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  • 1
    Electronic Resource
    Electronic Resource
    Endocardial Defibrillation Lead Extraction: (2003)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Spurious discharges due to late insulation break in an IS-1 pacing/sensing connector prompted ICD lead removal in 65-year-old man. The tip of the lead was easily freed and pulled back into the SVC by the superior approach. After that, the lead became trapped. The distal part of the lead was caught and easily withdrawn by inferior approach. Superior venous angiography showed extravascular location of the entrapped part of the lead due to the unintentional percutaneous puncture of the innominate vein after piercing the subclavian vein. It may be desirable to use contrast venography before intervention of extraction to ensure venous patency and lead location. (PACE 2003; 26:2036–2038)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.00314.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Steroid-Eluting Electrodes Prevent Chronic Pacing Threshold Rise in the Atrial Chamher After Oral Propafenone Administration (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 20 (1997), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of the study was to evaluate chronic atrial pacing threshold increase after oral propafenone therapy. Fifty patients affected by advanced AV block and sick sinus syndrome were studied at least 6 months after pacemaker implantation, before and after oral propafenone therapy (450–900 mg/day based on body weight). The patients were subdivided into three groups as to the type of electrode implanted, all three unipolar: group I (20 patients) Medtronic CapSure 4003, group II (13 patients) Medtronic Target Tip 4011, group III (17 patients) Medtronic 4057 screw-in leads. In all cases, Medtronic unipolar pacemakers were implanted with the same noninvasive autothreshold measurement method. Propafenone and 5-OH-propafenone blood levels were measured 3–5 hours after drug administration. The pacing autothreshold was measured at 0.8, 1.6, and 2.5 V by reducing the pulse width. After propafenone. groups II and III showed a statistically significant threshold rise (P ranging from 〈 0.01 to 〈0.05), whereas no significant difference was found in group I. Propafenone and 5-OH-propafenone blood levels did not show any significant difference among the three groups. Strength-durution curves were drawn for the three groups before und after propafenone: at baseline the curves shifted to the left with the steep part above the knee, clearly favoring CapSure over the other two groups. After propafenone, the curves shifted to the right, with the flat part progressively more evident in groups II and III. In the atrial chamber, steroid-eluting leads prevented threshold increase after propafenone therapy, in contrast with a significant threshold rise with conventional porous and screw-in leads.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1997.tb06167.x
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  • 3
    Electronic Resource
    Electronic Resource
    Risk of Complications of Atrial Fibrillation (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 20 (1997), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Atrial fibrillation is associated with three major risk of complications: thromboembolism, hemodynamic compromise, and arrhythmogenesis. In patients with chronic atrial fibrillation the incidence of embolization is about 5% per year. The risk of embolism and in particular of stroke can be reduced by warfarine anticoagulation. Aspirin is generally less effective than warfarin, although it is probably more effective than placebo. The hemodynamic complications which may occur during atrial fibrillation are mainly due to the loss of effective atrial contraction, the irregular ventricular rhythm, and the possible excessively rapid ventricular rate. Sudden death is a recognized manifestation of Wolff-Parkinson-White syndrome and is considered to be precipitated by atrial fibrillation in the majority of patients. Torsades de pointes is perhaps the most widely recognized proarrhythmia associated with treatment of atrial fibrillation, especially with 1A antiarrhythmic drugs and sotalol. The chronic treatment with type 1C drugs in 3.5%–5% of patients may induce atrial flutter with 1:1 conduction with significant hemodynamic compromise.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1997.tb06117.x
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  • 4
    Electronic Resource
    Electronic Resource
    The Role of EP-Guided Therapy in Ventricular Arrhythmias: Beta-Blockers, Sotalol, and ICD's (2000)
    Springer
    Journal of interventional cardiac electrophysiology 4 (2000), S. 57-63 
    Details
    ISSN: 1572-8595
    Keywords: electrophysiologic study ; ventricular tachycardia ; ventricular fibrillation ; sotalol ; beta-block
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Arrhythmic death can be reduced by antiarrhythmic drugs to a range of 2—4%. Electrophysiologic study by testing noninducibility of ventricular arrhythmia represents the classic method for evaluating the effectiveness of drug therapy. Several clinical studies have shown thaat sotalol suppresses VT induction and prevents arrhythmias recurrences at long term follow-up in 23% to 67% of patients. The efficacy of sotalol EP guided therapy in preventing VT/VF is not necessarily related to prevention of sudden death. In the ESVEM study the superiority of d,l-sotalol to other antiarrhythmic drugs was confirmed. The response to programmed ventricular stimulation was found to be strongly predictive for arrhythmia free state while the failure of sotalol therapy to suppress VT at the EP study was associated with an high recurrence rate (40%). However, EP study failes to predict freedom from sudden death. The beta-blocking activity of racemic sotalol may account for some of the observed survival benefit. Beta-blockers therapy reduces mortality in patients after myocardial infarction primarily by a reduction of sudden death. A reduction of death, worsening heart failure and life threatening ventricular arrhythmias was shown in a recent study on carvedilol. In the prospective study of Steinbeck the EP guided-therapy did not improve the overall outcome when compared to metoprolol. Suppression of inducible arrhythmias by antiarrhythmic drugs was associated with a better outcome. The effectiveness of defibrillator therapy in reducing overall mortality, has been uncertain since great clinical trials have been concluded. MADIT, AVID and CASH trials confirmed the superiority of ICD therapy over antiarrhythmic drugs therapy: ICD should be considered the first choice therapy in post-cardiac arrest patients. The ongoing BEST Trial will give us further responses about the interaction between EP study and metoprolol effect compared to ICD in patients post myocardial infarction also focusing on tolerability and compliance of the beta-blocking therapy in patients with low ejection fraction. In this study will be useful to optimize therapy in patients at high risk of sudden death
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1009822313578
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    Paper (German National Licenses)
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