BOOK
Pacemakers and Implantable Cardioverter Defibrillators, An Issue of Cardiology Clinics, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Cardiology Clinics examines pacemakers and implantable cardioverter defibrillators (ICD). Topics include device selection, indications and guidelines for device therapy, shock avoidance, lead advisories and recalls, lead extraction, subcutaneous ICDs, device tools to manage the heart failure patient, and many more.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Pacemakers and Implantable\rCardioverter Defibrillators | i | ||
| copyright\r | ii | ||
| Contributors | iii | ||
| Contents | v | ||
| Cardiology Clinics\r | ix | ||
| Preface\r | xi | ||
| Erratum | xiii | ||
| Newer Indications for ICD and CRT | 181 | ||
| Key points | 181 | ||
| ICD therapy | 181 | ||
| Secondary Prevention | 181 | ||
| Primary Prevention | 182 | ||
| ICD Guideline Changes | 184 | ||
| CRT | 184 | ||
| Summary | 189 | ||
| References | 189 | ||
| Shock Avoidance and the Newer Tachycardia Therapy Algorithms | 191 | ||
| Key points | 191 | ||
| Introduction | 191 | ||
| Background | 191 | ||
| Management Options to Minimize Shock Therapy | 192 | ||
| Medical therapy | 192 | ||
| Catheter ablation | 193 | ||
| Device programming | 193 | ||
| Lowest Detected Rate | 194 | ||
| Detection Duration | 194 | ||
| Antitachycardia Pacing (ATP) | 194 | ||
| SVT Discrimination | 195 | ||
| Sudden Onset | 195 | ||
| Stability | 195 | ||
| Morphology | 195 | ||
| AV Relationship and Choosing Single-Chamber or Dual-Chamber ICDs | 196 | ||
| Ventricular Oversensing | 196 | ||
| Remote Interrogation and Monitoring | 197 | ||
| Summary | 197 | ||
| References | 197 | ||
| Lead Extractions | 201 | ||
| Key points | 201 | ||
| Introduction | 201 | ||
| Indications for lead extraction | 201 | ||
| CIED Infection | 201 | ||
| Chronic Pain Indication | 202 | ||
| Thrombosis or Venous Stenosis Indications | 202 | ||
| Functional Lead Indications | 202 | ||
| Nonfunctional Lead Indications | 204 | ||
| Procedural aspects | 204 | ||
| Facilities and Training Requirements | 204 | ||
| Preprocedural Considerations | 205 | ||
| Procedure Considerations | 205 | ||
| Device Pocket Preparation | 206 | ||
| Lead Extraction Procedure | 206 | ||
| Emergency Surgical Management of Vascular and Cardiac Injury | 208 | ||
| Lead Extraction Complications and Outcomes | 208 | ||
| Summary | 210 | ||
| References | 210 | ||
| Is Defibrillation Testing Necessary? | 211 | ||
| Key points | 211 | ||
| Introduction | 211 | ||
| Definition of defibrillation threshold | 211 | ||
| Reasons to support defibrillation testing | 212 | ||
| Assessment of System Integrity and Reliable Sensing | 212 | ||
| Discovery of High DFTs Needing System Modification | 212 | ||
| Poor Predictive Value of Clinical Factors in Identifying High DFTs | 212 | ||
| Increased Assurance that Defibrillation of VF Will Be Successful During Clinical Events | 214 | ||
| Discovery of Low DFTs that May Allow Programming of Lower First-Shock Energies | 214 | ||
| Assurance of a Safety Margin for Testing After Addition of Antiarrhythmic Drugs, such as Amiodarone, that May Raise DFTs | 214 | ||
| Assurance that the Device Is Not a Lemon | 214 | ||
| Assessment of Lead Problems that May Only Be Identified with High-Voltage Testing | 214 | ||
| Assessment for Device-Device Interaction in Patients with More than One Cardiac Implantable Electrical Device | 214 | ||
