Successful New Generation LAA Closure Device Implantation After Prior Incomplete Surgical LAA Ligation.

We present a case of percutaneous closure of a prior incomplete surgical left atrial appendage (LAA) ligation after a failed closure attempt using the first-generation Watchman device. The new generation Watchman FLX device (Boston Scientific) was implanted in this technically and anatomically challenging LAA patient using multimodality fusion imaging. ().

Antibacterial Envelope Is Associated With Low Infection Rates After Implantable Cardioverter-Defibrillator and Cardiac Resynchronization Therapy Device Replacement: Results of the Citadel and Centurion Studies.

Objectives: This study sought to determine whether the nonabsorbable TYRX Antibacterial Envelope (TYRX) reduces major cardiovascular implantable electronic device (CIED) infections 12 months after implant.

Background: TYRX is a monofilament polypropylene mesh impregnated with minocycline and rifampin specifically designed to hold a CIED in place and elute antimicrobials over time. There are limited data on its ability to reduce CIED infections.

Investigation of the Utility of the Audible Alert in Recent Generation Medtronic Implantable Cardioverter Defibrillators.

Background: Medtronic implantable cardioverter defibrillators (ICDs; Medtronic Inc., Mounds View, MN, USA) are equipped with Patient Alert™, a feature in which the ICD generator emits a series of audible tones to notify patients of possible system malfunction. A prior study of this issue revealed that only 50% of patients with older Medtronic devices were able to hear alerts.

A pilot study of cardiac electrophysiology catheters to map and pace bladder electrical activity.

Aims: This is a pilot study to evaluate the feasibility of using diagnostic cardiac electrophysiology catheters for recording intrinsic urinary bladder electrical activity and for electrical pacing capture of bladder tissue.

Methods: During cystoscopy, a curved quadripolar catheter was introduced and contact was made with the right and left halves of the dome and trigone in adult female patients undergoing cystoscopy. Electrical activity was recorded, using a commercially available cardiac electrophysiologic recording system, before and during pacing at 0.

Magnetic resonance imaging diagnosis of left atrial abscess after ablation of atrial fibrillation.

We report a 52-year-old patient with a late presentation of a fistula that occurred after catheter ablation for atrial fibrillation. A secondary left atrial wall abscess was diagnosed by upper endoscopy and cardiac magnetic resonance imaging. Emergency operative repair was successful, with no adverse cardiac or gastrointestinal sequelae.

Implantation success and infection in cardiovascular implantable electronic device procedures utilizing an antibacterial envelope.

Background: Cardiovascular implantable electronic device (CIED) infection rates are increasing faster than implantation rates. More effective antimicrobial prophylaxis may help reduce CIED infections and improve clinical outcomes. The AIGIS(Rx)(®) antibacterial envelope is a polymer mesh implanted in the generator pocket with the CIED.

Alert tones are frequently inaudible among patients with implantable cardioverter-defibrillators.

Background: Current management guidelines for patients with Medtronic Sprint Fidelis ICD leads (Medtronic Inc., Minneapolis, MN, USA) include prominent use of Patient Alert, a feature in which the ICD generator emits audible beeps at two programmable frequencies. Because hearing loss is highly prevalent beyond the sixth decade of life, the utility of this feature is unclear.

Use of the retained guidewire technique facilitates left ventricular epicardial capture during biventricular defibrillator implantation.

We report a case of biventricular implantable cardioverter-defibrillator (ICD) insertion in which standard lead placement techniques could not achieve left ventricular capture. Protrusion of the guidewire beyond a venous stenosis provided adequate left ventricular capture.

Continuous nonfluoroscopic localization of the esophagus during radiofrequency catheter ablation of atrial fibrillation.

Introduction: Atrial-esophageal fistula formation is a dreaded complication of radiofrequency catheter ablation for atrial fibrillation. Esophageal localization is of potential value in avoiding lesion placement where the left atrium is juxtaposed to the esophagus.

Methods And Results: Twenty-seven patients underwent 33 pulmonary vein encirclement procedures.

Use of a sterile, disposable, radiation-absorbing shield reduces occupational exposure to scatter radiation during pectoral device implantation.

The aim of this study was to demonstrate the effectiveness of a radiation-absorbing shield in reducing physicians' occupational radiation exposure during pectoral device implantation. A sterile, disposable, lead-free radiation-absorbing surgical drape containing x-ray attenuation material was evaluated. Twenty procedures used the radiation absorbing drape, and 20 were performed without the shielding.