"treatment-related,\" and \"post-diagnosis general questions.\" Across all categories, >50% of experts rated responses as \"excellent\" or \"very good,\" indicating the potential for improvement in the AI's clinical response methodology. This study highlights the efficacy of ChatGPT as an AF informational resource, with expert-rated responses comparable to those of clinicians. While proficient, concerns include infrequent updates and ethical considerations. Nevertheless, it underscores the growing role of AI in health care information access.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 7","pages":"5946-5949"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11238883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621174","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}