BOOK
Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy E-Book
Kenneth A. Ellenbogen | Bruce L. Wilkoff | G. Neal Kay | Chu Pak Lau | Angelo Auricchio
(2016)
Additional Information
Book Details
Abstract
Your must-have bench reference for cardiac electrophysiology is now better than ever! This globally recognized gold standard text provides a complete overview of clinical EP, with in-depth, expert information that helps you deliver superior clinical outcomes. In this updated 5th Edition, you’ll find all-new material on devices, techniques, trials, and much more – all designed to help you strengthen your skills in this fast-changing area and stay on the cutting edge of today’s most successful cardiac EP techniques.
- Expert guidance from world authorities who contribute fresh perspectives on the challenging clinical area of cardiac electrophysiology.
- New focus on clinical relevance throughout , with reorganized content and 15 new chapters.
- New coverage of balloons, snares, venoplasty, spinal and neural stimulation, subcutaneous ICDs and leadless pacing, non-CS lead implantation, His bundle pacing, and much more.
- New sections on cardiac anatomy and physiology and imaging of the heart, a new chapter covering radiography of devices, and thought-provoking new information on the basic science of device implantation.
- State-of-the-art guidance on pacing for spinal and neural stimulation, computer simulation and modeling, biological pacemakers, perioperative and pre-procedural management of device patients, and much more.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | cover | ||
Inside Front Cover | ifc1 | ||
Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy | i | ||
Copyright Page | ii | ||
Dedication | iii | ||
Contributors | iv | ||
Preface | ix | ||
Table Of Contents | xi | ||
Video Contents | xiii | ||
1 Basic Principles | 1 | ||
1 Cardiac Anatomy and Pathology | 3 | ||
The Heart in the Chest | 3 | ||
Relationships of Cardiac Chambers | 3 | ||
The Right Atrium | 4 | ||
Right Atrial Appendage, Terminal Crest, and Sinus Node | 4 | ||
Eustachian Valve, Vestibule, Triangle of Koch, and Atrioventricular Node | 5 | ||
The Venous Component, Orifices of Caval Veins, and Coronary Sinus | 7 | ||
The Anterior Wall and the Atrial Septum | 7 | ||
The Right Ventricle | 8 | ||
The Left Atrium | 9 | ||
The Left Ventricle | 10 | ||
The Cardiac Veins | 11 | ||
References | 13 | ||
2 Imaging of Cardiac Anatomy | 15 | ||
Imaging Techniques in Cardiology | 15 | ||
Fluoroscopic Anatomy | 15 | ||
The Position of the Heart | 15 | ||
Anatomy | 15 | ||
Imaging Technique | 16 | ||
The Esophagus | 16 | ||
Anatomy | 16 | ||
Imaging Techniques | 16 | ||
The Right Atrium | 17 | ||
Anatomy | 17 | ||
Imaging Techniques | 17 | ||
General Concepts | 17 | ||
Terminal Crest | 19 | ||
2 Engineering and Construction of Devices and Leads | 249 | ||
8 Power Sources and Capacitors for Pacemakers and Implantable Cardioverter-Defibrillators | 251 | ||
Introduction | 251 | ||
Batteries | 251 | ||
Basic Function and Electrochemistry of Batteries | 251 | ||
Energy Storage in Batteries | 251 | ||
Chemical Reactions | 251 | ||
Major Components of Batteries | 251 | ||
Anode and Cathode | 251 | ||
Electrolyte | 252 | ||
Separator | 252 | ||
Current Collector | 252 | ||
Sealing of Batteries | 252 | ||
Classification of Batteries | 252 | ||
Primary Batteries | 252 | ||
Secondary Batteries | 252 | ||
Functional Characteristics of Batteries | 252 | ||
Capacity | 252 | ||
Energy and Energy Density | 253 | ||
Stoichiometry and Cell Balance | 253 | ||
Cell Voltage and Current | 253 | ||
Internal Resistance and Impedance | 253 | ||
Nonideal Battery Behavior | 253 | ||
Polarization | 253 | ||
Self-Discharge and Other Parasitic Reactions | 253 | ||
Use of Batteries in Implantable Cardiac Rhythm Management Devices | 254 | ||
Implantable Battery Design Requirements | 254 | ||
Power Requirements | 254 | ||
Average Versus Instantaneous Current Drain | 254 | ||
Shape, Size, and Mass Constraints | 254 | ||
Relationship Between Size, Energy Density, and Current Drain | 255 | ||
The Battery and Longevity of the Pulse Generator | 255 | ||
Effect of Pulse Width on Pacing Current | 255 | ||
Effect of Pulse Amplitude on Pacing Current | 255 | ||
Effect of Lead Impedance on Pacing Current | 256 | ||
Summary of Programming Effects on Longevity of Bradycardia Pulse Generators | 256 | ||
Considerations for Longevity of ICDs | 256 | ||
Battery End-of-Service Indication | 256 | ||
Elective Replacement Indicator | 256 | ||
Methods for Monitoring State of Battery Discharge | 256 | ||
Battery Voltage | 256 | ||
Battery Impedance | 257 | ||
Consumed Charge | 257 | ||
Blended Methods | 257 | ||
False RRT Triggering | 257 | ||
Clinical Indicators of the Battery Replacement Time | 257 | ||
Battery Chemistries Used in Pacemakers | 258 | ||
The Lithium/Iodine Battery | 258 | ||
Lithium/Iodine Cell Structure | 258 | ||
Discharge Curve for the Lithium/Iodine Battery | 258 | ||
Effects of Current Drain on Deliverable Capacity of Lithium/Iodine Cells | 258 | ||
The Lithium/Carbon Monofluoride Battery | 258 | ||
The Lithium/Hybrid Cathode Battery | 258 | ||
The Lithium/Manganese Dioxide Battery | 259 | ||
Battery Chemistries Used in Defibrillators | 259 | ||
Comparison of Pacemaker and Defibrillator Batteries | 259 | ||
Types of Batteries Used in ICDs | 260 | ||
Li/SVO Batteries | 260 | ||
Charge Time-Optimized Li/SVO ICD Batteries | 261 | ||
Lithium/Manganese Dioxide Batteries | 261 | ||
Silver-Vanadium Oxide-Carbon Monofluoride (Layered Dual Cathode and Hybrid Cathode) | 262 | ||
Safety | 262 | ||
Emerging Power Sources | 262 | ||
Rechargeable Lithium-Ion Batteries | 262 | ||
Principles of Operation | 263 | ||
Method of Recharge | 263 | ||
End-of-Service Life Indication | 263 | ||
Miniature Batteries for Leadless Devices | 263 | ||
Energy Harvesting | 264 | ||