| Evidence-Based Medicine, Clinical Trials, and Standard of Care | 215 | ||
| Reasons to avoid defibrillation testing | 215 | ||
| Low Probability of High DFTs | 215 | ||
| Majority of Treated Events Are VT, Effectively Treated with Antitachycardia Pacing | 215 | ||
| Even If a First Shock Fails, Subsequent Shocks Likely Are Successful | 215 | ||
| DFT Testing Requires Heavier Sedation and Additional Personnel | 215 | ||
| Complications Related to Defibrillation Testing Can Lead to Morbidity or Even Mortality | 216 | ||
| Shocks May Increase Mortality | 217 | ||
| Defibrillation Testing Limits Expansion of Device Implantation | 218 | ||
| Defibrillation Testing Increases Costs | 218 | ||
| DFT impact on mortality and arrhythmic death | 218 | ||
| Current practice trends | 219 | ||
| Paucity of randomized trial data | 219 | ||
| Summary | 220 | ||
| References | 220 | ||
| The Totally Subcutaneous Implantable Defibrillator | 225 | ||
| Key points | 225 | ||
| Introduction | 225 | ||
| Specifications | 227 | ||
| Patient selection | 227 | ||
| Surgical technique and perioperative management | 229 | ||
| Clinical outcomes | 231 | ||
| Complications and concerns | 234 | ||
| Summary | 234 | ||
| Supplementary data | 234 | ||
| References | 234 | ||
| The Modern EP Practice | 239 | ||
| Key points | 239 | ||
| Introduction | 239 | ||
| Remote Follow-up and Remote Monitoring | 240 | ||
| Remote Technologies | 240 | ||
| Clinical Trials | 240 | ||
| Device management | 242 | ||
| Recalls and Advisories | 242 | ||
| Disease management | 243 | ||
| AF | 243 | ||
| HF | 244 | ||
| Mega-Cohort Studies | 244 | ||
| Barriers to enrolling in remote monitoring | 244 | ||
| The follow-up clinic in the era of remote monitoring | 246 | ||
| Best-Case Scenario | 246 | ||
| Current Reality | 246 | ||
| Future directions | 247 | ||
| Shared Labor Force Model | 247 | ||
| Creating an Integrated Remote Monitoring Center | 249 | ||
| Role of Remote Interrogation in Other Health Care Settings | 249 | ||
| Remote Reprogramming | 249 | ||
| Summary | 250 | ||
| References | 250 | ||
| The Role of the Wearable Cardioverter Defibrillator in Clinical Practice | 253 | ||
| Key points | 253 | ||
| Description | 253 | ||
| Programming and detection | 254 | ||
| Monitoring capabilities | 255 | ||
| Current approved indications for WCD use | 255 | ||
| WCD indications in guidelines and expert consensus statements | 255 | ||
| The WCD usage in clinical practice | 257 | ||
| ICD versus WCD use for primary prevention of SCD | 258 | ||
| Early after MI with LV dysfunction | 258 | ||
| Risk of SCD Early After MI | 258 | ||
| Role of an ICD Early After MI | 259 | ||
| Role of the WCD Early After MI | 260 | ||
| Recommendations | 260 | ||
| Early after coronary revascularization with LV dysfunction | 260 | ||
| Risk of Mortality Early After Coronary Revascularization | 261 | ||
| Role of the ICD Early After Coronary Revascularization | 261 | ||
| Role of the WCD | 261 | ||
| Recommendations | 261 | ||
| Early after recent diagnosis of cardiomyopathy | 262 | ||
| Role of an ICD Early After Diagnosis of Heart Failure | 263 | ||
| Does Atrial Fibrillation Detected by Cardiac Implantable Electronic Devices Have Clinical Relevance? | 271 | ||
| Key points | 271 | ||
| Part 1: Sensitivity and specificity of AF detection by implanted devices | 271 | ||
