Cardiac rhythm devices

BACKGROUND: Individuals with developmental and/or intellectual disabilities (I/DD) are at a greater risk for atrial fibrillation (AF), the most common type of cardiac arrhythmia. AF is associated with heart failure, stroke, poor mental health, and reduced quality of life. Management and treatment decisions are based on the ability to detect AF; however, noninvasive, remote cardiac monitoring may not be tolerated by individuals with I/DD. OBJECTIVE: To examine adherence to the placement of an ambulatory cardiac rhythm monitoring patch device by adult patients with I/DD...

A 66-year-old female with end-stage renal disease and heart failure with reduced ejection fraction, status post implantable cardioverter defibrillator (ICD) presented to the emergency department with dizziness and fatigue. An electrocardiogram showed sinus rhythm, complete atrioventricular block, and ventricular paced rhythm at 30 beats per minute (bpm). Device interrogation revealed a programmed VVI mode with a lower rate limit of 40 bpm and evidence of T wave oversensing. Serologic studies were remarkable for hyperkalemia (7...

Arrhythmia, a frequently encountered and life-threatening cardiac disorder, can manifest as a transient or isolated event. Traditional automatic arrhythmia detection methods have predominantly relied on QRS-wave signal detection. Contemporary research has focused on the utilization of wearable devices for continuous monitoring of heart rates and rhythms through single-lead electrocardiogram (ECG), which holds the potential to promptly detect arrhythmias. However, in this study, we employed a convolutional neural network (CNN) to classify distinct arrhythmias without QRS wave detection step...

BACKGROUND: Cardiac conduction disorders (CCD) in patients <50 years are a rare and mostly unknown condition. OBJECTIVE: We aimed to assess clinical characteristics and genetic background of patients < 50 years with CCD of unknown origin. METHODS: We retrospectively review a consecutive series of patients with a diagnosis of CCD before the age of 50 referred to our Centre between January 2019 and December 2021. Patients underwent complete clinical examination and genetic evaluation...

BACKGROUND: Atrial fibrillation (AF) represents a hazardous cardiac arrhythmia that significantly elevates the risk of stroke and heart failure. Despite its severity, its diagnosis largely relies on the proficiency of health care professionals. At present, the real-time identification of paroxysmal AF is hindered by the lack of automated techniques. Consequently, a highly effective machine learning algorithm specifically designed for AF detection could offer substantial clinical benefits...

This document on cardiovascular infection, including infective endocarditis, is the first in the American Society of Nuclear Cardiology Imaging Indications (ASNC I2 ) series to assess the role of radionuclide imaging in the multimodality context for the evaluation of complex systemic diseases with multi-societal involvement including pertinent disciplines. A rigorous modified Delphi approach was used to determine consensus clinical indications, diagnostic criteria, and an algorithmic approach to diagnosis of cardiovascular infection including infective endocarditis...

Atrial fibrillation surgery is beneficial for restoring sinus rhythm and maintaining the physiological atrial contraction to prevent left atrial thrombus formation. The radial procedure, a good alternative to the maze procedure, has been performed at Nippon Medical School;it was designed to maintain physiological atrial excitation and blood flow. The design reduces the incision line and avoids conduction delay in the atrium through the use of ablation devices and intraoperative mapping of atrial excitation patterns...

The second generation of transcatheter pacing systems, called Micra AV, can provide atrio-ventricular (AV) synchronous pacing via a new pacing algorithm relying on sensing mechanical atrial contraction. Several novel programming parameters were introduced to enable AV synchronous pacing, including an A3 and A4 window as well as a conduction and an activity mode switch. In addition to several automated features, manual programming optimization of some of the novel parameters is key to improving AV synchrony...

OBJECTIVES: There is limited information on long-term outcomes and trajectories of ventricular and valvular functions in patients with congenitally corrected transposition of the great arteries after anatomic repair according to the operative strategy with a median follow-up period of more than 10 years. METHODS: Twenty-nine patients who underwent anatomic repair in Okayama University Hospital between January 1994 and December 2020 were reviewed. Outcomes were compared between patients underwent a double switch operation (DS group) and patients with an atrial switch with a Rastelli operation (Rastelli-Seninng/Mustard group)...