Predictive Models and Accelerated Test Methods | 264 | ||
Capacitors | 264 | ||
Basic Function of Capacitors | 264 | ||
ICD Device Requirements Important for Capacitors | 265 | ||
ICD Capacitor Types | 265 | ||
Anode Materials in Current ICD Capacitors | 265 | ||
Cathode Materials in Current ICD Capacitors | 266 | ||
Parasitic Reactions in Current ICD Capacitors | 266 | ||
Energy Delivery | 266 | ||
Energy Density | 266 | ||
ICD Capacitor Construction | 267 | ||
Stacked-Plate Aluminum Electrolytic Construction | 267 | ||
Tantalum Electrolytic Capacitor Construction | 267 | ||
Long-Term Degradation of Uncharged Capacitors: Deformation | 267 | ||
Future Developments | 268 | ||
Effects of Batteries and Capacitors on Defibrillation Performance | 268 | ||
Energy Losses in Defibrillators | 268 | ||
Clinical Implications of Battery and Capacitor Design on Defibrillation Therapy | 268 | ||
References | 269 | ||
9 Lead Connection Systems and Standards for Cardiac Implantable Electronic Devices | 270 | ||
Early Years: Clinical Confusion and Need for Standardized Connection Systems | 270 | ||
Unipolar Pacemaker Connection Systems | 270 | ||
Bipolar Pacemaker Connection Systems | 270 | ||
Advent of Adaptors: A Necessary Evil | 271 | ||
Initial Voluntary Connector Standards | 272 | ||
Voluntary Standard 1 | 272 | ||
IS-1 Pacing Lead Connector Standard | 273 | ||
Early ICD Lead Connectors | 274 | ||
DF-1 Standard | 274 | ||
DF4/IS4 Standard | 275 | ||
DF4 and IS4 Connector Labeling and Use | 275 | ||
DF4 and IS4 Device Connector Cavity Design | 277 | ||
DF4 and IS4 Clinical Advantages and Disadvantages | 278 | ||
DF4 and IS4 Preclinical Testing and Subsequent Regulatory and Clinical Approach | 279 | ||
DF4/IS4 Connector System Patient Testing at Implant | 279 | ||
Conclusions | 279 | ||
References | 280 | ||
10 Sensors for Implantable Cardiac Pacing Devices | 281 | ||
Basis of Rate-Adaptive Pacing | 281 | ||
Exercise Response in Heart Failure | 281 | ||
Heart Rate Response for Nonexercise Needs | 281 | ||
Ideal Sensor Characteristics | 281 | ||
Classification of Sensors and Algorithms | 281 | ||
Technical Classification | 282 | ||
Activity Sensing | 284 | ||
Principle of Activity Sensing | 284 | ||
Technical Aspects of Activity Sensors | 285 | ||
Algorithms | 287 | ||
Current Activity-Sensing Devices | 287 | ||
Medtronic Activity-Sensing Devices | 287 | ||
St. Jude Medical Activity-Sensing Devices | 289 | ||
Boston Scientific Activity-Sensing Devices | 289 | ||
Biotronik Activity-Sensing Devices | 289 | ||
Sorin Activity Sensors | 290 | ||
Clinical Experience with Activity Sensors | 290 | ||
Limitations of Activity-Sensing Devices | 291 | ||
Minute Ventilation Sensing | 291 | ||
Physiologic Principle | 291 | ||
Relationship Between Heart Rate and Respiratory Parameters During Exercise | 291 | ||
Anaerobic Threshold | 292 | ||
Effect of Pulmonary Disease and Congestive Heart Failure on Minute Ventilation Sensing | 292 | ||
The Minute Volume Sensor | 292 | ||
Algorithm | 293 | ||
Current Minute Ventilation-Sensing Devices | 293 | ||
Boston Scientific Minute Ventilation-Sensing Devices | 293 | ||
Sorin Minute Ventilation-Sensing Devices | 294 | ||
Sleep Apnea Monitoring | 294 | ||
Clinical Experience of Minute Ventilation-Sensing Pacemakers | 294 | ||
Limitations of Minute Ventilation Sensing | 294 | ||
Unipolar Ventricular Impedance: Closed-Loop Stimulation Sensor | 295 | ||
Sensor and Algorithm | 295 | ||
Clinical Experience of Closed-Loop Stimulation Pacemakers | 296 | ||
Advantages and Limitations | 298 | ||
Special Lead Sensors | 298 | ||
Peak Endocardial Acceleration | 298 | ||
Sensor and Algorithm | 298 | ||
Clinical Use of Peak Endocardial Acceleration Sensor | 298 | ||
Central Venous Temperature | 299 | ||
Variations of Central Venous Temperature Changes on Exercise and Other Physiologic Conditions | 299 | ||
Sensor and Algorithm | 300 | ||
Clinical Performance | 300 | ||
Advantages and Limitations | 300 | ||
3 Established and Emerging Clinical Concepts | 373 | ||
13 Pacing for Sinus Node Disease | 375 | ||
Pathophysiology of Sinus Node Disease | 375 | ||
Cellular Electrophysiology of Sinus Node Disease | 375 | ||
Clinical Electrophysiology of Sinus Node Disease | 375 | ||
Clinical Presentation | 378 | ||
Diagnosis of Sinus Node Disease | 378 | ||
Natural History | 378 | ||
Clinical Outcomes in Sinus Node Disease | 378 | ||
Pacing and Survival in Sinus Node Disease | 378 | ||
Pacing and Atrial Fibrillation in Sinus Node Disease | 379 | ||
Atrial Fibrillation Detection in Pacemakers | 380 | ||
Atrial Based Versus Ventricular Pacing for Prevention of Atrial Fibrillation | 382 | ||
Atrial Pacing Versus Dual-Chamber Pacing for Prevention of Atrial Fibrillation | 383 | ||
Pacing Algorithms for Prevention of Atrial Fibrillation | 383 | ||
Are There Subgroups Who Benefit From Atrial Fibrillation Prevention Pacing Therapies? | 384 | ||
Pacing Algorithms for Termination of Atrial Fibrillation | 384 | ||
Site-Specific Atrial Pacing for Prevention of Atrial Fibrillation | 386 | ||
Pacing and Stroke in Sinus Node Disease | 386 | ||
Relationship Between Stroke Risk and Atrial Fibrillation Burden/Atrial Fibrillation Duration | 388 | ||
Pacing and Pacemaker Syndrome in Sinus Node Disease | 388 | ||
Pacing and Heart Failure in Sinus Node Disease | 389 | ||
Pacing and Quality of Life in Sinus Node Disease | 390 | ||
Chronotropic Incompetence | 390 | ||
Potential Detrimental Effects of Ventricular Pacing in Sinus Node Disease | 390 | ||
Ventricular Pacing and Risk of Atrial Fibrillation | 390 | ||
Right Ventricular Pacing and Heart Failure Risk | 390 | ||
Algorithms to Minimize Right Ventricular Pacing | 391 | ||
Dynamic/Adaptive Atrioventricular Intervals | 391 | ||
Mode Switching From AAI to DDD | 391 | ||
Clinical Outcomes With Algorithms to Minimize Right Ventricular Pacing | 392 | ||
Is One Mode for Minimizing Ventricular Pacing Superior? | 394 | ||
