Cardiac resynchronization therapy (CRT), also known as biventricular pacing, provides symptomatic relief, clinical improvement, prolonged survival, and a better quality of life for many heart failure patients. CRT defibrillators (CRT-D) also provide potentially life-saving tachyarrhythmia therapies for these patients. Many of the challenges that occur during the implantation of CRT devices are due not only to venous anatomy, but to diaphragmatic stimulation and/or high left ventricular (LV) thresholds while positioning the LV lead.
In August 2004, the FDA approved EASYTRAK ® 2 and EASYT

Despite significant advances in medical therapy of congestive heart failure (CHF), patients with class III and IV CHF suffer from a poor quality of life and a grave prognosis.^1,2
Currently, there is ample evidence that atrial synchronized sequential pacing in left or both ventricles improves some electrical abnormalities and provides symptomatic relief for selected patients with stage III or IV CHF.^3-7 Left atrial (LA) pacing remains unexplored as a treatment modality in these patients.

Case Report. A 72-year-old man with stage III CHF due to ischemi

What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab?
The Pediatric Arrhythmia Service at MUSC has one fully dedicated digital bi-plane Philips cath lab, and one procedure room where we do pacemaker evaluations, tilts and other minor procedures. We also have a "Same Day" area where minor procedures requiring sedations can be performed. There are two pediatric electrophysiologist (Drs. Saul and Blaufox), one fellow, two arrhythmia nurse specialists and three EP/CVT techs, as well as a secretary and manager, all dedicated to t

Please describe your medical background. What made you choose pediatric electrophysiology?
I graduated from medical school at the University of Texas in Houston, and from there I trained in pediatrics at Baylor College of Medicine in Houston. After that, I went to the Medical University of South Carolina for my pediatric cardiology and electrophysiology training. I trained under Drs. Paul Gillette and Chris Case there. I have been here at Children s Mercy for about two years.
I decided on pediatric electrophysiology because I found cardiology fascinating. I liked the techniqu

Technology has the ability to make healthcare occupations less physically demanding as well as reducing procedural steps and tedious paperwork. These advances are still in the early stages of adoption in most healthcare organizations.
A study commissioned by the American Hospital Association in 2001 found that for every hour of patient care, 30 to 60 minutes of additional paperwork was generated for nurses. This paperwork takes away from the time that the nurse has to provide care to patients. Nursing retention surveys have shown the importance and correlation of patient contact to job satis

Please describe your medical background and education. Why did you choose to work in the field of electrophysiology?
I completed my undergraduate at Abilene Christian University, then graduated from the University of Texas Graduate School of Biomedical Science. I attended Medical School at the University of Oklahoma, completed my Surgery Internship at Mount Sinai School of Medicine, then attended the University of Michigan for  my Internal  Medicine residency, Cardiology and Cardiac Electrophysiology Fellowships. I did undergraduate  and graduate research in tumor virology,

The ACCF/AHA/HRS/SCAI Fluoroscopy Clinical Competence Statement has appeared in JACC and is available online at the respective site of each of these organizations. The purpose of this article is to review the rationale for the document, look at the knowledge base proposed, and reflect on the implications for electrophysiology practices.

Why Has This Document Been Developed?
Clinical electrophysiology in the cardiac catheterization lab has evolved from performance of just diagnostic EP studies to some rather lengthy ablation and device implant procedures. Because of the complexity in

Currently Under Discussion:

R2 Pads
Does anyone routinely position the R2 pads under fluroscopy so that they are placed exactly over the heart?
R. Sparrow, RN

We do not use flouroscopy to position the pads directly over the heart. However, during our EP cases, we prefer the pads to be in an anterior-posterior position. We are a pediatric facility but we almost exclusively use anterior-posterior pads. We use the Zoll radioluscent pads for adults and the Medtronic physio-control radioluscent pads for children under 15 kg.  
L. Payne, RN

In the  full service  EP