Parameter signature of a reel problem.

Clinics involved in follow-up of cardiac implantable electronic devices, especially implantable cardiac defibrillators (ICDs), increasing rely upon remote monitoring. This case describes the parameter signature characteristic of an uncommon but well-described syndrome. Analysis of the nature and timing of the sequence of abnormalities contained in the archived device data, all of which is available for review via remote monitoring, reveals the cause for failure of this primary prevention ICD system.

Doppler guided extrathoracic introducer insertion.

Recent reports have raised concern over the use of standard subclavian puncture for placement of permanent pacing leads. This study reports the initial experience of one implanter in 59 consecutive, unselected patients undergoing implantation of a variety of pacing leads in whom a simple Doppler flow detector was used to guide extrathoracic venipuncture of the lateral subclavian/axillary vein. A total of 100 leads were placed for 48 right- and 11 left-sided systems.

Maleficent magnets and mangled megabytes.

Personal computers have become common-place in physicians' practices and their use in cardiac pacing for programming and follow-up is increasing. The most commonly used media for mass data storage are ferromagnetic. That the toroidal and bar magnets used to activate reed switches pose a threat to such data is well known but the degree of care necessary in handling magnets around storage media, especially the vulnerable floppy diskettes, is not generally appreciated.