Complications/Clinical Nuances of Algorithms to Minimize Ventricular Pacing | 394 | ||
Treatment of Sinus Node Disease | 394 | ||
Pacing Modalities in Sinus Node Disease | 394 | ||
Chronotropic Incompetence and Rate-Adaptive Pacing | 395 | ||
Alternative Ventricular Pacing Sites | 396 | ||
Biologic Pacemakers | 396 | ||
References | 396 | ||
14 Atrioventricular Conduction System Disease | 399 | ||
Anatomy | 399 | ||
Anatomy of the His Bundle | 399 | ||
Diagnosis of Atrioventricular Conduction Disturbances | 399 | ||
Electrocardiography | 399 | ||
Electrophysiologic Study | 405 | ||
Identifying Patients at Risk for Atrioventricular Block | 406 | ||
Classification, Epidemiology, and Natural History of Atrioventricular Conduction Disturbances | 407 | ||
First-Degree Atrioventricular Block | 408 | ||
Second-Degree Atrioventricular Block | 408 | ||
Complete Heart Block | 409 | ||
Paroxysmal Atrioventricular Block | 409 | ||
Idiopathic Paroxysmal Atrioventricular Block | 409 | ||
Bundle Branch Block | 409 | ||
Congenital Atrioventricular Block | 410 | ||
Inherited Conduction System Diseases | 410 | ||
Cardiac Sodium Channel and Conduction Disorders | 411 | ||
Acquired Causes of Atrioventricular Block | 413 | ||
Indications for Permanent Pacing in Chronic Atrioventricular Block | 418 | ||
Acute Myocardial Infarction | 419 | ||
Atrioventricular Block Without Bundle Branch Block | 420 | ||
Atrioventricular Block with Bundle Branch Block | 420 | ||
Impact of Reperfusion | 421 | ||
Bundle Branch Block after Recovery | 423 | ||
Electrophysiologic Studies in Atrioventricular Block and Bundle Branch Block | 423 | ||
Indications for Pacing | 423 | ||
Temporary Pacing | 423 | ||
Permanent Pacing | 424 | ||
Selection of Pacing Mode in Atrioventricular Block | 425 | ||
VDD(R) Pacing | 427 | ||
Optimal Atrioventricular Interval Programming | 428 | ||
Site-Specific Ventricular Pacing in Atrioventricular Block | 430 | ||
Biventricular Pacing | 434 | ||
Permanent His Bundle Pacing | 434 | ||
Criteria for His Bundle Pacing | 436 | ||
Pacing Outcomes | 437 | ||
His Bundle Pacing in Atrioventricular Block | 439 | ||
His Bundle Pacing in Bundle Branch Block | 441 | ||
Implantation Site of Permanent His Bundle Pacing Lead | 441 | ||
Effect of His Bundle Pacing on Cardiac Function | 441 | ||
Special Considerations with His Bundle Pacing | 442 | ||
Future Directions in His Bundle Pacing | 444 | ||
Automatic Capture Verification and Pacing Output Management | 446 | ||
Summary | 449 | ||
Conclusion | 450 | ||
References | 450 | ||
15 Pacing in Reflex (Neurally-Mediated) Syncopes | 454 | ||
The Clinical Spectrum of Reflex Syncopes | 454 | ||
Vasovagal Syncope (Typical and Atypical Forms) | 454 | ||
Clinical Perspective | 454 | ||
Epidemiology | 454 | ||
Conservative Therapy | 455 | ||
Lifestyle Measures | 455 | ||
Physical Counterpressure Maneuvers | 455 | ||
Tilt Training (Standing Training) | 455 | ||
Additional Treatments | 456 | ||
Pharmacologic Therapy | 456 | ||
Rationale and Evidence for Cardiac Pacing Therapy | 456 | ||
Evidence From the Trials on Patients With Tilt-Induced Vasovagal Syncope | 456 | ||
Evidence From the Trials in Patients With Suspected or Certain Vasovagal (Reflex) Syncope and Electrocardiogram-Documented Asystole | 456 | ||
Carotid Sinus Syndrome | 458 | ||
Clinical Perspective | 458 | ||
Diagnosis With Carotid Sinus Massage | 458 | ||
Rationale and Evidences for Cardiac Pacing Therapy | 458 | ||
Evidence From the Trials in Patients With Carotid Sinus Syndrome | 458 | ||
Adenosine-Sensitive Syncope | 459 | ||
Reflex Syncopes: Indications for Pacing | 461 | ||
Reflex Syncopes: Choice of Pacing Mode | 462 | ||
References | 462 | ||
16 Defibrillation Therapy | 464 | ||
Implantable Cardioverter-Defibrillators | 464 | ||
Early Clinical Trials with Implantable Cardioverter-Defibrillators in Cardiac Arrest Survivors | 464 | ||
Clinical Trials in Primary Prevention of Sudden Cardiac Death | 464 | ||
Current Implantable Cardioverter-Defibrillator Indication Guidelines | 467 | ||
Remote Monitoring of Devices | 469 | ||
Implantable Cardioverter-Defibrillator Programming | 470 | ||
Cardiac Resynchronization Therapy | 472 | ||
Wearable Cardioverter Defibrillators | 475 | ||
Subcutaneous Implantable Cardioverter-Defibrillators | 477 | ||
Real World Effectiveness | 478 | ||
Conclusion | 479 | ||
References | 479 | ||
17 Subcutaneous and Epicardial Defibrillators | 482 | ||
Subcutaneous Implantable Cardioverter-Defibrillator System: Technology and Development | 482 | ||
Implantation | 482 | ||
Effectiveness and Safety | 482 | ||
Arrhythmia Detection, Sensitivity, and Discrimination | 484 | ||
Indications | 486 | ||
Limitations | 486 | ||
4 Implantation Techniques | 629 | ||
26 Permanent Pacemaker and Implantable Cardioverter-Defibrillator Implantation in Adults | 631 | ||
Personnel | 631 | ||
Physician/Surgeon | 631 | ||
Support Personnel | 631 | ||
Implantation Facility and Equipment | 632 | ||
Preoperative Planning and Assessment | 634 | ||
Inpatient Versus Outpatient Procedure | 634 | ||
Additional Preoperative Patient Assessment | 634 | ||
Preoperative Orders | 635 | ||
General Information | 636 | ||
Site Preparation and Draping | 636 | ||
Anesthesia, Sedation, and Pain Relief | 636 | ||
Antibiotic Prophylaxis and Wound Irrigation | 637 | ||
Anatomic Approaches for Implantation | 638 | ||
Transvenous Pacemaker Placement | 641 | ||
Cephalic Venous Access | 641 | ||
Subclavian Venous Access | 642 | ||
Axillary Venous Access | 643 | ||
Methods of Multilead Introduction | 652 | ||
Multiple Separate Venipunctures and Use of Multiple Sheath Sets | 652 | ||
One Percutaneous Puncture and Use of Large Sheath With Passage of Multiple Electrodes | 652 | ||
Retained-Guidewire Technique | 652 | ||
Sheath Set Technique With Cutdown Approach | 652 | ||
Placement of the Right Ventricular Lead | 653 | ||