Stroke prevention following successful catheter ablation of atrial fibrillation remains a controversial topic. Oral anticoagulation is associated with a significant reduction in stroke risk in the general atrial fibrillation population but may be associated with an increased risk of major bleeding, and the benefit: risk ratio must be considered. Improvement in successful catheter ablation and widespread use of cardiac monitoring devices may allow for novel anticoagulation strategies in a subset of patients with atrial fibrillation, which may optimize stroke prevention while minimizing bleeding risk...

BACKGROUND: Cardiac resynchronization therapy (CRT) with biventricular pacing (BVP) is a well-established therapy in patients with reduced left ventricular ejection fraction (LVEF), heart failure, and left bundle branch (LBB) block. LBB area pacing (LBBAP) has recently been shown to be a feasible and effective alternative to BVP. Comparative data on the risk of complications between LBBAP and BVP among patients undergoing CRT are lacking. OBJECTIVE: The aim of this study was to compare the long-term risk of procedure-related complications between LBBAP and BVP in a cohort of patients undergoing CRT...

No abstract text is available yet for this article.

BACKGROUND: During the COVID-19 pandemic, professional societies recommended deferral of elective procedures for optimal resource utilization. OBJECTIVE: We sought to assess changes in procedural trends and outcomes of electrophysiology (EP) procedures during the pandemic. METHODS: National Inpatient Sample databases was used to identify all EP procedures performed in the US (2016-2020) using ICD-10 codes. We evaluated trends in utilization, cost/revenue, and outcomes from EP procedures performed...

No abstract text is available yet for this article.

OBJECTIVE: Intraosseous (IO) access is frequently utilized during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients. Due to proximity to the heart and differential flow rates, the anatomical site of IO access may impact patient outcomes. Using a large dataset, we aimed to compare the outcomes of OHCA patients who received upper or lower extremity IO access during resuscitation. METHODS: The ESO Data Collaborative public use research datasets were used for this retrospective study...

Background Atrial fibrillation (AF) is a type of heart disease characterized by an irregular cardiac rhythm. The complications of AF are associated with significant morbidity, mortality, and medical expenses. This emphasizes the significance of detecting AF early using a feasible device. Methods A total of 123 patients who attended cardiology and INR clinics were enrolled, with 51 of them having AF. The blood pressure of all patients was measured three times using the Rossmax X5, while a single-lead electrocardiogram (ECG) was monitored simultaneously...

Out-of-hospital cardiac arrest (OHCA) represents a significant healthcare issue that is often underestimated. OHCA predominantly affects the general population, with staggering numbers: 400 000 cases annually in Europe and 350 000 in the United States, contributing to 50% of cardiovascular-related deaths. The vast majority of OHCA cases begin with a shockable rhythm, making effective treatment possible through early defibrillation, even by non-medical personnel using automated external defibrillators (AEDs)...

Ictal asystole (IA) is a rare but potentially life-threatening complication of focal epilepsy. The sudden onset of loss of consciousness and drop attacks in a patient with chronic epilepsy should suggest the possibility of this complication. Once the diagnosis is established, rapid management should be considered, especially in high-risk cases. The approach does not differ between temporal and extratemporal lobe epilepsies. Strategies can be aimed at preventing the emergence of cortical epileptic activity from the beginning (surgery, antiseizure therapy), neutralizing negative chronotropic effects on the heart (cardiac neuromodulation), or restarting the heart rhythm with a pacemaker...

BACKGROUND: Left arial appendage exclusion (LAAE) is an effective alternative to long-term anticoagulation in patients with atrial fibrillation (AF). Not all patients considered for LAAE undergo the procedure due to ineligibility, anatomical or medical constraints, and patient preference. OBJECTIVE: To report on the management strategies and long-term clinical outcomes of patients referred to a dedicated multidisciplinary LAAE clinic including all who subsequently did and did not undergo LAAE...

No abstract text is available yet for this article.