Cardiac rehabilitation: Effective yet underutilized in patients with cardiovascular disease.

Cardiac rehabilitation is a comprehensive program that treats patients with multiple cardiac conditions including post-myocardial infarction, stable angina, post-coronary artery bypass surgery, chronic heart failure, and peripheral vascular disease with structured exercise, and nutrition and risk factor counseling. It is an effective tool that has been shown to improve not only quality of life but also reduce adverse cardiac events, including death. While the value of cardiac rehabilitation is supported by a large body of evidence and its recommendation by the American Heart Association/American College of Cardiology it is significantly underutilized due to both patient and systemic factors.

Associations between pain, objective sleep efficiency and cognition in patients with implantable cardioverter defibrillators.

Introduction: Patients with implantable cardioverter defibrillators (ICDs) frequently experience sleep disruption. Prior work shows associations between objective (actigraphic) sleep and cognition in these patients, but whether pain affects associations between measures of sleep fragmentation (eg, sleep efficiency, SE) and cognition is unknown. The present study examined independent and interactive associations between objective SE and pain on cognitive performance in patients with ICDs.

Minimally invasive thoracoscopic surgery is an effective approach for treating inappropriate sinus tachycardia.

Introduction: Inappropriate sinus tachycardia (IST) is characterized by increased heart rate out of proportion to normal physiologic demand. IST ablation is challenging for the electrophysiology community due to the epicardial location of the sinus node and the risk of phrenic nerve (PN) injury during catheter ablation. In this study, we investigated the safety and efficacy of a minimally invasive thoracoscopic surgery for elimination of IST.

Cognitive performance in patients with implantable cardioverter defibrillators: Associations with objective sleep duration, age and anxiety.

Sleep disturbance and anxiety are highly prevalent in patients with implantable cardiac defibrillators (ICDs). There is limited research, however, on the associations between cognitive performance and sleep parameters, age and anxiety. Forty-one patients with ICDs and self-reported sleep disturbance completed 14 days of actigraphy (M  = 60.

Iatrogenic Ventricular Fibrillation after Direct-Current Cardioversion of Preexcited Atrial Fibrillation Caused by Inadvertent T-Wave Synchronization.

Direct-current cardioversion is an important means of managing arrhythmias. During treatment, carefully synchronizing energy delivery to the QRS complex is necessary to avoid ventricular fibrillation caused by a shock during the vulnerable period of ventricular repolarization, that is, a shock on the T wave. The presence of an accessory pathway and ventricular preexcitation can lead to difficulty in distinguishing the QRS complex from the T wave because of bizarre, wide, irregular QRS complexes and prominent repolarization.

Patients With Implantable Cardioverter Defibrillators on Social Media Report More Shock Anxiety Than Clinic Patients: Results From an Online Survey.

Background: Coping with heart disease and the potential for implantable cardioverter defibrillator (ICD) shocks challenges the psychological adjustment of patients with ICDs. Social media use may be used to seek education and support from others.

Objective: The aim of this study was to examine the content of information sought online and whether a social media sample of patients with ICDs report more device-specific anxiety than clinic-based normative samples.

Sleep, Psychosocial Functioning, and Device-Specific Adjustment in Patients with Implantable Cardioverter Defibrillators (ICDs).

Rates of sleep disorders and associated adjustment were examined in patients with implantable cardioverter defibrillators (ICDs; n = 42; Mage = 61.57, SD = 12.60).

Implantation of a cardiac resynchronization therapy defibrillator in a patient with bilateral deep brain stimulator: feasibility and technique.

Uncommonly, a patient with a NeuroStimulator Device (NSD) for a neurologic indication requires a cardiovascular implantable electronic device (CIED) for a cardiac indication. Typically in those with a unilateral pectoral NSD, the contralateral pectoral space is used for CIED implantation; however, in very rare occasions the patient has bilateral pectoral NSDs which makes subsequent implantation of a CIED challenging both because of placement and device interaction. Herein, we introduce the case of a 68-year-old gentleman with bilateral pectoral deep brain stimulators for Parkinsonism who received cardiac resynchronization therapy-defibrillator (CRT-D) for advanced heart failure.

Phantom shocks unmasked: clinical data and proposed mechanism of memory reactivation of past traumatic shocks in patients with implantable cardioverter defibrillators.

Background: Implantable cardioverter defibrillators (ICD), despite an unequivocal clinical benefit, are known to have a complex psychosocial impact on the patients. ICD shocks and the resultant psychobiological changes are known to contribute to increased levels of anxiety, depression, and post-shock stress symptoms in these patients. Phantom shock is a patient-reported perception of an ICD shock in the absence of any actual shock; however, its pathophysiological understanding is poor.

Comparison of actigraphic and subjective measures of sleep in implantable cardioverter defibrillator and coronary artery disease patients.

Background: Cardiac patients frequently have insomnia symptoms that may pose risk for future cardiac events. Poor sleep relates to hyperarousal, anxiety and depression, and the incidence of hypertension and myocardial infarction.

Hypothesis: The authors hypothesized that implantable cardioverter defibrillator (ICD) patients would have poorer sleep than coronary artery disease (CAD) patients related to hypervigilance for device functioning and shock discharge.

Cardiac arrhythmias during pregnancy.

This article reviews the appropriate evaluation and management of cardiac arrhythmias in the pregnant patient. Any treatment strategy in this patient population has the inherent potential to adversely affect the health of the unborn child. As such, there is no room for empiric therapy in these patients.

Lead astray: minimally invasive removal of a pacing lead in the left ventricle.

Pacemaker and implantable cardioverter defibrillator (ICD) leads are placed routinely with few notable complications. A rarely described complication of transvenous lead placement is malpositioning into the left ventricle. This situation can cause additional complications in the form of thromboembolic events.

Female-specific education, management, and lifestyle enhancement for implantable cardioverter defibrillator patients: the FEMALE-ICD study.

Background: Significant rates of psychological distress occur in implantable cardioverter defibrillator (ICD) patients. Research has demonstrated that women are particularly at risk for developing distress and warrant psychosocial attention. The major objectives were to implement and test the effectiveness of a female-specific psychosocial group intervention on disease-specific quality of life outcomes in outpatient female ICD recipients versus a wait-list control group.