Epicardial versus endocardial permanent pacing in adults with congenital heart disease.

Background: Permanent pacing (PM) in patients with congenital heart disease (CHD) presents unique challenges-with little known about the long-term outcomes.

Methods: Pacemaker complications and reinterventions were reviewed over a 38-year period and were grouped by epicardial or endocardial approaches.

Results: The average age at intervention was 37 ± 19 years for 106 patients and 259 PM procedures were performed (2.

Complication risk with pulse generator change: implications when reacting to a device advisory or recall.

Background: Recent advisories and recalls of pacemakers and implantable cardioverter-defibrillators (ICDs) have highlighted the need for evidence-based recommendations regarding management of patients with advisory devices. In order to better facilitate decision-making when weighing the relative risks and benefits of performing generator changes in these patients, we conducted a review to assess operative complication rates.

Methods: We reviewed generator changes performed between 2000 and 2005 at the Mayo Clinic-Rochester, including a total of 732 change-outs consisting of 570 done for elective replacement indicators (ERI) and 162 for manufacturer advisories or recalls.

Use of cellular telephones in the hospital environment.

Objective: To determine whether cellular telephones used in a normal way would cause interference with medical devices located in patient care areas of hospitals.

Methods: Two cellular telephones from different cellular carriers were tested in various patient care areas between February 15, 2006, and June 29, 2006. To monitor the medical devices and equipment in the patient care areas during testing, we observed the device displays and alarms.

Is there an adverse outcome from abandoned pacing leads?

Background: Indications for extraction of an abandoned pacemaker lead (APL) are controversial. The purpose of this study was to determine whether or not APLs should be extracted in the absence of pacemaker-related problems.

Methods And Results: We retrospectively reviewed, from 1977 through 1998, all patients with retained, non-functional leads and identified 433-266 males and 167 females.

Permanent pacing in patients with univentricular heart.

Patients with one of several varieties of malformation designated as "univentricular hearts" may be especially challenging when permanent pacing is required. Our objective was to review our experience in this subset of patients that had undergone permanent pacing and thus determine the optimal approach. A retrospective chart review was done of 32 patients with some variety of "univentricular" malformation who had required permanent pacing at our institution.