Bleeding risk factors affecting warfarin therapy in the elderly with atrial fibrillation.

Purpose: Inadequate anticoagulation among elderly individuals with atrial fibrillation (AF) is a common problem. This synthesis of the literature review describes the pathophysiology of AF, explains the mechanism of action of warfarin (Coumadin), identifies factors that contribute to warfarin (Coumadin)-associated bleeding in the elderly population, and explores alternatives to warfarin (Coumadin) therapy. Implications for advanced practice nurse practice, education, and research will be discussed.

Insulation failure with externalized conductor of a Linox SD lead: a case report.

A 53-year-old man with a dual-chamber implantable cardioverter-defibrillator presented to the electrophysiology (EP) lab for an EP study in evaluation of supraventricular tachycardia despite medical therapy. Fluoroscopic imaging during placement of diagnostic catheters demonstrated insulation failure with an externalized conductor on the right ventricular defibrillator lead just distal to the proximal defibrillator coil. Device interrogation revealed normal pacing, and shock impedances, normal sensing, and stable pacing thresholds.

Association between left ventricular ejection fraction post-cardiac resynchronization treatment and subsequent implantable cardioverter defibrillator therapy for sustained ventricular tachyarrhythmias.

Background: Although cardiac resynchronization therapy (CRT) can improve left ventricular ejection fraction (LVEF), it is not known whether a specific level of improvement will predict future implantable cardioverter defibrillator (ICD) therapy.

Methods And Results: CRT-defibrillator (CRT-D) was implanted in 423 patients at 1 institution between October 2, 2001 and January 19, 2007. A retrospective analysis was performed to evaluate the relationship between post-CRT-D LVEF and ICD therapy for ventricular tachyarrhythmias.

Differentiating junctional tachycardia and atrioventricular node re-entry tachycardia based on response to atrial extrastimulus pacing.

Objectives: The purpose of this study was to differentiate non-re-entrant junctional tachycardia (JT) and typical atrioventricular node re-entry tachycardia (AVNRT).

Background: JT may mimic AVNRT. Ablation of JT is associated with a lower success rate and a higher incidence of heart block.

Successful management of acute failure of the systemic right ventricle with cardiac resynchronization therapy.

Management of systemic right ventricular (RV) failure can be challenging. Anatomical abnormality due to congenital heart disease adds to the complexity when interventions are performed. We report a patient with acute systemic RV failure who was successfully managed with cardiac resynchronization therapy.