Commonly Searched EP Topics
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EP Lab Digest - ICD
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When an ICD detects ventricular tachycardia or fibrillation, it shocks the heart to restore the normal rhythm.
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The Importance of Psychological Support for the Implantable Cardioverter Defibrillator Patient
Thousands of implantable cardiac defibrillators (ICDs) have been implanted in patients every year since 1985.1,2 The device clearly is life saving for high-risk patients with lethal arrhythmias. Although some patients have lost consciousness before a shock from an ICD is delivered, far more are awake and alert when they receive this life-saving therapy. Many patients describe this experience as feeling as if a lighting bolt hit them or as being kicked in the chest by a horse.3
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Remote ICD Monitoring: Discussing the Technology with Dr. Lawrence Gessman
Lawrence J. Gessman, MD is the director of Electrophysiology at Cooper Heart Institute at Cooper University Hospital and Associate Professor of Medicine at the University of Medicine and Dentistry-Robert Wood Johnson Medical School in Camden, New Jersey. He also serves as a medical consultant for Raytel Cardiac Services, which specializes in remote implanted cardiac device monitoring. In this article, Dr. Gessman discusses how remote monitoring is a beneficial service for both the patient and the physician. Many ICD patients find the service safe and easy to use, while physicians prefer its ?real-time? ICD checks, which results in greater physician productivity.
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The American College of Cardiology ? National Cardiovascular Data Registry?s (ACC-NCDR) ICD Registry? Requirements: Reporting Data on Primary Prevention ICDs
In this article, the author provides everything you need to know about the ACC-NCDR?s ICD Registry?, which became effective April 1, 2006.
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Troubleshooter?s Casebook: VT or SVT: How Does the ICD Know for Sure?
When it comes to rhythm disorders, many times what is going on in the ventricle has more to do with what?s going on in the atrium than any ventricular problem. For example, if you know a patient has an intrinsic ventricular rate of 150 beats per minute (bpm), it?s impossible for us to name the arrhythmia until we see an ECG.
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Electrocautery-Induced Ventricular Tachycardia and Fibrillation during Device Implantation and Explantation
Electrocautery is commonly employed during surgical implantation and explantation of pacemakers and implantable cardioverter-defibrillators (ICDs). Four cases of electrocautery-induced ventricular tachyarrhythmias including ventricular tachycardia (VT) or ventricular fibrillation (VF) during device implantation or explantation are described. Methods. The incidence of electrocautery-induced VT or VF at Winthrop University Hospital was analyzed over a 5-year period (November 2000 to March 2006). Specific devices, indications for device implantation or explantation, electrocautery configuration, and grounding patch placement were analyzed. Results. Between November 2000 to March 2006, 4,698 devices were implanted and/or explanted at Winthrop University Hospital, of which 4 patients developed electrocautery-induced ventricular tachyarrhythmias. The patients had a mean age of 64 ± 16 years, and mean left ventricular ejection fraction of 34 ± 9 percent. Three patients (75%) had severe coronary artery disease with prior myocardial infarction. Three patients (66%) had clinical hypertension. Three patients developed ventricular tachycardia during elective explantation of a malfunctioning device. One patient developed ventricular fibrillation during pacemaker implantation. Prior to each explant, the ICD was programmed off. Patients underwent explantation of a Medtronic Marquis model #7230CX ICD, Medtronic Marquis DR #7274 and Guidant Ventak Prizm 2 model #1861. The mean age of explanted devices was 35 ± 13 months. Conclusions. This study demonstrates a 0.09% incidence of provoked sustained ventricular tachycardia or ventricular fibrillation requiring external defibrillation during device implantation or explantation. This occurred despite programming off the ICD prior to device replacement, positioning the grounding pad far from the pulse generator and the use of bipolar electrocautery. We hypothesize that direct current energy is delivered to the pulse generator, lead and/or connector and then to the
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The ICD: When Smarter is Better and Less is More: The VITALITY AVT INTRINSIC RV Study
In this article, author Dr. Olshansky discusses the VITALITY AVT INTRINSIC RV Study, which has the largest number of ICD patients compared to any other ICD trial to date. It is also considered the fastest enrolling ICD study ever conducted.
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Is There a Role for Risk Stratification in the MADIT II/SCD-HeFT Era?
This is the last section of a three-part series on Microvolt T-Wave Alternans. In his article, Dr. Stein discusses the continued role for risk stratification in the modern era.
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April 2004
Implantable Defibrillators Reduce Death by 23 Percent in Landmark Heart Failure Trial NIH Study Indicates Need to More Aggressively Identify and Protect Patients at Risk for SCA People with heart failure live longer when they receive an implantable cardioverter-defibrillator (ICD), according to results of the landmark Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Remote follow-up of CRT-ICD devices allows clinicians to review the status of and changes to a patient's heart condition...
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Implantable Cardioverter Defibrillators in Non-Ischemic Cardiomyopathies: The Importance of Time
Over 450,000 deaths related to arrhythmia occur annually.1 An alarming 80% of sudden death cases occur out of the hospital, and despite improvements in resuscitation methods, community awareness, and availability of automatic external defibrillators, very few survive the arrest.2,3
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The American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR®) ICD Registry?: One Hospital?s Experience
Numerous clinical trials have demonstrated the benefit of implantable cardioverter-defibrillators (ICDs) in preventing sudden cardiac death in vulnerable patient populations. As a result, ICD implantation is now accepted therapy for a wide range of patients, for both primary and secondary indications.
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