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Pacemaker

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101. Cost-effectiveness Analysis of Magnetic Resonance Imaging-Conditional Pacemaker Implantation: Insights from a Multicenter Study and Implications in the Current Era. (PubMed)

Cost-effectiveness Analysis of Magnetic Resonance Imaging-Conditional Pacemaker Implantation: Insights from a Multicenter Study and Implications in the Current Era. Magnetic resonance imaging (MRI)-conditional pacemakers (M-PPMs) grant patients greater accessibility to MRI scans. The cost-effectiveness of implanting M-PPM is unknown.The purpose of this study was to determine the cost-effectiveness of M-PPM implantation.Cost-effectiveness analysis was performed on patients receiving a M-PPM (...) across 4 institutions. The incremental cost-effectiveness ratio (ICER) was calculated by dividing the sum of the total incremental cost of implanting a M-PPM vs a conventional pacemaker and the cost of MRI scans by the utility of MRI scans in terms of quality-adjusted life-years (QALY) gained. QALY and lifespan of M-PPM (7-11 years) data were obtained from the literature. The benchmark of <$100,000 per QALY was used as the threshold for cost-effectiveness. Computer modeling/simulations were used

2018 Heart Rhythm

102. The Maze Procedure and Postoperative Pacemakers. (PubMed)

The Maze Procedure and Postoperative Pacemakers. There is concern that the right atrial lesions of the maze procedure lead to more permanent pacemakers postoperatively and that they provide little therapeutic advantage over left atrial lesions alone.A discussion of the pertinent anatomy related to atrial fibrillation and the performance of the maze procedure, the potential ways that the specialized conduction system could theoretically be damaged by the procedure, non-procedure-related causes (...) for increased postoperative pacemaker requirements, and the basis for the efficacy of the right atrial lesions of the maze procedure are presented. Several factors that can lead to a dysfunctional sinoatrial node preoperatively in patients with atrial fibrillation are also discussed.The reasons new permanent pacemakers are required after a maze procedure include the high success rates of the surgery with subsequent unmasking of preoperative sick sinus syndrome, excessive extracardiac dissection that damages

2018 Annals of Thoracic Surgery

103. Safety and Feasibility of Leadless Pacemaker in Patients Undergoing Atrioventricular node Ablation for Atrial Fibrillation. (PubMed)

Safety and Feasibility of Leadless Pacemaker in Patients Undergoing Atrioventricular node Ablation for Atrial Fibrillation. Atrioventricular node (AVN) ablation and permanent pacing is an established strategy for rate control in the management of symptomatic atrial fibrillation (AF). Leadless pacemakers (LPs) can overcome some of the short-term and long-term limitations of conventional transvenous pacemakers (CTPs).The purpose of this study was to compare the feasibility and safety of LP (...) with those of single-chamber CTP in patients with AF undergoing AVN ablation.We conducted a multicenter observational study of patients undergoing AVN ablation and pacemaker implantation (LP vs single-chamber CTP) between February 1, 2014 and November 15, 2016. The primary efficacy end points were acceptable sensing (R wave amplitude ≥5.0 mV) and pacing thresholds (≤2.0 V at 0.4 ms) at follow-up. Safety end points included device-related major and minor (early <1 month, late >1 month) adverse events.A

2018 Heart Rhythm

104. A Novel "Trousers-Like" Technique for The Extraction Of 22-Year-Old Pacemaker Leads. (PubMed)

A Novel "Trousers-Like" Technique for The Extraction Of 22-Year-Old Pacemaker Leads. Cardiac management devices have become an integral part of our armament for treatment of heart diseases. However, complications may arise that mandate extraction of either the device or the lead. The noninterventional lead extraction has become a topic of avid debate as simple traction is associated with low success rates whereas laser-assisted extraction carries a high economic cost. Herein we present a case (...) of 22-year-old pacemaker leads extracted with a novel "trouserslike technique" that could present an attractive alternative for leads implanted for more than 10 years when laser sheaths are not accessible.Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2018 Annals of Thoracic Surgery