| AF Detection Based on Mode-Switching | 272 | ||
| AF Detection Based on Rate and Pattern | 272 | ||
| AF Detection Based on Ventricular Irregularity and Incoherence | 272 | ||
| Summary | 273 | ||
| Part 2: Evidence: device-detected AF is associated with thromboembolic events | 273 | ||
| Part 3: Temporal proximity of device-detected AF episodes to TE events | 277 | ||
| Part 4: Newly detected AF in patients with no prior history of AF | 277 | ||
| Part 5: The future | 279 | ||
| Limitations | 279 | ||
| Summary | 280 | ||
| References | 280 | ||
| Newer Algorithms in Bradycardia Management | 283 | ||
| Key points | 283 | ||
| Introduction | 283 | ||
| Automated threshold testing | 284 | ||
| Algorithms aimed at avoiding RV pacing | 285 | ||
| Pacemaker-mediated tachycardia: prevention and intervention | 287 | ||
| Mode-switch algorithms | 287 | ||
| Rate-responsive pacing | 288 | ||
| Arrhythmia storage and remote monitoring | 289 | ||
| Summary | 290 | ||
| References | 290 | ||
| Indications for Cardiac Resynchronization Therapy | 293 | ||
| Key points | 293 | ||
| Pacing for heart failure | 293 | ||
| Initial indications | 294 | ||
| Evolution of CRT | 295 | ||
| Earlier Timing of CRT: REVERSE and MADIT-CRT | 295 | ||
| Narrow QRS Duration: EchoCRT | 295 | ||
| Higher LVEF: MIRACLE EF | 296 | ||
| AV Block Requiring Ventricular Pacing: BLOCK HF | 296 | ||
| Post–Myocardial Infarction HF: PROMPT | 296 | ||
| Summary | 296 | ||
| References | 297 | ||
| MRI for Patients with Cardiac Implantable Electrical Devices | 299 | ||
| Key points | 299 | ||
| Introduction | 299 | ||
| Known risks associated with MRI | 299 | ||
| The Hopkins protocol | 300 | ||
| MRI within 6 weeks of device implantation | 300 | ||
| State of the art: MRI-conditional devices | 302 | ||
| Early clinical experiences with lead-related complications | 303 | ||
| Summary | 303 | ||
| References | 303 | ||
| Implantable Defibrillators in Long QT Syndrome, Brugada Syndrome, Hypertrophic Cardiomyopathy, and Arrhythmogenic Right Ven ... | 305 | ||
| Key points | 305 | ||
| Introduction | 305 | ||
| LQTS | 305 | ||
| Overview, Clinical Presentation, and Pathophysiology | 305 | ||
| Diagnosis | 306 | ||
| Risk Stratification | 306 | ||
| Beta-Blockade and Adjunctive Therapies for Sudden Death Prevention | 307 | ||
| Defibrillator Therapy for Sudden Death Prevention | 307 | ||
| ICD Considerations Specific to LQTS | 307 | ||
| BrS | 307 | ||
| Overview, Clinical Presentation, and Pathophysiology | 307 | ||
| Diagnosis | 308 | ||
| Risk Stratification | 309 | ||
| Defibrillator and Adjunctive Therapies for Sudden Death Prevention | 309 | ||
| HCM | 310 | ||
| Overview, Clinical Presentation, and Pathophysiology | 310 | ||
| Risk Stratification | 311 | ||
| Defibrillator and Adjunctive Therapy for Sudden Death Prevention | 311 | ||
| ICD Considerations Specific to HCM | 311 | ||
| ARVC | 312 | ||
| Overview, Clinical Presentation, and Pathophysiology | 312 | ||
| Diagnosis | 313 | ||
| Risk Stratification | 313 | ||
| Defibrillator and Adjunctive Therapy for Sudden Death Prevention | 313 | ||
| ICD Considerations Specific to ARVC | 313 | ||
| General considerations in the inherited syndrome population | 313 | ||
| Risk at Time of Implantation | 313 | ||
| Reducing Shocks | 313 | ||
| Device Durability | 313 | ||
| Role of Subcutaneous Device | 314 | ||
| References | 314 | ||
| Index | 319 |