Placement of Atrial Leads | 658 | ||
Implantable Cartioverter-Defibrillator-Specific Lead Issues | 660 | ||
Subcutaneous Defibrillation Electrodes | 660 | ||
Azygos Vein Defibrillation Coil | 660 | ||
Coronary Sinus Coil | 660 | ||
Upgrading Techniques | 660 | ||
Cardiac Implantable Electronic Devices Connectivity | 661 | ||
Securing Leads, Creating Pockets, and Closure | 662 | ||
Epicardial Lead Placemanent Placement of Epicardial Electrodes | 665 | ||
Epicardial Approach | 665 | ||
Median Sternotomy Approach | 665 | ||
Left Anterolateral Thoracotomy Approach | 665 | ||
Subxiphoid Approach | 666 | ||
Left Subcostal Approach | 666 | ||
Thoracoscopic Approach | 667 | ||
Cosmetic Approach to Device Implantation | 667 | ||
Submuscular Pectoral Pocket | 668 | ||
Special Considerations and Situations | 672 | ||
Use of the Iliac Vein | 672 | ||
Transiliac Implantable Cardioverter-Defibrillator Implantation | 673 | ||
Use of the Jugular Vein | 673 | ||
Alternatives to Radiography during Implantation | 674 | ||
Repositioning of Electrodes | 675 | ||
Alternatives to Transvenous Lead Placement | 675 | ||
Misplacement of Lead in Left Ventricle | 679 | ||
Selective Site Pacing | 680 | ||
General Considerations | 680 | ||
Anatomic Considerations | 681 | ||
Right Atrium | 681 | ||
Right Ventricle | 682 | ||
Radiographic Anatomy | 683 | ||
Atrial Septal Pacing | 684 | ||
Right Ventricular Selective Site Pacing | 686 | ||
Direct His Bundle Pacing | 687 | ||
The Future of Selective Site Pacing | 688 | ||
Immediate Postoperative Care | 688 | ||
References | 689 | ||
27 Pacemaker and Implantable Cardioverter-Defibrillator Management in Children and Congenital Heart Disease | 692 | ||
Pediatric Indications for Pacing | 692 | ||
Sinus Node Dysfunction | 692 | ||
Atrioventricular Node Dysfunction | 693 | ||
Other Pacing Indications | 694 | ||
Cardiac Resynchronization | 695 | ||
Lead Implantation Technique | 695 | ||
Epicardial Pacing | 697 | ||
Other Considerations | 697 | ||
Indications for Implantable Cardioverter-Defibrillator Implantation in Children and Adults with Congenital Heart Disease | 698 | ||
Congenital Heart Disease | 699 | ||
Patients with Inherited Arrhythmia Syndromes | 700 | ||
Technical Considerations in Implantable Cardioverter-Defibrillator Implantation for Pediatric Patients and Patients with Congenital Heart Disease | 700 | ||
Ventricular Fibrillation and “Defibrillation Testing” in Pediatrics | 701 | ||
Approach to the Pediatric Patient with High Defibrillation Thresholds | 701 | ||
Programming | 702 | ||
Implantable Cardioverter-Defibrillator Programming Suggestions | 703 | ||
Lead Complications | 704 | ||
Psychosocial Aspects | 706 | ||
Summary | 706 | ||
References | 707 | ||
28 Implantation of the Subcutaneous Implantable Cardioverter-Defibrillator | 709 | ||
Identifying Candidates for Subcutaneous Implantable Cardioverter-Defibrillator Therapy | 709 | ||
Patient Selection | 709 | ||
Patient Assessment | 709 | ||
General Considerations for Subcutaneous Implantable Cardioverter-Defibrillator Implantation | 709 | ||
Personnel and Equipment | 709 | ||
Planning of the Procedure | 710 | ||
Preparation | 711 | ||
Anesthesia | 711 | ||
Patient Positioning | 711 | ||
Incision Marking | 711 | ||
Surgical Site Preparation | 712 | ||
Implantation of the Subcutaneous Implantable Cardioverter-Defibrillator | 712 | ||
Creating the Pocket | 712 | ||
Lead Tunneling | 712 | ||
Three-Incision Implantation Technique | 713 | ||
Xiphoid-to-Superior Parasternal Tunneling | 713 | ||
Two-Incision Implantation Technique | 714 | ||
Placing the Device in the Pocket | 714 | ||
Postoperative Care | 715 | ||
Alternative Implant Positions | 715 | ||
Submuscular Implantation | 715 | ||
Sub-Serratus Anterior Position of the Can | 715 | ||
Lead and Can Positions in Patients with Anatomic Variations | 715 | ||
Troubleshooting | 715 | ||
Device Extraction | 715 | ||
Infection | 715 | ||
Pocket Erosion | 716 | ||
Defibrillation Threshold Testing Failure | 716 | ||
Considerations for the Future | 717 | ||
Conclusions | 717 | ||
References | 717 | ||
29 Intraprocedural Assessment of Stimulation, Sensing, Detection, and Defibrillation | 718 | ||
Principles Related to Stimulation | 718 | ||
Physiology of Cardiac Pacing | 718 | ||
Determining Optimal Lead Position | 718 | ||
Imaging for Lead Placement | 718 | ||
Lead Placement | 720 | ||
Right Atrial Leads | 720 | ||
Right Ventricular Leads | 720 | ||
Left Ventricular Leads | 720 | ||
Evaluation for Extracardiac Stimulation | 722 | ||
Assessing for Current of Injury | 722 | ||
Wavelet Size, Slew Rate, and Lead Impedance | 722 | ||
Sensed Signals | 722 | ||
Pacing Capture Thresholds | 722 | ||
Lead Impedance | 722 | ||
Slew Rates | 723 | ||
Stimulation Threshold Testing and the Strength-Duration Curve | 723 | ||
Wedensky Effect and Wedensky Facilitation | 724 | ||
Bipolar and Unipolar Stimulation | 725 | ||
Cathodal and Anodal Stimulation | 725 | ||
Capture Latency and Exit Block | 726 | ||
Principles Related to Sensing | 727 | ||
Physiology of Intracardiac Sensing | 727 | ||
Near-Field and Far-Field Signals | 728 | ||
Unipolar, Integrated Bipolar, and True Bipolar Sensing | 728 | ||
Approach to Undersensing | 728 | ||
Approach to Oversensing | 729 | ||
Lead Issues | 729 | ||
Metabolic and Structural Factors | 730 | ||
Electromagnetic Interference | 730 | ||
Sensing in Cardiac Resynchronization Devices | 730 | ||
Principles Related to Arrhythmia Detection and Defibrillation Threshold Testing | 730 | ||
Overview of Detection and Arrhythmia Discriminators | 730 | ||
Intraprocedural Defibrillation Testing | 734 | ||
Assessment of Sensing | 734 | ||
Assessment of Defibrillation Margin | 734 | ||
Evolution of Implantable Cardioverter-Defibrillator Testing | 735 | ||
When Defibrillation Testing Should Be Considered | 735 | ||
Contraindications to Defibrillation Testing | 735 | ||