105. Protein Kinase 2<i>β</i> Is Expressed in Neural Crest-Derived Urinary Pacemaker Cells and Required for Pyeloureteric Contraction. (PubMed)

Protein Kinase 2β Is Expressed in Neural Crest-Derived Urinary Pacemaker Cells and Required for Pyeloureteric Contraction. Nonobstructive hydronephrosis, defined as dilatation of the renal pelvis with or without dilatation of the ureter, is the most common antenatal abnormality detected by fetal ultrasound. Yet, the etiology of nonobstructive hydronephrosis is poorly defined. We previously demonstrated that defective development of urinary tract pacemaker cells (utPMCs) expressing

2018 Journal of the American Society of Nephrology

106. Magnetic Resonance Imaging Safety in Non-Conditional Pacemaker and Defibrillator Recipients: A Meta Analysis and Systematic Review. (PubMed)

Magnetic Resonance Imaging Safety in Non-Conditional Pacemaker and Defibrillator Recipients: A Meta Analysis and Systematic Review. Recommendations regarding performance of magnetic resonance imaging (MRI) in non-MRI conditional pacemaker and defibrillator recipients are evolving. Previous studies have suggested low adverse event rates with MRI in nonconditional cardiac implantable electronic device (CIED) recipients, but low power limits optimal characterization of risk.The purpose (...) was unchanged, and inappropriate shocks were avoided with pre-MRI programming changes.This review demonstrated low lead failure and clinical event rates in non-MRI conditional pacemaker and defibrillator recipients undergoing MRI. Observed changes were small and interstudy variance was low, suggesting that the composite event rates offer a reasonable estimate of true effect. The observed adverse events reinforce the need for ongoing vigilance and caution, particularly with older devices.Copyright © 2018

2018 Heart Rhythm

107. Marked First-Degree Atrioventricular Block and Pseudo-Pacemaker Syndrome in a Pediatric Patient. (PubMed)

Marked First-Degree Atrioventricular Block and Pseudo-Pacemaker Syndrome in a Pediatric Patient. We describe a 17-year-old female who presented with 3 weeks of abdominal pain, exercise intolerance, and an episode of altered mental status found to have marked first-degree atrioventricular block. Exercise stress test and cardiac catheterization demonstrated pseudo-pacemaker syndrome, and a permanent pacemaker was placed. Following placement, she has resolution of symptoms and markedly improved

2018 Pediatric Cardiology

108. Pacemaker implantation rate after transcatheter aortic valve implantation with early and new-generation devices: a systematic review. (PubMed)

Pacemaker implantation rate after transcatheter aortic valve implantation with early and new-generation devices: a systematic review. The incidence of new-onset conduction abnormalities requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) with new-generation prostheses remains debated. This systematic review analyses the incidence of PPI after TAVI with new-generation devices and evaluates the electrical, anatomical, and procedural factors

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2018 European Heart Journal

109. Association between paced QRS duration and atrial fibrillation after permanent pacemaker implantation: A retrospective observational cohort study. (PubMed)

Association between paced QRS duration and atrial fibrillation after permanent pacemaker implantation: A retrospective observational cohort study. Right ventricular pacing often results in prolonged QRS duration (QRSd) as the result of right ventricular stimulation, and atrial fibrillation (AF) may result. The association of pacing-induced prolonged QRSd and AF in patients with permanent pacemakers is unknown.We selected 180 consecutive patients who underwent pacemaker implantation for complete (...) /advanced atrioventricular block. All of the patients were paced from the right ventricular septum. Electrocardiography recordings were obtained at the beginning and the end of pacemaker implantation. QRSd was measured in all 12 leads. The QRSd variation was calculated by subtracting the preimplantation QRSd from the postimplantation QRSd.The occurrence of AF was observed in 64 (35.56%) patients (follow-up 33.62 ± 21.47 mo). No significant differences in preimplantation QRSd were observed between the AF

