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The use of cardiac implantable electronic devices (CIEDs) has substantially increased in the last decades. They have a significant impact on reducing morbidity and mortality of patients suffering from cardiac arrhythmias and heart failure. Several developments of technical issues have appeared over recent years to improve safety and efficacy. However, their role in daily clinical practice is still unclear. For instance, different leadless technologies, such as leadless pacemakers, subcutaneous defibrillators or wearables are only partly or not included in the current guideline recommendations. There are also several attempts to improve clinical response to cardiac resynchronization therapy with multipoint or fusion optimized technologies, it is however not clear which patients really benefit from these. The same is true for novel conduction system pacing modalities: His-bundle pacing seems to be the most physiological but manually challenging compared to left bundle branch area pacing, which latter restores only the physiologic activation of the left ventricle but may be easier to perform. The classical indications for primary prophylactic ICD are also questioned based on some new study results, highlighting the need for an improved, more detailed and individual risk stratification for better patient selection. We have important but somehow controversial study results regarding preventive antibiotic therapy (incremental perioperative antibiotics vs antibiotic-eluting envelope) during CIED implantation. Lead extraction tools are also expanding but randomized controlled trials regarding the best approach are completely missing in this field. The importance of remote monitoring is also constantly growing, especially in the current pandemic times, the best way of patient selection needs however more research.
Cardiac Resynchronization Therapy continues to evolve at a rapidpace. Growing clinical experience and additional clinical trialsare resulting in changes in how patients are selected for CRT. This new edition of the successful Cardiac ResynchronizationTherapy builds on the strengths of the first edition, providingbasic knowledge as well as an up-to-date summary of new advances inCRT for heart failure. Fully updated to include information ontechnological advances, trouble shooting and recent key clinicaltrials, and with nine new chapters, this expanded text provides thelatest information, keeping the reader up-to-date with this rapidlyevolving field. The second edition of Cardiac Resynchronization Therapyis an essential addition to your collection.
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.
With a focus on the growing field of cardiology remote monitoring, this state-of-the-art reference provides must-know clinical and technical information as well as recent advances in application, engineering, and clinical impact from the current literature. Authoritative coverage of implantable devices and ambulatory ECG brings you up to speed on recent practice changes in remote monitoring that have alleviated the volume of in-office patient follow-ups, allowed for physicians to monitor more patients, enabled better patient compliance, and most importantly, provided earlier warning signs of cardiac problems.
In the rapidly evolving field of treating cardiac arrhythmias, the importance of direct management of patients with implantable cardiac devices is growing. The devices have become increasingly complex, and understanding their algorithms and growing programming options is essential for physicians who implant and manage them. Written by experts and world authorities in the field, Pacemakers and Implantable Cardioverter Defibrillators: An Expert's Manual provides electrophysiologists, fellows in training, nurses, and cardiovascular technicians involved in day-to-day management of device patients with detailed information about the many device algorithms and interactions. Heavily illustrated with over 300 figures and tables Uniquely meets the day-to-day needs of all direct management professionals Focuses in detail on algorithms Describes device interactions, addressing every major manufacturer Provides in-depth insight into pacing, including biventricular pacing Discusses arrhythmia detection and device classification, testing, and therapy Pacemakers and Implantable Cardioverter Defibrillators: An Expert's Manual was listed by the American Journal of Cardiology as one of the "Good Books in Cardiovascular Disease in 2010." - American Journal of Cardiology Vol. 107, Issue 8, Pages 1250-1251
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 arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed. Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States.
Heart failure affects over 5 million patients in the United States alone, and is a chronic and debilitating disease. While a number of pharmacologic therapies have shown varying degrees of effectiveness, many recent advances in the treatment of heart failure has focused on device based therapies. In Device Therapy in Heart Failure, William H. Maisel and a panel of authorities on the use and implementation of device based therapies provide a comprehensive overview of the current and developing technologies that are used to treat heart failure. Individual chapters provide an in-depth analysis of devices such as CRT’s and ICD’s, while broader topics such as the pathophysiology of heart failure and its current medical therapies are also discussed. Additional topics include Pacing and Defibrillation for Atrial Arrhythmias, Atrial Fibrillation Ablation, and Percutaneous Treatment of Coronary Artery Disease.