Understanding and Managing Atrial Fibrillation in Patients with Kidney Disease.

Chronic kidney disease (CKD) is on the rise due to the increased rate of related comorbidities such as diabetes and hypertension. Patients with CKD are at higher risk of cardiovascular events and atrial fibrillation is more common in this patient population. It is estimated that the prevalence of chronic atrial fibrillation in patients with CKD is two to three times higher than general population.

Meta-analysis of safety and efficacy of uninterrupted warfarin compared to heparin-based bridging therapy during implantation of cardiac rhythm devices.

Optimal management of perioperative anticoagulation in patients undergoing pacemaker or implantable cardioverter-defibrillator implantation is not yet established. We performed a meta-analysis of the published literature to assess the safety and efficacy of perioperative heparin-based bridging therapy versus uninterrupted warfarin therapy in patients undergoing pacemaker or implantable cardioverter-defibrillator implantation. We performed a systematic review of MEDLINE (1950 to 2012), EMBASE (1988 to 2012), Cochrane Controlled Trials Register (fourth quarter 2011), and reports presented at scientific meetings (1994 to 2011).

Devices to treat peripheral chronic total occlusions.

Chronic total occlusions occur in approximately 40% of patients with peripheral vascular disease and are a difficult lesion subset to treat by endovascular approaches. The challenge lies in the difficulty in placing a wire across the site of occlusion and remaining in an intraluminal position. Conventional percutaneous transluminal balloon angioplasty for chronic total occlusions involves advancing a stiff wire through the site of obstruction, has the chance for vessel dissection and perforation, and is associated with high rates of procedural failure.

Electromagnetic interference between external defibrillator and cardiac resynchronization therapy-pacemaker (CRT-P) devices.

Background: Implantable heart rhythm devices are susceptible to interference in hospitals where electromagnetic interference (EMI) sources are ubiquitous.

Case Description: We report three cases in which EMI from the external defibrillator caused the inability to interrogate Boston Scientific cardiac resynchronization therapy-pacemaker (CRT-P) devices. We have documented interference with the Boston Scientific CRT-P Contact Renewal device model numbers H120/H125 (Natick, MA, USA) and two brands of external defibrillators: the Philips Heartstart XL model number M4735A (Andover, MA, USA) and the Hewlett-Packard Codemaster model number M1722B (Palo Alto, CA, USA).

Use of a percutaneous left ventricular assist device for high-risk cardiac interventions and cardiogenic shock.

Objective: We sought to describe the use of the TandemHeart percutaneous left ventricular assist device (PVAD) in a group of high-risk patients undergoing complex cardiovascular procedures.

Background: There is a substantial risk of acute decompensation and death in patients with cardiogenic shock or a reduced cardiac reserve undergoing high-risk cardiovascular interventions. The TandemHeart PVAD provides near-total hemodynamic support in this setting.

Peripheral chronic total occlusions treated with subintimal angioplasty and a true lumen re-entry device.

Objective: We sought to verify how effective the Pioneer catheter (Medtronic, Inc., Minneapolis, Minnesota) is in overcoming the complexity of re-entry during subintimal angioplasty and provide a case series describing the technique.

Background: Subintimal angioplasty is effective in treating peripheral chronic total occlusions (CTO).

Use of high-frequency vibrational energy in the treatment of peripheral chronic total occlusions.

Purpose: Peripheral chronic total occlusions (CTO) are challenging lesions to treat. The CROSSER system (FlowCardia, Sunnyvale, CA) uses high-frequency low-amplitude vibrations to break through the cap of the CTO and had been shown to be successful in coronary CTOs. This is a case series demonstrating the use of the CROSSER system with peripheral CTOs.

Complication rate of diagnostic carotid angiography performed by interventional cardiologists.

Objective: The aim of this study was to evaluate the complication rate of diagnostic carotid angiography performed by interventional cardiologists and compare it to previously published data.

Background: Percutaneous treatment for carotid artery stenosis is increasingly being performed. Previously published data describes the complication rate of diagnostic carotid angiography performed by radiologists and vascular surgeons, yet the information regarding interventional cardiologists is sparse.