5:2002 (Sept./Oct.)
Rapid Coronary Sinus Access in Cardiac Resynchronization Therapy:Initial Experience With the New SafeSheathCSG/Worley-1-09-STD
- Sat, 5/3/08 - 1:34pm
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Cardiac resynchronization therapy requires placement of a pacing lead to activate the posterolateral left ventricle (LV) prior to its anticipated and delayed depolarization. Epicardial LV access has been achieved by placing pacing leads in coronary sinus venous tributaries; however, access to the coronary sinus and delivery systems providing support for lead placement has proven a technically challenging task.
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Catheter Ablation Using Alternative Energy Sources
- Sat, 5/3/08 - 1:34pm
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First of all, energy delivery can be accomplished simply by using the existing hardware within a standard diagnostic catheter. Using, more or less, the same electrodes, delivery of high frequency electrical signal in the range of radio wave is transformed into heat through cardiac tissue resistive mechanism. This heating creates tissue desiccation that is contained within a few millimeters surrounding the tip of the electrode. Thus, ablation using RF energy was found to be safe and, for purposes of localized tissue destruction, effective. Many patients with disabling arrhythmias caused by a focal substrate, such as a supraventricular tachycardia utilizing dual atrioventricular-nodal pathways (AVNRT), accessory pathways (Wolff-Parkinson-White syndrome), or focal atrial or ventricular reentry [such as idiopathic ventricular tachycardia (VT) arising at the right ventricular outflow tract] could benefit from a curative procedure using simple application of RF ablation.
U.S. FDA Approved MADIT II Indication for the Implantable Cardioverter/ Defibrillator
- Sat, 5/3/08 - 1:34pm
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Recently, the U.S. FDA approved MADIT II indications for the implantable cardioverter/defibrillator. Specifically, they find that it is an acceptable indication for implanting these devices in patients who have experienced myocardial infarction and who have severe left ventricular dysfunction (an ejection fraction of less than or equal to 30%). Importantly, the patient s do not need to have an electrophysiology study and do not need to have an arrhythmia as a prerequisite for this prophylactic indication. At the present, it is unclear when Medicare will approve this indication for reimb
Spotlight Interview: Einstein Heart Institute
- Sat, 5/3/08 - 1:34pm
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What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab?
The Electrophysiology Lab at Einstein Heart Institute has one dedicated electrophysiology lab and an AICD and pacemaker clinic. Our team consists of two electrophysiologists, four registered nurses and two secretaries.
When was the EP lab started at your institution?
Electrophysiology services began at Einstein in 1986.
What types of procedures are performed at your facility? Approximately how many are performed each week?
Electrophysiology services provided by Einstein include tilt table testing, cardioversions, diagnostic electrophysiology studies, ablations (including atrial fibrillation), AICD and pacemaker implants including bi-ventricular device implants for heart failure. We perform approximately 13 to 15 cases per week, as well as a 15 to 20 person-per-week device clinic.
Atrial Defibrillation: A New Treatment for Atrial Fibrillation How Do We Best Manage These Patients?
- Sat, 5/3/08 - 1:34pm
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Atrial fibrillation (AF) affects over 3.3 million Americans, and 5 million people worldwide. Patients with atrial fibrillation often have associated symptoms such as heart palpitations, fatigue, dizziness, shortness of breath, and/or pressure or discomfort in the chest. It may also cause more serious complications such as syncope, stroke, or heart failure. Atrial fibrillation can interrupt patients work schedules, social functions and other daily activities.
Incessant Ventricular Tachycardia
- Sat, 5/3/08 - 1:34pm
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Intractable ventricular tachyarrhythmias (IVTA) have been defined as frequent, recurrent and recalcitrant ventricular tachyarrhythmias and/or ventricular fibrillation (VF), which may result in significant symptoms potentially associated with hemodynamic compromise.1 IVTA is classically associated with a poor prognosis.2 We present a multi-tiered approach utilizing advanced cardiac life support guidelines, current pharmacological regimens, ventricular burst pacing with overdrive suppression, intra-aortic balloon counterpulsation (IABCP), coronary revascularization and implantable cardioverter defibrillator (ICD) insertion to successfully achieve a favorable outcome.
Case Report.
EP Lab Digest Interviews Gale Wilson-Steele
- Sat, 5/3/08 - 1:34pm
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- 1784 reads
When did digital healthcare start to take off and become more prevalent? What has been your role in this? How and when did you get started in this business?
We figured the Internet was particularly useful for finding information and was a good way to look for people. Patients move around, change doctors, and when they get a health condition that needs treatment, they want to know what doctors are available in their city. When finding a provider directory, if the patient were to go through their health insurance company, those directories were usually out of date; they were printed
Biosense Webster Announces U.S. Release of the First Dual Sensor 8 mm Tip Ablation Catheters for Treating Atrial Flutter
- Sat, 5/3/08 - 1:34pm
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Biosense Webster, a Johnson & Johnson company, announced U.S. release of the first Dual Sensor 8 mm tip ablation catheters specifically designed for the treatment of atrial flutter. The NAVISTAR DS and CELSIUS DS catheters received marketing clearance by the U.S. Food and Drug Administration on September 30, 2002.
Roy Tanaka, U.S. President of Biosense Webster, said "U.S. introduction of the first Dual Sensor 8 mm Tip Catheters reinforce our commitment to remain at the forefront of advanced catheter technology. Our company had achieved an industry milestone by providing clinicians with the