To Test or Not to Test? | 735 | ||
Performance of Defibrillation Testing | 736 | ||
References | 736 | ||
30 Coronary Sinus Lead Implantation | 739 | ||
Introduction | 739 | ||
Left Ventricular Lead Position and Response | 739 | ||
Newer Tools for Delivery of Coronary Venous Leads | 743 | ||
Coronary Sinus Access Catheter | 745 | ||
Telescoping Assist Catheter | 745 | ||
Vein Selector | 746 | ||
Inner Guide | 746 | ||
Previous Approach to the Shape and Use of Inner Guides | 746 | ||
New Approach to the Shape and Use of Delivery Guides | 749 | ||
Left Ventricular Lead Implantation Using the Author-Designed Delivery System | 749 | ||
Step-by-Step Summary | 749 | ||
Left Ventricular Lead Implantation with the Worley Delivery System and Interventional Techniques | 752 | ||
Details and Rationale | 752 | ||
Prepare the Patient for the Use of Iodinated Contrast Material | 752 | ||
Equipping and Setting up the Room | 752 | ||
Collect Available Left Ventricular Lead Implantation Equipment and Review Its Use | 752 | ||
Organize the Equipment to Be Readily Available in the Room | 752 | ||
Assemble the “Always Used” Equipment on the Table before Starting | 752 | ||
Pay Careful Attention to the Orientation of the Instrument Table during Various Stages of the Procedure | 752 | ||
Approach to Contrast | 753 | ||
Venous Access for Left Ventricular Lead Implantation | 753 | ||
Preventing Restricted Catheter/Lead Movement | 755 | ||
Separate Access for Each Lead | 755 | ||
Axillary versus Subclavian Venous Access | 755 | ||
Response to Subclavian Obstruction in Patient with Preexisting Leads | 755 | ||
The Platform for Left Ventricular Lead Placement | 756 | ||
Lumen Size | 756 | ||
Catheter Shape | 757 | ||
Cutting versus Peeling to Remove the Coronary Sinus Access Sheath | 758 | ||
Coronary Sinus Access for Left Ventricular Lead Implantation | 759 | ||
Contrast or Not for Coronary Sinus Cannulation? | 760 | ||
Limitations of the Noncontrast Method | 760 | ||
Limitation of the Contrast Method | 761 | ||
Turning Failure Into Success With the Use of Contrast | 761 | ||
Catheter Shape for Coronary Sinus Cannulation | 761 | ||
Catheter Shape and the Anatomy Surrounding the Coronary Sinus Ostium (Case Study 30-1) | 761 | ||
How to Locate the Ostium of the Coronary Sinus With Contrast Injection System | 763 | ||
Coronary Sinus Cannulation: A Two-Step Process with Contrast Injection | 764 | ||
Step 1: Locating the Ostium of the Coronary Sinus | 764 | ||
Anatomy Surrounding the Coronary Sinus Ostium as Defined by Contrast Injection | 765 | ||
Coronary Sinus Venous Anatomy | 767 | ||
Half-Strength versus Full-Strength Contrast Agent | 768 | ||
Occlusive Coronary Sinus Venography (CASE STUDY 30-2) | 770 | ||
Measures to Overcome Failure to Visualize the Coronary Venous Anatomy | 772 | ||
Selective Injection of the Coronary Veins | 772 | ||
Blind Draw Back Technique | 772 | ||
Focused Location and Injection of the Anterior or Middle Cardiac Veins | 772 | ||
Selective Injection for the Persistent Left Superior Vena Cava | 777 | ||
Coronary Artery Injection with Venous-Phase Images | 777 | ||
Basic Patterns of the Coronary Venous Anatomy | 777 | ||
Size Distribution | 777 | ||
Cannulation of the Difficult Coronary Sinus | 777 | ||
Finding the Difficult Coronary Sinus Ostium | 777 | ||
Anatomic Variants That Make It Difficult to Locate | 778 | ||
Step 2: Advancing a Sheath or Guide into the Coronary Sinus | 778 | ||
If the Sheath/Guide Is Difficult to Advance | 778 | ||
Anchor Balloon Technique | 780 | ||
5 Follow-Up and Programming | 959 | ||
36 Timing Cycles of Implantable Devices | 961 | ||
Pacing System Code | 961 | ||
Pacing Modes | 961 | ||
Single-Chamber Pacing Modes | 961 | ||
Single-Chamber Asynchronous Pacing (AOO, VOO) | 961 | ||
Single-Chamber Inhibited Pacing (AAI, VVI) | 961 | ||
Single-Chamber Triggered Pacing (AAT, VVT) | 961 | ||
Dual-Chamber Pacing Modes | 962 | ||
Dual-Chamber Asynchronous Pacing (DOO) | 962 | ||
Dual-Chamber Tracking Modes (DDD, VDD) | 963 | ||
Dual-Chamber Modes Without Tracking (DDI, VDI, DVI) | 963 | ||
Dual-Chamber Triggered Modes | 963 | ||
Timing Cycles of Single- and Dual-Chamber Pacing | 963 | ||
Single-Chamber Pacing | 964 | ||
Lower Rate Interval | 964 | ||
Refractory Period | 964 | ||
Timing Cycles in Different Single-Chamber Pacing Modes | 965 | ||
Single-Chamber Asynchronous Pacing (AOO, VOO) | 965 | ||
Single-Chamber Inhibited Pacing (AAI, VVI) | 965 | ||
Single-Chamber Rate Hysteresis | 965 | ||
Dual-Chamber Pacing | 965 | ||
Overview of Dual-Chamber Timing Cycles | 965 | ||
Lower Rate Interval | 965 | ||
Atrioventricular Interval and Ventriculoatrial Interval | 967 | ||
Refractory Periods | 967 | ||
Upper Rate Interval | 967 | ||
Blanking and Refractory Periods | 968 | ||
Confusing Terminology Regarding Blanking and Refractory Periods | 969 | ||
Atrioventricular Interval | 970 | ||
Atrioventricular Crosstalk and Ventricular Safety Pacing | 970 | ||
Differential Atrioventricular Interval | 971 | ||
Dynamic or Rate-Adaptive Atrioventricular Interval | 972 | ||
Atrioventricular Interval Hysteresis | 972 | ||
Timing Cycles in Different Dual-Chamber Pacing Modes | 973 | ||
Lower Rate (Base Rate) Timing | 973 | ||
Ventricular-Based Timing | 973 | ||
Atrial-Based Timing | 973 | ||
Comparison of Atrial-Based and Ventricular-Based Timing | 973 | ||
Hybrid Timing | 973 | ||
Dual-Chamber Rate Hysteresis | 975 | ||
Upper Rate Behavior | 975 | ||
Sensor-Driven or Rate-Adaptive Pacing | 978 | ||
Hemodynamics of Exercise and Basis for Rate-Adaptive Pacing | 978 | ||
Timing Cycles of Sensor-Driven Pacing | 978 | ||
Sensor Parameters | 978 | ||
Rate-Adaptive Algorithms | 979 | ||
Device Algorithms and Specific Features | 979 | ||
Algorithms for Detection of, and Response to, Atrial Tachyarrhythmias (Mode Switching) | 979 | ||
Timing Cycles for Mode Switching | 979 | ||
Atrial Sensitivity | 979 | ||
