Deceptive intracardiac electrograms during an ICD interrogation. A clinical challenge.

We present a case of a patient with significant structural heart disease from previous cardiac surgeries who presented for an electrophysiology study and radiofrequency ablation. The case highlights the significance of intra-atrial conduction delays in such patients and potential pitfalls it can present while interpreting intra-cardiac electrograms especially during implantable cardioverter defibrillator (ICD) interrogations.

Current procedural terminology coding in electrophysiology: focus on 2009 updates.

This article highlights the major changes in the current procedural terminology codes (CPT codes) that were announced by the American Medical Association in January 2009. These new CPT codes were developed to more accurately reflect current cardiac device monitoring capabilities, long-distance telemetry and remote interrogation as well as follow-up practices. Some of these new code sets are structured differently than the CPT codes that they replace.

Fatal outcome in a pacemaker-dependent patient.

The recent advisory of Medtronic Sprint Fidelis leads has resulted in significant controversy over proper management of patients. The current manufacture's guidelines recommend programming specific device alerts with close follow-up and implantable cardioverter-defibrillator lead replacement in patients with evidence of breach in lead integrity. Recently, several studies have identified significant limitations in this method of surveillance.

Impact of implantable cardioverter-defibrillator recalls on patients' anxiety, depression, and quality of life.

Background: In the past 2 years, multiple implantable cardioverter-defibrillator (ICD) manufacturers have issued recalls on ICD models due to the potential for serious malfunction and even patient death. Previous studies examining the relationship between these recalls and patients' psychological well-being have been limited by small sample size and conflicting results. The purpose of this study is to examine the association between ICD recalls and patients' anxiety, depression, and quality of life.

Laser lead extraction and baffle stenting to facilitate dual chamber implantable defibrillator upgrade in a patient with L-transposition of the great arteries status-post Senning/Rastelli repair: a case report and review of literature.

A case of successful laser extraction of a defibrillator lead with baffle stenting in a 15-year-old boy with dextrocardia, L-transposition, ventricular septal defect, and pulmonic stenosis status-post Senning/Rastelli repair is presented. Six-month follow-up revealed a significant increase in exercise tolerance and maximum oxygen consumption (VO(2)max).

Reverse electrical remodeling of the atria post cardioversion in patients who remain in sinus rhythm assessed by signal averaging of the P-wave.

Objectives: This study was designed to determine whether the signal-averaged electrocardiogram of the P-wave (SAPW) is an independent predictor of recurrence of atrial fibrillation (AF) post cardioversion (CV), and to assess atrial remodeling using SAPW.

Background: There are limited electrophysiologic data to predict the recurrence of AF post-CV. The electrical remodeling that occurs post-CV is poorly understood.

Radiofrequency ablation of swallowing-induced atrial tachycardia: case report and review of literature.

We report the case of a 47-year-old white man who presented with 1-year history of palpitations while swallowing. Event monitor confirmed the episodes were atrial tachycardia. Medical management with a calcium channel blocker did not alleviate the patient's symptoms.

Origin of all major coronary arteries from left sinus of Valsalva as a common coronary trunk: single coronary artery--a case report.

Coronary anomalies are divergent and can occur in up to 1% to 2% of patients. The most common of these anomalies is separate ostia of the left anterior descending and left circumflex arteries, followed by origin of the circumflex coronary artery from the right coronary artery and the left coronary artery from the right sinus of Valsalva, either as a separate ostium or as a part of single coronary artery. Anomalous origin of right coronary artery from the left sinus of Valsalva with a separate ostium or from the left main coronary artery is very rare.