7 (July 2005)
Troubleshooter's Case Book for Pacemaker and ICD Follow-Up: The Causes of Pauses
- Thu, 5/1/08 - 4:22pm
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What happens when you see a patient who should be paced, but whose ECG or EGM reveals pauses? Clearly, a patient receiving optimal pacing support is going to be paced regularly. Pauses indicate trouble. (Figure 1)
The best approach to troubleshooting is to be systematic and to proceed, step-by-step, through possible scenarios. This annotated ECG shows long pauses on the strip. However, before addressing that, the clinician should check programmed parameter settings and overall function of the device. In this case, the patient has a single-chamber pacemaker programmed to a base rate of 70 ppm with no rate response function. The measured values, including battery status, do not indicate anything unusual. The next step in the system is to confirm capture that is, that every ventricular output leads to a ventricular depolarization.
The Added Benefit of Closed Loop Stimulation: The AVAIL CLS/CRT Study
- Thu, 5/1/08 - 4:22pm
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Describe the main objectives of the AVAIL CLS/CRT Study. In addition, please describe the Closed Loop Stimulation (CLS) technology from BIOTRONIK.
The AVAIL Study s main objective is to demonstrate safety and effectiveness of biventricular pacing over conventional right ventricular pacing in patients with persistent, symptomatic atrial fibrillation (AF) undergoing atrioventricular (AV) node ablation. There was a prior study with a similar design called PAVE; this study was the first to demonstrate that biventricular pacing is superior to RV apical pacing in a similar patient population. In the AVAIL Study, we are going to broaden the findings of PAVE and explore the additional benefits of an algorithm developed by BIOTRONIK called CLS, which stands for Closed Loop Stimulation. We are going to investigate how biventricular pacing affects synchrony of ventricular contraction after AV nodal ablation this has not been studied until now.
Spotlight Interview: Sinai-Grace Hospital
- Thu, 5/1/08 - 4:22pm
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When was the EP lab started at your institution?
The electrophysiology program at Sinai Grace Hospital was started in 2002. Dr. Mukarram Siddiqui joined Sinai-Grace Hospital and was named Director of the Electrophysiology Lab in January 2003. Under Dr. Siddiqui s direction, the volume has increased significantly each year.
What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab? Who manages the lab?
Building for the Future: How to Navigate Turbulent Seas with a Little Help from the Land of Oz
- Thu, 5/1/08 - 4:22pm
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If that weren t enough, the Washington-based Advisory Board Company and their focused Cardiovascular Roundtable organization suggested, in a recent publication entitled Cardiac Services Survival, Competitive Imperatives for Future Prosperity in a Pressurized Market, that there was, A Gathering Storm. Yet we know from daily first-hand experience that the storm is not gathering; it is here and has been for a while. Many of us feel that there is no safe port in which to ride out this storm but rather, as the title of the Alliance of Cardiovascular Professionals (ACVP) conference suggested, we need to learn how to navigate in these turbulent seas.
10-Minute Interview: Elizabeth Ching, RN, Cleveland Clinic Foundation
- Thu, 5/1/08 - 4:22pm
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Describe your medical background. What made you decide to go into EP? Also, describe your work as Nurse Manager at the Device Clinic.
I had worked here at the clinic for about 3 or 4 years, so just for a short period of time. My background was in cardiology, so when I came here, I progressed through the ranks to head nurse on the cardiology floor, then to the cardiovascular ICU and later the cardiac OR. It was by a fluke that I ran into the physicians who started this area. We had the typical joke of when are you going to find me a job? and well, they did. That was in 1981. I ve been doing this for a long time now, and I really enjoy it. It is a constant learning situation things change so rapidly in our area, you just constantly have to keep updated.
Heart Rhythm Foundation Launches Sudden Cardiac Arrest Campaign
- Thu, 5/1/08 - 4:22pm
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What, specifically, are the goals of the campaign?
Educate health care professionals about SCA and prevention
Educate the public about SCA
Open the lines of communication between doctor and patient to encourage dialogue about SCA
Identify those who are at risk for SCA and urge those at risk to see their physician
Risk identification. In an effort to identify high-risk patients, a risk assessment survey is distributed or available online that asks individuals to respond to a brief set of questions related to their heart history and offers a scored assessment i
Email Discussion Group: July 2005
- Thu, 5/1/08 - 4:22pm
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We also have more responses as well as two new questions featured this month. If you would like to respond to these questions, please email us at eplabdigest@hotmail.com or go to www.eplabdigest.com and click on the email discussion group link. Our website is constantly being updated, so please check back often!
New Questions:
For EP Techs
I just visited and am new to the field, so I wondered if there are any good user groups for an EP lab tech? I am in Boston, but via the web I could access groups anywhere.
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