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In the last years, indications for defibrillators and cardiac resynchronization therapy have expanded enormously; for this reason, and also due to the extension of human life length, the number of patients with implanted cardiac devices have steadily increased. The leads implanted for the functioning of these devices, however, have a limited duration in time and more and more their extraction will be a frequent issue in clinical practice, in order to treat short- and long-term complications, such as infections and failures. Aim of this book is to provide readers with a state-of-the-art on lead extraction techniques. The chapters deal with leads characteristics, indications to lead removal, patient preparation, tools and techniques for extraction, and prevention and management of complications. In addition, a series of tips and tricks on how to treat some particular conditions (tight cost-clavicular space, fractured leads, ICD leads, dangered leads...etc.), are given. A new extracting technique, according to which the extraction is performed through the internal jugular vein is described; several examples are included and many figures provide a thorough depiction of this innovative procedure. The volume will be an excellent resource for all those involved in the management of cardiac patients: cardiologists, arrhythmologists, cardiac surgeons, GPs, pediatricians, and post-graduate students in these disciplines.
An essential companion for both the aspiring and practising electrophysiologist, The EHRA Book of Pacemaker, ICD and CRT Troubleshooting assists device specialists in tackling both common and unusual situations that that they may encounter during daily practice. Taking a case-based approach, it examines pacemakers, implantable cardioverter defibrillators and cardiac resynchronisation therapy. Much more than just a technical manual of device algorithms, the cases help readers to consolidate their technical knowledge, and improve their reasoning and observation skills so they are able to tackle device troubleshooting with confidence. The 70 cases are arranged in three sections by increasing levels of difficulty to walk readers through all the skills and knowledge they need in an easy to use and structured format. Each case contains a short clinical description and a device tracing followed by a multiple choice question. Answers are supplied with detailed annotations of the tracing and an in-depth discussion of the case, highlighting practical hints and tips as well as providing an overview of the technical function of devices. A useful summary of principal device features and functions is also included. The EHRA Book of Pacemaker, ICD and CRT Troubleshooting is the perfect companion for electrophysiologists, cardiology trainees and technical consultants working with device patients as well as for those studying for the EHRA accreditation exam in cardiac pacing.
Cardiac implantable device (CIED) infections are a key issue since they have serious consequences in terms of morbidity, mortality and associated costs for healthcare systems. Such infections are highly complex, which has implications for prevention (several factors underlie its development), diagnosis (requiring patient specific integration of several elements), acute treatment (choice of the antibiotic, lead extraction procedure), as well as long-term management (CIED re-implantation strategy and follow-up). Dealing with CIED infections requires appropriate organization of healthcare provision, with the creation of integrated hub-spoke referrals, and it has prompted many of the recent developments in CIED technologies: leadless pacemakers, subcutaneous defibrillators, antibacterial envelops and lead extraction devices. This book systematically examines all aspects of this multifaceted condition, discussing each clinical and organizational issue in a separate self-contained chapter. It starts by reviewing the epidemiology/pathophysiology of CIED infections, and then addresses acute and long-term management. Offering a comprehensive overview of the prevention of infections, considering both current and future perspectives, the book also provides practical suggestions along with recommendations from the literature in the field. This is the first book entirely focused on CIED infections. Written by an international team of leading experts it will appeal to broad audience, including cardiologists, electrophysiologists, infectious disease specialists, internists, healthcare professionals, health service managers and providers, researchers and those working in industries involved in the field.
Unique in the field, Surgical Implantation of Cardiac Rhythm Devices provides complete, easy-to-follow guidance for safe, effective surgical implantation of pacemakers, ICDs, and other devices. Beginning with surgical anatomy and surgical principles, expert authors provide thorough coverage of surgical technique and procedures – everything from sutures to special circumstances and complications. Detailed, high-quality illustrations show you exactly how to proceed, and each procedure includes an accompanying video clip online. - Outlines relevant anatomic structures and landmarks, as well as various types of sutures and instruments. - Provides authoritative, detailed guidance on transvenous lead placement, including novel or alternative placements, as well as implantation of subcutaneous ICDs. - Covers tools and techniques, anesthesia, radiation safety, pitfalls and complications, tips and pearls, patient preparation, postoperative patient management, and follow-up care. - Offers expert coverage of pediatric considerations and other special circumstances. - Allows you to view surgical procedures and relevant anatomy in video clips online, as well as through extensive, high-quality illustrations in the text. - Ideal for EP fellows, practicing electrophysiologists, and cardiologists who perform surgical procedures to implant pacemakers, ICDs, and other devices.