Comparison of Mode-Switching Algorithms | 980 | ||
Ventricular Rate Control | 981 | ||
Detection of Rapid Regular Atrial Tachyarrhythmias (Atrial Flutter) | 983 | ||
Mode Switch Episodes Versus Atrial Tachycardia/Atrial Fibrillation Episodes | 983 | ||
Algorithms for Prevention of Atrial Tachyarrhythmias | 985 | ||
Algorithms for Prevention of Atrial Fibrillation by Pacing | 985 | ||
Prevention of Pacing in the Atrial Vulnerable Period | 985 | ||
Algorithms to Minimize Ventricular Pacing | 989 | ||
Dynamic Atrioventricular Interval Prolongation (Atrioventricular Hysteresis) | 989 | ||
Atrioventricular Mode Switch (Atrial Pacing to Dual-Chamber Pacing) | 989 | ||
Algorithms for Rate Adjustment | 992 | ||
Algorithms to Promote Transient Rapid Pacing (for Neurally-Mediated Syncope) | 992 | ||
Algorithms to Promote Intrinsic Heart Rate | 992 | ||
Noncircadian algorithms. | 992 | ||
Circadian algorithms. | 997 | ||
Algorithms to Prevent Sudden Variations in Rate | 999 | ||
Prevention of Beat-Beat Variations in Rate | 999 | ||
Tracking modes. | 999 | ||
Nontracking modes (algorithms for regularization of ventricular rate in AF). | 999 | ||
Rate Adjustment During Mode Switch | 1000 | ||
Rate Regularization at the Upper Rate Limit | 1000 | ||
Pacemaker-Mediated Atrioventricular Dyssynchronous Rhythms | 1000 | ||
Classic Pacemaker-Mediated Tachycardia | 1000 | ||
Algorithms for Prevention, Detection, and Termination of Pacemaker-Mediated Tachycardia | 1002 | ||
Other Pacemaker Reentrant Tachycardias | 1002 | ||
Repetitive Nonreentrant Ventriculoatrial Synchrony | 1002 | ||
Response of Dual-Chamber Devices to Premature Ventricular Complexes | 1008 | ||
Timing Cycles of Biventricular Pacing | 1008 | ||
Goals of Biventricular Pacing | 1008 | ||
Pacing, Sensing, and Timing | 1008 | ||
Pacing | 1008 | ||
Sensing | 1008 | ||
Timing | 1010 | ||
Timing Cycles | 1010 | ||
Atrioventricular Interval and Interventricular (V-V) Interval | 1010 | ||
Interventricular delay. | 1010 | ||
Sensing within the AVI and the interventricular interval. | 1010 | ||
Blanking and Refractory Periods | 1011 | ||
Cross-chamber (atrial/ventricular). | 1011 | ||
Same chamber. | 1011 | ||
Interventricular refractory period. | 1011 | ||
Double counting and triple counting in CRT devices. | 1012 | ||
Lower Rate Interval and Lower Rate Timing | 1012 | ||
Upper Rate Interval and Upper Rate Behavior | 1013 | ||
TARP and iTARP | 1013 | ||
Features to Promote Biventricular Pacing | 1014 | ||
Suppression of Intrinsic Conduction/Response to Intrinsic Conduction | 1014 | ||
Dynamic adaptation of A-V and V-V intervals. | 1014 | ||
Triggered ventricular pacing. | 1014 | ||
Biventricular pacing during atrial tachyarrhythmias. | 1017 | ||
Prevention of Loss of Atrial Tracking (and Restoration of Tracking) | 1020 | ||
Features to Prevent Pacing in the Ventricular Vulnerable Period | 1020 | ||
Left Ventricular Protection Period | 1020 | ||
Pacemaker-Mediated Atrioventricular Dyssynchronous Rhythms in Cardiac Resynchronization Therapy Devices | 1020 | ||
Timing Cycles of Implantable Cardioverter-Defibrillators | 1020 | ||
Blanking and Refractory Periods in Implantable Cardioverter-Defibrillators | 1021 | ||
Ventricular Channel | 1021 | ||
Atrial Channel | 1022 | ||
Interaction between Pacing and Ventricular Tachyarrhythmia Detection | 1022 | ||
Upper Limit of Pacing Versus Lower Limit of Ventricular Tachycardia Detection | 1022 | ||
Conflict Between Pacing Parameters and Ventricular Tachyarrhythmia Detection | 1023 | ||
Features to Promote Ventricular Tachyarrhythmia Detection | 1023 | ||
Arrhythmia unhiding. | 1025 | ||
Shortening of the atrioventricular delay. | 1025 | ||
Bradycardia Functions Following Ventricular Tachycardia Detection and during/after Therapy for Ventricular Tachycardia/Ventricular Tachycardia Fibrillation | 1025 | ||
Response to External Influences | 1025 | ||
Noise Response | 1025 | ||
Electrical Reset (Power-on Reset) | 1027 | ||
Magnet Response | 1027 | ||
References | 1030 | ||
37 Pacemaker Programming and Troubleshooting | 1031 | ||
Pacemaker Programming | 1031 | ||
Pacing Mode | 1031 | ||
DDD(R) | 1031 | ||
DDI(R) | 1031 | ||
ADI(R) | 1031 | ||
VDD | 1031 | ||
VDI(R) | 1031 | ||
AAI(R) | 1031 | ||
VVI(R) | 1034 | ||
VVT | 1034 | ||
VOO or DOO | 1034 | ||
ODO or OVO or OAO | 1034 | ||
OOO | 1034 | ||
Baseline and Upper Rates | 1034 | ||
Rate Response | 1034 | ||
Pacing Output | 1034 | ||
Sensitivity | 1036 | ||
Atrioventricular Delay | 1036 | ||
Pacemaker Troubleshooting | 1037 | ||
Electrocardiograms in Patients with Pacemakers | 1037 | ||
Pacing Pulse Artifacts | 1037 | ||
Paced P-Wave Morphology | 1038 | ||
Paced QRS Morphology | 1038 | ||
Event Markers and Intracardiac Electrograms | 1038 | ||
Failure to Pace (Nonpacing) | 1040 | ||
Failure to Capture (Noncapture) | 1042 | ||
Oversensing | 1044 | ||
Far-Field R-Wave Oversensing | 1044 | ||
Far-Field P-Wave Oversensing | 1045 | ||
Near-Field Oversensing | 1046 | ||
T-Wave Oversensing | 1046 | ||
Myopotential Oversensing | 1046 | ||
Oversensing of Nonphysiologic Signals | 1046 | ||
Consequences and Management of Oversensing | 1048 | ||
Failure to Sense (Undersensing) | 1051 | ||
Specific Pacemaker Issues | 1053 | ||
Crosstalk | 1053 | ||
Pacemaker-Mediated Tachycardia | 1054 | ||
Endless-loop tachycardia. | 1055 | ||
Prerequisites. | 1055 | ||
Detection and termination. | 1055 | ||
Prevention. | 1056 | ||
Atrial arrhythmias. | 1057 | ||
Myopotential tracking. | 1058 | ||
Sensor-driven tachycardia. | 1059 | ||
Runaway pacemaker. | 1059 | ||
Cross-Stimulation | 1059 | ||
Repetitive Nonreentrant Ventriculoatrial Synchronous Rhythm | 1059 | ||
Systematic Pacemaker Electrocardiogram/Electrogram Interpretation | 1060 | ||
Conclusion | 1062 | ||
References | 1062 | ||
38 Implantable Cardioverter-Defibrillator Programming and Troubleshooting | 1064 | ||
General Principles | 1064 | ||
