Readers, thank you for all of your help this month! Please see below for all of your responses to the question on “Recycling Platinum Tips.” If you would like to respond, please email us at eplabdigest@hotmail.com or go to www.eplabdigest.com and click on the email discussion group link. Remember, when posting or responding to the discussion group, please let me know if you would like your name, location, and/or email address listed as well — that way you will get more instant results! In this issue, we also hear from our guest moderator, who has answered one of the questions under discussion. This month’s guest moderator response comes from EP Lab Digest board member Kalyanam Shivkumar, MD, PhD, whose institute provides their expertise on anesthesia utilization. Kalyanam Shivkumar, MD, PhD is the Director of the UCLA Cardiac Arrhythmia Center and EP Program. See the inset for the response. We hope to hear from you soon!

In this article, the authors provide an overview of the use of dexmedetomidine (Precedex) infusion to maintain continual sedation in the Electrophysiology Laboratory for patients undergoing lengthy atrial fibrillation ablation.

In July 2006, an informative heart fair was held to help educate both patients and the community about cardiology and EP. In this interview, we speak with Salwa Beheiry, RN, who helped organize the event. She is the Director of EP Services at Sutter Pacific Heart Centers in San Francisco, California.

At Kings Daughters Medical Center (KDMC), a 385-bed regional referral center in Ashland, Kentucky, the Heart and Vascular service line has experienced significant increases in volume in the last several years. Our cardiovascular services have grown from providing 6,500 cardiac catheterization procedures in 2003 to a projection of more than 12,000 in 2006. Given the critical role interventional devices and supplies play in supporting these procedures, the acquisition, storage, and utilization of thousands of high-priced items became a high organizational priority. For example, with 2,000 angioplasty/stent procedures completed in 2005, we estimated $5.6 million was invested in coronary stents alone.

Introduction. The purpose of this study was to retrospectively review the 5-year experience of a university hospital with implantable loop recorders (ILR) for the diagnosis of recurrent, unexplained syncope or presyncope. Methods. One hundred patients with syncope or presyncope of unknown etiology (negative tilt-table test, electrophysiology study and neurologic workup) underwent prolonged monitoring with an ILR from March 2000 to December 2004. All implants were performed using a first-generation (manual activation) or second-generation (manual plus automatic activation) ILR. Results. One hundred patients (70 women, 30 men) with a mean age of 68 ± 18 years received the ILR. Twenty-three patients had coronary artery disease; 2 patients had dilated cardiomyopathy. Ten patients received a first-generation ILR, and 90 patients received a second-generation ILR. After 9 ± 8 months’ follow up, ILR interrogation identified an arrhythmogenic etiology to the syncope/presync

FIX-HF-5 (Fix Heart Failure 5) is a clinical study designed to investigate the safety and effectiveness of a new system called the Optimizer for treating heart failure patients. The study is planning to enroll over 400 patients with New York Heart Association (NYHA) Class III or Class IV heart failure patients at sites across the United States. The trial began in mid 2004 and is expected to be completed by late 2006. The following is an update on the study’s progress at the Texas Cardiac Arrhythmia (TCA) Institute, which is one of the sites participating in the trial.

Dr. Peter Fischbach recently joined Children’s Healthcare of Atlanta Sibley Heart Center as a pediatric cardiologist. He previously served as the director of the Pediatric Electrophysiology Laboratory at the Michigan Congenital Heart Center. We spoke with him about his recent move, as well as his future research goals in EP.

Oregon Heart & Vascular Institute at Sacred Heart Medical Center is known as one of the premier providers of cardiovascular care in the Northwest. The institute was established in 2004 to better integrate care of both the heart and circulatory system and enhance the coordination of patient care. The Institute is composed of cardiologists, cardiac surgeons, interventional radiologists and vascular surgeons partnering with research teams at the University of Oregon. The Oregon Heart & Vascular Institute is dedicated to providing exceptional care for patients with cardiovascular disease with an emphasis on prevention and community education.