Fully revised and updated, the fourth edition of Cardiac Pacingand ICDs continues to be an accessible and practical clinicalreference for residents, fellows, surgeons, nurses, PAs, andtechnicians. The chapters are organized in the sequence of the evaluation ofan actual patient, making it an effective practical guide. Revisedchapters and updated artwork and tables plus a new chapter oncardiac resynchronization make the new edition an invaluableclinical resource. Features: · New chapter on Cardiac Resynchronization Therapy · Updated and better quality figures and tables · Updated content based on ACC/AHA/NASPE guidelines · Updated indications for ICD placement · Updated information on ICD and pacemakertroubleshooting
Introductory Chapter: Introduction to Advanced Concepts in Endocarditis.
A complete, how-to-do-it guide to planning, programming, implementing, and trouble-shooting todays pacemakers and other implantable cardiac devices Edited by a team of leading clinician-educators this is a practical, go-to reference for trainees and clinical staff who are new to or less experienced with the programming and management of implantable devices. It distills device best-practices into a single, quick-reference volume that focuses on essential tasks, common pitfalls, and likely complications. Each chapter follows a hands-on, how-to-do-it approach that helps readers quickly master even the most challenging device-related taskssuch as programming and how to respond confidently when complications arise. Todays pacemakers and other implantable EP devices are to earlier versions what smart phones are to rotary phones. They are not only smaller and more comfortable; they offer complex programming options that allow clinicians to adapt a device to individual patient requirements. As they continue to become smaller, smarter, and more adaptable, these devices also become more challenging for clinicians to set up, manage and monitor. This unique, quick-reference guide dramatically reduces the learning curve for mastering this essential technology by giving doctors and technicians the how-to information they need. Focuses on tasks clinicians perform, including pre-implementation, planning, programming, management, troubleshooting, and more Shows how expert clinicians achieve optimal outcomes in their own labs with real-world examples Features more than 300 images, including ECGs, X-ray and fluoroscopy, images from device interrogation, intracardiac electrograms, and color electoanatomical maps Provides eight videos on an accompanying website demonstrating key tasks and techniques Also available in an eBook version, enhanced with instructional videos, How-to Manual for Pacemaker and ICD Devices is an indispensable tool of the trade for electrophysiologists, fellows in electrophysiology, EP nurses, technical staff, and industry professionals.
This book describes the relationship of the skin with cardiovascular disease. It details the variety of genetic, autoimmune, metabolic and endocrine factors that link the two disciplines. Recognition of one sign or symptom in dermatology can lead to the investigation and discovery of an important related cardiac condition, the recognition of which is important to prevent cardiovascular complications. Similarly, a cardiac condition may be related to an underlying skin condition that requires treatment. Genetic examples of such instances included within the book include: pseudoxanthoma elasticum, epidermolysis bullosa with desmosome defects and plectin defects; Marfan syndrome; Autoimmune conditions include vasculitis, sarcoidosis, lupus; metabolic conditions include insulin resistance, eruptive xanthomas with hypertriglyceridemias and elevated cholesterol; endocrine disorders include thyroid acropachy with atrial fibrillation; insulin resistance with coronary artery disease and psoriasis or hidradenitis suppurativa. Skin and the Heart reviews the effects of genetic, autoimmune and endocrine diseases with connections between skin and heart. It is therefore a key reference for all practitioners and researchers working in both disciplines.
Different artificial tools, such as heart-pacing devices, wearable and implantable monitors, engineered heart valves and stents, and many other cardiac devices, are in use in medical practice. Recent developments in the methods of cardiac pacing along with appropriate selection of equipment are the purpose of this book. Implantable heart rate management devices and wearable cardiac monitors are discussed. Indications for using specific types of cardiac pacemakers, cardiac resynchronization therapy devices, and implantable cardioverter defibrillators (ICDs) are of interest and their contraindications are considered. Special attention is paid to using leadless devices. The subcutaneous ICD obviates the need for transvenous leads and leadless pacemakers are entirely implantable into the right ventricle. Finally, applications of user-friendly wearable devices for the detection of atrial arrhythmia are debated.
This book provides a comprehensive practical guide to the plethora of devices that have been developed to support the failing heart. It features easy to follow clinically relevant guidance on mechanical devices used for improving cardiac electrical conduction and cardiac output. Chapters cover indications and implant considerations for the implantable cardioverter defibrillator and cardiac resynchronization therapy devices and hemodynamic monitoring in the intensive care unit. Case-Based Device Therapy for Heart Failure describes how to properly use a range of available devices to treat heart failure. Thanks to its multidisciplinary authorship, it is a valuable resource for practising and trainee heart failure cardiologists, electrophysiologists and cardiac surgeons.