Initial Evaluation and Tools | 1064 | ||
Clinical History | 1064 | ||
Physical Examination | 1064 | ||
Electrocardiographic Recordings | 1065 | ||
Device Telemetry | 1065 | ||
Radiographic Evidence | 1067 | ||
Presentations | 1072 | ||
Multiple Shocks | 1072 | ||
Failure to Convert Ventricular Tachycardia or Ventricular Fibrillation | 1083 | ||
Failure to Detect Ventricular Tachycardia or Ventricular Fibrillation | 1083 | ||
Problems with Pacing | 1086 | ||
Other Issues | 1086 | ||
Summary | 1087 | ||
References | 1087 | ||
39 Cardiac Resynchronization Therapy Programming and Troubleshooting | 1090 | ||
Introduction | 1090 | ||
Cardiac Resynchronization Therapy Programming | 1090 | ||
General Principles on Cardiac Resynchronization Therapy Programming | 1090 | ||
Minimize Right Atrial Pacing | 1090 | ||
Program Appropriate AV and VV Delays | 1090 | ||
Program Adequate Pacing Output | 1090 | ||
Program Higher Tracking Rates | 1090 | ||
Appropriate Programming of Postventricular Atrial Refractory Period and Associated Algorithms | 1090 | ||
Avoid Interruption of Cardiac Resynchronization Therapy Due to Arrhythmias | 1090 | ||
Consider Algorithms to Promote Cardiac Resynchronization Therapy | 1090 | ||
Recognize Anodal Capture on Electrocardiogram as a Reason for Nonresponse | 1090 | ||
Strategies to Deal With Phrenic Nerve Capture | 1091 | ||
Understand Optimization Algorithms, Outcomes, and Applicability to Individual Patients | 1091 | ||
Device Manufacturer–Specific Cardiac Resynchronization Therapy Features | 1091 | ||
Medtronic-Specific Cardiac Resynchronization Therapy Features | 1091 | ||
Adaptive CRT. | 1091 | ||
Multipolar LV pacing leads with additional LV pacing vectors. | 1092 | ||
Ventricular-sense response. | 1093 | ||
Conducted AF response. | 1094 | ||
Atrial tracking recovery. | 1094 | ||
Ventricular sense episodes. | 1096 | ||
St. Jude Medical–Specific Cardiac Resynchronization Therapy Features | 1096 | ||
Quick opt. | 1096 | ||
Multipolar LV pacing leads with additional LV pacing vectors. | 1096 | ||
RV-LV conduction time measurement. | 1096 | ||
Trigger pacing. | 1096 | ||
Negative AV/PV hysteresis. | 1096 | ||
Boston Scientific Cardiac Resynchronization Therapy–Related Specific Features | 1096 | ||
Smart delay. | 1096 | ||
RV-LV delay. | 1096 | ||
Multipolar LV pacing with additional LV pacing vectors. | 1097 | ||
Ventricular rate regulation. | 1097 | ||
BiV triggered pacing. | 1097 | ||
LV sensing and protection periods. | 1097 | ||
Tracking preference. | 1097 | ||
Sorin-Related Specific Features | 1097 | ||
Multiple LV pacing vectors. | 1097 | ||
VV delay. | 1097 | ||
SonR (endocardial acceleration sensor) hemodynamic optimization. | 1101 | ||
Biotronik Devices: Cardiac Resynchronization Therapy–Related Features | 1101 | ||
Multiple LV pacing vectors. | 1101 | ||
LV pacing protection. | 1101 | ||
Triggered LV pacing. | 1101 | ||
VV delay. | 1101 | ||
Negative AV hysteresis. | 1101 | ||
Cardiac Resynchronization Therapy Troubleshooting | 1101 | ||
Pacing Malfunction | 1103 | ||
Noncapture | 1103 | ||
Elevated Pacing Threshold | 1106 | ||
Autocapture Failure | 1107 | ||
Diaphragmatic stimulation. | 1108 | ||
Anodal stimulation. | 1110 | ||
Sensing Abnormality | 1111 | ||
Double-Counting | 1111 | ||
Oversensing | 1112 | ||
Undersensing | 1112 | ||
Generator | 1112 | ||
Electromagnetic Interference | 1113 | ||
Radiation Effect | 1113 | ||
Proarrhythmia | 1114 | ||
Cardiac Resynchronization Therapy Device and Other Cardiac Device Interaction | 1114 | ||
Recognition and Management of Poor Response to Cardiac Resynchronization Therapy | 1116 | ||
Pre-Cardiac Resynchronization Therapy Implant: Patient Selection | 1116 | ||
Cardiomyopathy and Scar Burden | 1116 | ||
Cardiac Resynchronization Therapy Implant: Optimal Left Ventricular Lead Position | 1118 | ||
Postcardiac Resynchronization Therapy Management | 1122 | ||
Inadequate Biventricular Pacing | 1122 | ||
Cardiac Resynchronization Therapy Programming | 1122 | ||
Atrial Fibrillation | 1122 | ||
Premature Contractions | 1123 | ||
AV and VV Programming | 1127 | ||
Echo-guided optimization. | 1127 | ||
Impedance cardiography. | 1129 | ||
Finger photoplethysmography (FPPG). | 1129 | ||
Acoustic cardiography. | 1129 | ||
Electrocardiography. | 1129 | ||
References | 1131 | ||
40 Follow-Up of Cardiac Implantable Electronic Devices—Remote Monitoring and in Person | 1133 | ||
Monitoring Goals | 1133 | ||
In-Person Monitoring | 1133 | ||
Remote Technologies | 1133 | ||
Transtelephonic Monitoring Without Interrogation | 1133 | ||
Modern Systems | 1134 | ||
Remote Management | 1135 | ||
Clinical Applications | 1135 | ||
Outpatient Clinic Workload Reduction and Optimization | 1135 | ||
Device Managment | 1136 | ||
Lead and Device Performance | 1136 | ||
Advisories | 1142 | ||
Disease Management | 1142 | ||
Arrhythmias | 1142 | ||
Atrial Fibrillation | 1142 | ||
Ventricular Arrhythmias | 1145 | ||
Heart Failure | 1145 | ||
Implementing Remote Monitoring | 1145 | ||
Device Clinic | 1149 | ||
The Organizational Model | 1150 | ||
Role and Responsibilities of the Patient | 1153 | ||
Patient Acceptance and Satisfaction | 1153 | ||
Economics | 1153 | ||
Data Management | 1154 | ||
Regulatory Issues | 1155 | ||
Medicolegal Issues | 1155 | ||
Summary | 1155 | ||
References | 1156 | ||
41 Perioperative and Periprocedural Management, Electromagnetic Interference, and Cardiac Implantable Electronic Devices | 1158 | ||
Considerations for Patients with Cardiac Implantable Electronic Devices Undergoing Surgical OR Invasive Procedures | 1158 | ||
Clinical Status Affecting Arrhythmic Risk OR Device Function | 1158 | ||
Electromagnetic Interference | 1158 | ||
Oversensing | 1158 | ||
Device Reset | 1159 | ||
Damage to the Lead-Tissue Interface | 1159 | ||
Battery Life | 1159 | ||
Changes in Programming | 1159 | ||
Physical Damage to the Cardiac Implantable Electronic Device Related to Surgical Procedures | 1159 | ||
