Readers, is your lab a dedicated EP lab or is it shared with the Cath Lab? We are finding that many EP labs these days are now separate from the Cath Lab. The following accounts of cross training in the electrophysiology lab were taken from Spotlight Interviews published in EP Lab Digest dating back to September 2001. Please note that some of the managers comments were edited slightly so as to focus solely on the management and organizational aspects of their cath labs.

Readers, is your EP lab separate from the Cath lab? How long has this been? Do you have cross-training inside

The information gleaned from the study of anti-arrhythmic drugs is often complicated by the multiple mechanisms by which arrhythmias are generated, and by the fact that we often do not fully understand the relationship between risks and benefits of a given drug.¹ This brief overview will attempt to put some of these issues into a current perspective. The Vaughn-Williams anti-arrhythmic drug classifications, current agendas for arrhythmia control and prevention, and some of the promising new drugs will be reviewed.

Cryoablation is making its way as the preferred technology in the treatment of arrhythmias. Dr. Strieper, of Children s Healthcare of Atlanta (CHOA), recently began using the procedure in pediatric patients. In this article, she describes the procedure and its success rates.

Atrial fibrillation is the most common sustained arrhythmia in humans, with a prevalence of 1% in the general population, and is associated with a significant increase in morbidity and mortality.¹ The impressive results of surgical MAZE procedures in treating atrial fibrillation have formed the basis for considerable enthusiasm for treating this arrhythmia with a similar but percutaneous catheter ablation approach.

In this interview, this dedicated EP lab takes time to remember Dr. Brian McGovern, who was involved with starting the program in 1990.

Occasionally, access may be difficult during a permanent pacemaker implant. Knowing the tricks of the trade are very important in order to perform an apparently complicated procedure quite easily.

Case Report
Despite a previous pulmonary vein (PV) isolation, a 51-year-old man developed recurrent paroxysmal atrial fibrillation (AF) after six months. AF occurred two to three times per week, with each episode lasting 24 to 30 hours. The patient had also undergone percutaneous coronary intervention with stent placement in the LAD three years previously. The original PV isolation procedure had only successfully isolated the left superior and left inferior pulmonary veins. Isolation of the right superior PV had been attempted but not completed due to limitations in procedure time. Th

Dr. Sangrigoli is co-author of a clinical study on Mobile Cardiac Outpatient Telemetry, which was presented at the 2003 NASPE Scientific Sessions.¹ In this study, the investigators found that Mobile Cardiac Outpatient Telemetry (MCOT) detected serious arrhythmias in 53% of patients who had previously been monitored with Holter and/or event recording, where no arrhythmia had been detected. MCOT led to a change in treatment in 34% of all patients studied.

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 unexplained sudden deaths in this ethnic group.⁴

Atrial infarction (ATI) is detected in about 0.7-42% of autopsy findings of acute myocardial infarction (AMI) depends on whether or not the atria are specifically examined.^1-3 Electrocardiography (ECG) is the only means of which antemortem diagnosis of ATI can be made. PR-segment represents the period of atrial repolarization. Significant PR-segment depression in inferior leads with reciprocal PR-segment elevation in lead I is used as one of the diagnostic criteria for ATI.⁴ However, the sensitivity of these diagnostic criteria is low, in the range of 5.4â