Commonly Searched EP Topics
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EP Lab Digest - Ventricular Fibrillation
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During ventricular fibrillation, the heart's lower chambers contract in a rapid, unsynchronized way, causing the heart to pump little or no blood.
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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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10-Minute Interview: Michael Weiner, CEO, Biophan Technologies, Inc.
Recently, two exciting new patents were issued to Biophan Technologies, Inc. that will help revolutionize current devices. The first patented technology adds a monitoring signal to current devices to help detect fibrillation earlier. The second patented technology helps prolong battery life in devices. In addition, Dr. Spencer Rosero contributes new information about the temporary percutaneous pacing-defibrillation system.
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Survival after Spontaneous Coronary Artery Dissection Presenting with Ventricular Fibrillation Arrest
Spontaneous coronary artery dissection (SCAD) is a rarely documented etiology of myocardial infarction and sudden cardiac death (SCD). We present a case of a 37-year-old non-pregnant female who presented with a left anterior descending artery (LAD) dissection complicated by ventricular fibrillation arrest. After early diagnostic catheterization and medical management, our patient experienced a complete recovery, returning to her pre-SCD status without limitation. This case is unique in that the SCAD did not occur in the context of previously described associations. Also, this is only the second reported case of a patient with SCAD who survived documented SCD. Our case suggests that medical management is a reasonable option in patients with single-vessel non-left main/proximal LAD artery SCAD.
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Transthoracic Biphasic Defibrillation: The Case for Non-Escalating Energy Protocols
Transthoracic Biphasic Defibrillation: The Case for Non-Escalating Energy Protocols Features: Transthoracic Biphasic Defibrillation: The Case for Non-Escalating Energy Protocols - David H. Cooke, MD, Division of Cardiology; Lutheran General Hospital, Park Ridge, Illinois Theoretical effect of reduced shunting in the face of high transthoracic resistance. were defibrillated by the first low-energy BTE shock and 100% were ultimately defibrillated with repeated shocks of the same energy level.6...
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Wearable Defibrillators: A New Tool in the Management of Ventricular Tachycardia/Ventricular Fibrillation
Sudden cardiac arrest accounts for about 300,000 deaths each year in the United States. Several randomized control trials have established the efficacy of implantable cardioverter-defibrillators (ICDs) for primary as well as secondary prophylaxis against sudden cardiac death. Based on these studies, the Center for Medicare/Medicaid Services (CMS) has approved the implantation of ICDs among patients who are at high risk of sudden cardiac death.
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Brugada Syndrome: Case Report and Review of the Literature
Brugada Syndrome: Case Report and Review of the Literature Features: Brugada Syndrome: Case Report and Review of the Literature - Ronald Lo, MD, Sanjay S. Mehta, MD, David Witkes, DO, Todd J, Cohen, MD In 1992, Brugada and colleagues described a clinical syndrome characterized by a right bundle branch block pattern and ST segment elevations in leads V1-V3, now called Brugada syndrome.1 Brugada syndrome is associated with sudden cardiac death or idiopathic ventricular fibrillation in ...
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Mechanisms of Microvolt T-Wave Alternans Testing
In the first of this three-part section, we will be discussing a program that was put together by Cambridge Heart, Inc., on the topic of Microvolt T-Wave Alternans Testing. In his presentation, Dr. Costantini is going to be talking about the mechanism of action of Microvolt T-Wave Alternans.
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Syncope: Unleashing the Tiger
Welcome to the new ?EP 101? section of EP Lab Digest! In each of our upcoming issues, we will explore a basic topic in electrophysiology. In this month?s issue, Drs. Sandesara and Olshansky discuss a case in which the patient was experiencing multiple episodes of syncope. They describe which methods they used to diagnose and treat the patient, as well as explain common challenges one might encounter along the way.
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Survival Rates of Sudden Cardiac Arrest in Young Athletes
In recent research, Drs. Jonathan Drezner and Kenneth Rogers studied the incidence of sudden cardiac arrest (SCA) in young athletes in intercollegiate sports. Interestingly, they found that early defibrillation and resuscitation efforts had little effect on the survival outcome of these athletes. In addition, they note that there is currently no universally accepted system to detect SCA in these young athletes in the U.S. In this article, I asked Dr. Drezner what he thinks needs to be done to help detect at-risk athletes sooner, and see what other type of research is needed to learn more about SCA in young athletes. Jonathan Drezner, MD is Associate Professor, Team Physician, and Associate Director of the Sports Medicine Fellowship in the Department of Family Medicine at the University of Washington in Seattle.
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Brugada Syndrome
Brugada Syndrome Features: Brugada Syndrome - Kathryn A. Glatter, MD (Assistant Professor of Medicine, Director UC-Davis EP Lab); Nipavan Chiamvimonvat, MD (Associate Professor of Medicine); Jeanny K. Park, MD (Associate Professor, Director of Pediatric EP Program) The Brugada syndrome (BS) is another inherited ion channelopathy which causes unexplained sudden death, particularly in middle-aged males.1?3 It is more common in southeast Asia and should particularly be considered when looking at...
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