Robotics
At the Heart Rhythm Society annual scientific sessions in May 2007, the word for the day was robotics. There was a huge amount of buzz regarding the approval of Hansen Medical s Sensei Robotic Catheter System as well as the intrigue of the Stereotaxis Niobe ^® Magnetic Navigation System. Another important phrase of the day was remote navigation. The Hansen Medical system is a robotic system that employs a 14 French steerable sheath in which the ablation catheter is passive. A large control station with a new concept in catheter manipulation was introduced at the meeting, where the entire system was on display. In addition, Stereotaxis, which uses magnetic navigation and soft flexible catheters guided by a magnetic field, was also on display.

Recalls

Mo al-Ahdab, MD, FAAP

Why did you choose to work in the field of pediatric electrophysiology? Describe your medical background.

My passion for the field started in medical school, during the time I was learning how to read electrocardiograms. During my residency training in pediatrics at the University of Illinois at Chicago, I was exposed to some patients with arrhythmia issues that were medically treated. When Dr. Mark Ovadia joined the program and started to perform EPS and ablations on these patients, I was amazed how a life of a patient can change from one where they were taking one or two anti-arrhythmics to being drug-free and symptom-free after their procedure.

Is PillCam ESO and the Given Imaging System also currently used for gastroenterology procedures?
Yes, PillCam ESO was developed for patients suffering from esophageal disorders, such as esophageal varices, which may result in fatal bleeding, and Barrett s esophagus, which is an early indication for esophageal cancer. It provides a patient-friendly alternative to esophageal endoscopy and the associated sedation and discomfort. PillCam ESO contains an imaging device and light source at both ends of the capsule and takes up to 14 images per second a total of 2,600 color images

Clinical History
A 56-year-old female with non-ischemic dilated cardiomyopathy, an ejection fraction of 25%, congestive heart failure, recurrent atrial fibrillation, pulmonary hypertension, and hyperlipidemia, states that she has periodic palpitations associated with shortness of breath. She denies chest pain, orthopnea, dizziness, and syncope.

Device History
S/P ICD implantation:
ICD: Medtronic D154ATG EnTrust
A Lead: Medtronic 5076 CapSure Fix Novus
V Lead: Medtronic 6949 Sprint Fidelis

Medications
Coreg: 6.25 mg bid
Digoxin: 0.25 m

Under Discussion:

EP Lab Work Schedule
Our EP lab will be going to 8-hour shifts, 5 days a week in a couple of months. This is a decision that is widely unpopular with our nurses and techs. I am wondering if any other EP labs work 8-hour shifts (all 7-3:30) 5 days a week, and if so, what has been your experience with this scheduling format? Any pros, cons, suggestions?
Lee Henry, RN
(To reply to this question, please type Work Schedule in your subject line.)

We consider ourselves 8-hour shifts Monday through Friday, but we cannot leave until all cases

How did the idea of putting automated external defibrillators (AEDs) in all Ohio schools come about? How did you get started?

About eight years ago, Josh Miller, a 15-year-old high school football player from Barbarton, Ohio, ran off the football field on a Friday night and collapsed. He died of a sudden cardiac arrest (SCA). I had the unfortunate experience of watching the videotape of his death, and it was the most sickening thing I ve ever seen in my life. It was like going to a movie that you had seen a 100 times before and knew exactly how it was going to end, but you were hoping and praying it would end differently. In that normally boisterous stadium you could hear a pin drop, except for the wail of his mother it was a sound that reverberated in my soul.

The hospital is part of the larger University Medical Center, which is the largest among Hamburg s hospitals with approximately 1,400 hospital beds. The medical center treats approximately 50,000 inpatients annually and approximately 250,000 outpatients as well as 50,000 emergency patients.
Following is a look at the University Heart Center at the University Hospital Hamburg-Eppendorf. Professor Stephan Willems and Dr. Daniel Steven discuss with us the inner workings of clinical electrophysiology and the latest advancements in medical technology that enable them to provide their pati

Our laboratory is equipped with an EP MedSystems recording system (EP MedSystems, Inc., West Berlin, New Jersey), intracardiac ultrasound, and both Carto (Biosense Webster Inc., a Johnson & Johnson company, Diamond Bar, California) and EnSite NavX (St. Jude Medical, St. Paul, Minnesota) mapping systems.

AF Approach

UMass Memorial Medical Center, located in Worcester, Massachusetts, has two electrophysiology (EP) labs. They perform approximately 1,300 EP procedures annually and maintain an inventory value of approximately $1 million at any given time. With cardiac rhythm devices ranging from $5,000-$35,000 each, and catheters costing a few thousand dollars each, UMass wanted a streamlined solution for managing this costly inventory. Specifically, our staff at UMass was looking to decrease the volume of items being stored in the labs and storerooms, while also differentiating between OEM (Original Equipment Manufacturer) products and reprocessed items.

The purpose of this article is to provide a simple educational overview for staff members about tilt table testing. Although the specifics of this test can vary from place to place, there are fundamental basics that should be understood. Therefore, our goal is to give a brief outline of what to grasp when performing this test. With the help of the Providence Heart Institute s EP lab team and director Dr. Christian Machado, we will cover the how to of tilting.

What is a tilt table test?