It’s been a busy year for our discussion group, and although we are nearing the end of 2007, the discussion group is still bustling with questions. If you would like to join in on the discussion, please email us at eplabdigest@hotmail.com or visit us at www.eplabdigest.com (click on the email discussion group link). Remember, when posting or responding to the discussion group, please let us know if you would like your name, location, and/or email address listed as well. We look forward to hearing from you!

Current procedures for the treatment of atrial fibrillation (AF) are still in a process of development and evolution. Circumferential pulmonary vein ablation efficacy is not at the point where we can be satisfied with medium to long-term outcomes. We believe that this lack of efficacy is multi-faceted and not solely related to pathophysiological concepts, but also to technical challenges such as three-dimensional (3D) anatomical orientation and stable, reproducible catheter access. At Leipzig Heart Center, we are experiencing some success with techniques and tools designed to rectify these challenges. One of the approaches we have recently begun to utilize is ablation within a 3D image of the patient’s left atrium without any further electroanatomical chamber reconstruction. This way, highly accurate and realistic anatomical information guide the navigation of the ablation catheter.

In this article, one EP lab nurse describes how her institution has handled the issue of deep sedation.

This December, the first annual Western Atrial Fibrillation Symposium will be held. In this article, author Michael Huntsman provides all the information you need about this featured event.

In this article, we learn about the Prospective, Randomized Evaluation of Cardiac Compass With OptiVol in the Early Detection of Decompensation Events for Heart Failure (PRECEDE-HF) trial, which is now enrolling patients. Dr. Abraham, Professor of Medicine and Chief of the Division of Cardiovascular Medicine at the Ohio State University Medical Center, is the principal investigator in this trial.

Marketed by Shire under the name Ethmozine^®, morizine hydrochloride has been available in the United States as an antiarrhythmic medication for approximately 20 years. It is used in the treatment of both supraventricular and ventricular arrhythmias, most often when other treatments have failed, are poorly tolerated, or are contraindicated. On July 30, 2007, Shire posted a notice on the U.S. Food and Drug Administration’s Web site under the heading “Drugs to be Discontinued” that Ethmozine^® would be discontinued on August 28, 2007. Given that Ethmozine^® is used in patients with life-threatening arrhythmias and has no generic alternative, the Heart Rhythm Society (HRS) contacted Shire to attempt to change the decision in a manner that would protect patients and provide adequate time for physicians to safely adjust treatment.

Nicole Jarrell, RNC, MSN, is a Nurse Expert in the Cardiac Intensive Cardiac Unit (CICU) at Children’s Healthcare of Atlanta’s Sibley Heart Center. J. Renee Watson, RN, CIC is the Manager of Infection Control/Occupational Health at Children’s Healthcare of Atlanta. Recently Nicole Jarrell, RNC, MSN and J. Renee Watson, RN, CIC conducted research initiatives to minimize the risk of catheter-related blood stream infections in high-risk pediatric patients.

In this article, Drs. Kranjcec and Abriel describe the possible link between gasoline vapor exposure and Brugada syndrome. Keep reading to learn more about their interesting findings.

In this new feature, see if you can figure out what is being demonstrated in the Holter recording.