Preoperative Evaluation of the Patient with a Cardiac Implantable Electronic Device OR Arrhythmias | 1159 | ||
Role of the Electrophysiology/ Cardiology Team | 1159 | ||
Role of the Anesthesiology/Surgical Team | 1161 | ||
Reprogramming Versus Magnet Use | 1162 | ||
Reprogramming the Cardiac Implantable Electronic Device | 1162 | ||
Magnet Response | 1162 | ||
No Reprogramming OR Magnet Use | 1164 | ||
Subcutaneous Implantable Cardioverter-Defibrillator | 1164 | ||
Novel Pacemakers | 1165 | ||
Implantable Loop Recorders | 1166 | ||
Emergency Procedures | 1166 | ||
Intraoperative Management of the Patient with a Cardiac Implantable Electronic Device | 1166 | ||
Intraoperative Monitoring | 1166 | ||
Central Venous Catheter Placement and Cardiac Implantable Electronic Device Leads | 1166 | ||
Location of the Electrosurgical Return Patch | 1167 | ||
Postoperative Management of the Patient with a Cardiac Implantable Electronic Device | 1167 | ||
Mechanism of Specific EMI Sources and Risk to the Cardiac Implantable Electronic Device | 1167 | ||
Electrosurgical Energy | 1167 | ||
Direct Current Cardioversion | 1168 | ||
Radiofrequency Ablation | 1168 | ||
Diagnostic Radiation | 1168 | ||
Therapeutic Radiation | 1169 | ||
Electroconvulsive Therapy | 1170 | ||
Transurethral Resection of the Prostate/Transurethral Needle Ablation | 1170 | ||
Colonoscopy/Gastroscopy | 1170 | ||
Ocular Procedures | 1170 | ||
Magnetic Drapes | 1170 | ||
Tissue Expanders with Magnets | 1170 | ||
Transcutaneous Electrical Nerve Stimulation/Spinal Cord Stimulators | 1170 | ||
Radiofrequency Identification Devices | 1170 | ||
Electromyography and Nerve Conduction Velocity Studies | 1170 | ||
Lithotripsy | 1171 | ||
Argon Plasma Coagulation | 1171 | ||
Procedures with No Risk | 1171 | ||
Electromagnetic Interference in the Nonmedical Environment | 1171 | ||
Cellular Telephones and Other Home Electronics | 1171 | ||
Industrial Equipment and Occupational Exposures | 1171 | ||
Security Systems | 1172 | ||
Scuba Diving and Hyperbaric Oxygen | 1172 | ||
Conclusion | 1172 | ||
References | 1173 | ||
42 Managing Advisories of Cardiac Implantable Electronic Devices | 1175 | ||
Introduction | 1175 | ||
Device Performance | 1175 | ||
Types of Advisories | 1175 | ||
Review of Device Advisories | 1176 | ||
Generator-Associated Device Advisories | 1176 | ||
Lead-Associated Advisories | 1178 | ||
The Sprint Fidelis Lead Advisory | 1181 | ||
The Riata Lead Advisory | 1182 | ||
Approach to the Patient with an Advisory | 1185 | ||
Lead Advisory Versus Generator Advisory | 1187 | ||
Current Surveillance Mechanisms | 1187 | ||
Conclusion | 1189 | ||
References | 1189 | ||
43 Establishing and Managing a Device Clinic and Database | 1191 | ||
Clinics for the Follow-Up of Cardiovascular Implantable Electronic Devices | 1191 | ||
Increased Cardiovascular Implantable Electronic Device Follow-Up Volume | 1191 | ||
Goal of Cardiovascular Implantable Electronic Device Follow-Up | 1191 | ||
Personnel Involved in Cardiovascular Implantable Electronic Device Follow-Up | 1191 | ||
Paradigms for Cardiovascular Implantable Electronic Device Follow-Up Including Remote Monitoring | 1192 | ||
Organization of a Pacemaker Follow-Up (in-Person) | 1193 | ||
Organization of an Implantable Cardioverter-Defibrilltor Follow-Up (in-Person) | 1193 | ||
Organization of the Follow-Up of a Cardiac Resynchronization Therapy Device (CRT-P or CRT-D) | 1195 | ||
Organization of Remote Follow-Up for Cardiovascular Implantable Electronic Devices | 1195 | ||
Cardiovascular Implantable Electronic Device Database Integration | 1196 | ||
Implementation, Health Economics and Reimbursement | 1197 | ||
References | 1199 | ||
44 Social and Ethical Principles of Device Therapy | 1201 | ||
The Ethics of Cardiac Implantable Electronic Device Reuse | 1201 | ||
Disparities in Access to Cardiac Implantable Electronic Devices | 1201 | ||
Donations to Improve Access to Cardiac Implantable Electronic Device Therapy | 1201 | ||
Potential Sources of Reused Devices | 1201 | ||
Support for Cardiac Implantable Electronic Device Reuse on Humanitarian Grounds | 1202 | ||
Evidence in Favor of Safety and Efficacy of Cardiac Implantable Electronic Device Reuse | 1202 | ||
Legal Obstacles, Regulatory Considerations, and Solutions | 1203 | ||
Ethical Considerations of Cardiac Implantable Electronic Device Reuse | 1203 | ||
Responsibilities of the Reprocessor | 1205 | ||
Conclusions | 1205 | ||
The Ethics of Cardiac Implantable Electronic Device Deactivation in Terminally Ill Patients | 1206 | ||
Ethical and Legal Foundations of End-of-Life Care and Applications to Cardiac Implantable Electronic Devices | 1206 | ||
Cardiac Implantable Electronic Device Function Near the Time of Death | 1206 | ||
Views on Cardiac Implantable Electronic Device Deactivation | 1207 | ||
Heart Rhythm Society Consensus Statement of 2010 | 1207 | ||
The Ethics of Deactivating Cardiac Implantable Electronic Device Therapies | 1207 | ||
Physician Agency | 1208 | ||
Discussing the Role of Cardiac Implantable Electronic Device Therapy with Patients | 1208 | ||
Logistics of Cardiac Implantable Electronic Device Activation | 1208 | ||
Device Deactivation Plan | 1209 | ||
Reprogramming the Cardiac Implantable Electronic Device | 1209 | ||
Inpatient Care Settings | 1209 | ||
Patients at Home or Outside of Inpatient Medical Facilities | 1209 | ||
Pediatric Patients | 1209 | ||
Conclusions | 1209 | ||
References | 1210 | ||
Index | 1211 | ||
A | 1211 | ||
B | 1213 | ||
C | 1214 | ||
D | 1217 | ||
E | 1218 | ||
F | 1219 | ||
G | 1220 | ||
H | 1220 | ||
I | 1221 | ||
J | 1222 | ||
K | 1222 | ||
L | 1222 | ||
M | 1224 | ||
N | 1224 | ||
O | 1225 | ||
P | 1225 | ||
Q | 1227 | ||
R | 1227 | ||
S | 1228 | ||
T | 1230 | ||
U | 1231 | ||
V | 1231 | ||
W | 1232 | ||
X | 1232 | ||
Z | 1232 | ||
Inside Back Cover | ibc1 |