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2018 Medicine

110. Long-Term Outcomes in Patients With New Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement. (PubMed)

Long-Term Outcomes in Patients With New Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement. This study sought to evaluate the long-term clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR).Conduction disturbances leading to PPI are common following TAVR. However, no data exist regarding the impact of PPI on long-term outcomes post-TAVR.This was a multicenter study including a total of 1,629 patients without

2018 JACC. Cardiovascular interventions

111. Case Report of the Safety Assessment of Transcranial Magnetic Stimulation Use in a Patient With Cardiac Pacemaker: To Pulse or Not to Pulse? (PubMed)

Case Report of the Safety Assessment of Transcranial Magnetic Stimulation Use in a Patient With Cardiac Pacemaker: To Pulse or Not to Pulse? Single-pulse transcranial magnetic stimulation (sTMS) is an emerging neuromodulation method reported to be useful in migraine. Despite a low propensity for side effects, some concern with its use in patients with cardiac pacemakers has been expressed.We present a patient with chronic migraine with a cardiac pacemaker, who had tried unsuccessfully several (...) migraine preventives with either poor efficacy or tolerability. With involvement of the cardiology team, we tested the effect of sTMS on her pacemaker and found it to be a safe and effective option for her.Having regard to the risk/benefit ratio of sTMS, its use in patients with disabling migraine in the presence of a cardiac pacemaker can be carefully evaluated and may represent a useful therapeutic option.© 2018 American Headache Society.

2018 Headache

112. Effect of New-Onset Left Bundle Branch Block After Transcatheter Aortic Valve Implantation (CoreValve) on Mortality, Frequency of Re-Hospitalization, and Need for Pacemaker

Effect of New-Onset Left Bundle Branch Block After Transcatheter Aortic Valve Implantation (CoreValve) on Mortality, Frequency of Re-Hospitalization, and Need for Pacemaker New-onset conduction disturbances are common after transcatheter aortic valve implantation (TAVI). The most common complication is left bundle branch block (LBBB). The clinical impact of new-onset LBBB after TAVI remains controversial. The aim of this study was to analyze the clinical impact of new-onset LBBB in terms (...) of mortality and morbidity (need for pacemakers and admissions for heart failure) at long-term follow-up. From April 2008 to December 2014, 220 patients who had severe aortic stenosis were treated with the implantation of a CoreValve prosthesis. Sixty-seven of these patients were excluded from the analysis, including 22 patients with pre-existing LBBB and 45 with a permanent pacemaker, implanted previously or within 72 hours of implantation. The remaining 153 patients were divided into 2 groups: group 1 (n

2016 EvidenceUpdates

113. Need for Permanent Pacemaker after Surgical Aortic Valve Replacement Reduces Long-Term Survival. (PubMed)

Need for Permanent Pacemaker after Surgical Aortic Valve Replacement Reduces Long-Term Survival. Permanent pacemaker (PPM) implantation has been touted as an inconsequential complication after transcatheter aortic valve replacement. As transcatheter aortic valve replacement moves to lower risk patients, the long-term implications remain poorly understood; therefore, we evaluated the long-term outcomes of pacemaker for surgical aortic valve replacement patients.A total of 2,600 consecutive

2018 Annals of Thoracic Surgery

114. Correlation of tricuspid regurgitation and new pacemaker implantation in patients undergoing transcatheter aortic valve implantation. (PubMed)

Correlation of tricuspid regurgitation and new pacemaker implantation in patients undergoing transcatheter aortic valve implantation. Conduction abnormalities (CA), in particular complete atrioventricular block (CAVB), requiring permanent pacemaker (PPM) implantation, are frequent complications after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS). However, the potential mechanisms are still incompletely understood. The objective of this retrospective (...) decreased.PPM implantation is a frequent complication in patients undergoing TAVI. Increasing severity of TR seems to be a consequence of left and right ventricular overload caused by severe AS and is a significant predictor of new CAVB after TAVI.Conduction abnormalities (CA) requiring permanent pacemaker (PPM) implantation, are frequent complications after transcatheter aortic valve implantation (TAVI). This study included patients without prior CA/PPM who underwent TAVI. Of 563 patients 61 (10.8

2018 International journal of cardiology

115. The benefit of pacemaker therapy in patients with neurally mediated syncope and documented asystole: a meta-analysis of implantable loop recorder studies.

