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Electrophysiology Journal Articles, Videos And Insights

Electrophysiology: FEATURED Articles

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Electrophysiology: Latest Articles

European Journal of Arrhythmia & Electrophysiology. 2018;4(2):Epub ahead of print

Electrophysiology: FEATURED VIDEOS

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Pier Lambiase (Institute of Cardiovascular Science, University College London, London) discusses the implantation of first- and second-line subcutaneous defibrillators and patient suitability for implantation. Implantation is mainly suitable for any patient that does not require a lead in their heart. The main contraindications for implantation are if the patient has a unipolar pacemaker, or if they have a recurrent monomorphic ventricular tachycardia which is responsive to ATP. Patients are screened through the use of ECG and an automated screening tool, which compares the patient's results to an electronic template to see if the patient would pass screening with the device implanted. There are three vectors that can be used - ideally, two vectors are preferred to allow for some reserve but it is acceptable to have one vector for the patient. Filmed at EHRA 2018, Barcelona. Questions: 1. Please outline the key factors indicating patient suitability for first- and second-line subcutaneous defibrillator implantation. 0:07 2. What are the key contraindications for implantation of a subcutaneous defibrillator? 0:43 3. How do you screen patients ahead of subcutaneous defibrillator implantation? 1:05 4. What measures do you take to refine your patient selection criteria? How can data from patient registries help? 2:01
Haran Burri discusses the remote monitoring of cardiac resynchronisation therapy, the ACUITY X4 multipolar leads and the outcomes of the RALLY-X4 study. FILMED AT THE CARDIOSTIM ANNUAL MEETING, JUNE 2016 WHAT ARE THE ADVANTAGES OF THE ACUITY X4 MULTIPOLAR LEADS? 00:10 – So these are quadripolar leads that allow us to more easily position them in the coronary sinus veins. They also give us more options to reduce the pacing thresholds, the captured thresholds. And finally, to avoid pacing the phrenic nerve. WHAT HAVE BEEN THE OUTCOMES OF THE RALLY-X4 STUDY? 00:33 – So, this was actually the first phase which we’re presenting here at CardioStim, the post-marketing clinical follow-up in the first 201 patients. And what we found was that the success for delivery of CRT at three months was present in all but one of the 201 patients, that’s to say, in over 99% of patients who received CRT delivery at three months. And in fact the electrical measurements were very good, with on average about 1 volt captured thresholds and very good stability. We had no cases that needed to be re-operated for early dislodgement. There was one case that needed repositioning due to persistent phrenic nerve capture. WHY IS REMOTE MONITORING OF CRT NEEDED? 01:28 – It’s becoming the standard of care now for these patients. These patients have high incidences of clinical issues, arrhythmias, be it atrial arrhythmias or ventricular arrhythmias that could benefit from being monitored and diagnosed early on. They also have more heart failure events. So, we can monitor various parameters for heart failure. And finally, these patients are also at a somewhat higher risk for technical issues, that’s to say, for instance, high left ventricular threshold. And these are things that we can actually monitor using remote monitoring and act upon them more quickly. WHAT ARE THE LIMITATIONS OF THE REMOTE MONITORING OF CRT DEVICES? 02:14 – So, the limitations are data overload because these devices can upload quite a lot of data off the patients to the hospitals, and the hospital staff are faced with a lot of data overload. So, what could work around this are integrated diagnostics where you have automatic algorithms that look at different parameters and risk stratify patients into higher risk, medium risk and lower risk, meaning that the hospital staff can focus on those patients who are at higher risk—that’s about 10% of the patients—and then deal specifically with those 10% of patients.

Electrophysiology: Latest Videos

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Petr Neuzil (Cardiocentre, Na Homolce Hospital, Prague) talks about the latest technologies currently being researched in the treatment of arrhythmia. New technologies and innovations such as RF balloons (such as the Biosense Webster; Helios), electroporation and diamond tip RF catheters aim to...
Pier Lambiase (Institute of Cardiovascular Science, University College London, London) discusses the implantation of first- and second-line subcutaneous defibrillators and patient suitability for implantation. Implantation is mainly suitable for any patient that does not require a lead in their...
Francesco Santoro (Asklepios Klinik St. Georg, Hamburg) discusses the GErman Italian STress Cardiomyopathy (GEIST) registry – a large international, multicentre registry – and their recent findings in persistent ST elevation. They analysed patients who had elevated ST for more than 48 hours...
Dipak Kotecha (Institute of Cardiovascular Sciences, University of Birmingham) discusses the FAST trial - the first long-term follow-up of a randomised trial comparing thoracoscopic surgical atrial fibrillation ablation with catheter ablation with the aim of rhythm control. Thoracoscopic ablation...
Claudio Tondo (Centro Cardiologico Monzio, Milan) discusses the benefits of hybrid ablation compared to the currently approved ablation methods in the treatment of atrial fibrillation. The hybrid ablation approach involves a combination of surgery with electrophysiological cathater ablation. It...
Joachim Ehrlich discusses the major challenges for antiarrhythmic treatment of atrial fibrillation and the progress of development of new ion channel inhibition agents.

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