The benefit of pacemaker therapy in patients with neurally mediated syncope and documented asystole: a meta-analysis of implantable loop recorder studies. Although the efficacy of cardiac pacing in patients with neurally mediated syncope (NMS) and documented asystole is established, a more robust point estimate of the benefit, which is not possible with any individual study, is lacking.We undertook a meta-analysis of individual participant data from four studies that reported follow-up data (...) for pacemaker therapy. Follow-up was available in 121 (60%) of those patients with asystolic events. Syncope recurred after pacing in 18 (14.9%) patients with an actuarial rate of 13% [95% confidence interval (CI) ±6] at 1 year, 21% (95%CI ±10) at 2 years, and 24% (95%CI ±11) at 3 years. On multivariable Cox regression analysis, positive tilt test response was the only significant predictor of syncope recurrence with a hazard ratio (95% CI) of 4.3 (1.4-13). On the contrary, type of asystolic event (sinus

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2018 Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

116. Electroconvulsive therapy in 77-year-old patient with pacemaker: a case report (PubMed)

Electroconvulsive therapy in 77-year-old patient with pacemaker: a case report The treatment of a 77-year-old patient suffering from severe psychotic depression with a cardiac pacemaker is described. Because of treatment-resistant depression, electroconvulsive therapy (ECT) was introduced. In the course of ECT, there was a great improvement in his mental state without any cardiac complications. This case may be evidence for the safety and effectiveness of ECT in the elderly, even with cardiac (...) comorbidities. Some recommendations for ECT in patients with pacemakers are discussed.

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2018 Neuropsychiatric disease and treatment

117. Late diagnosis of a congenitally corrected transposition of the great arteries discovered at pacemaker implantation in a patient previously diagnosed with dextrocardia and situs solitus (PubMed)

Late diagnosis of a congenitally corrected transposition of the great arteries discovered at pacemaker implantation in a patient previously diagnosed with dextrocardia and situs solitus Congenitally corrected transposition of the great arteries (CCTGA) should not be missed in patients with dextrocardia and situs solitus. We report a case of a 56-year-old man with late diagnosis of CCTGA after ventricular lead replacement. Free LV wall pacing may be favorable in these patients so to prevent

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2018 Clinical Case Reports

118. Leadless pacemaker implantation after transcatheter lead extraction in complex anatomy patient (PubMed)

Leadless pacemaker implantation after transcatheter lead extraction in complex anatomy patient After transvenous lead extraction, leadless pacemaker might be a valid alternative to the traditional two-step strategy including an active fixation leads temporary PM and subsequent contralateral permanent implantation in patients who are pacemaker-dependent. Moreover, leadless PM might be of great importance in patients presenting with congenital vascular or cardiac abnormality.

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2018 Clinical Case Reports

119. Is There Always a Need for Permanent Pacemaker Replacement After Device Infection? A Tale of Two Patients (PubMed)

Is There Always a Need for Permanent Pacemaker Replacement After Device Infection? A Tale of Two Patients There has been an increase in number of cardiac implantable electronic devices (CIEDs) implantation and with this we have witnessed increased rates of CIED infection mainly in elderly population. It is important to assess conditions that may not reliably improve with cardiac pacing or those who lack adequate beneficial effect from permanent pacing before contemplating implantation

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2018 Cardiology Research

120. A Pacemaker that was Avoided (PubMed)

A Pacemaker that was Avoided Thyroxine is an essential hormone in the human body and exerts many effects on the cardiovascular system. The low metabolic state in hypothyroidism causes bradycardia and reduced cardiac contractility leading to reduced cardiac output. Severe bradycardia and atrioventricular (AV) blocks secondary to hypothyroidism have also been reported. We present a case of severe hypothyroidism causing a high-grade AV block which was successfully treated with thyroxine hormone (...) replacement without requiring cardiac pacemaker placement.

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2018 Cureus

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