A Modular Communicative Leadless Pacing-Defibrillator System.

Background: The subcutaneous implantable cardioverter-defibrillator (ICD) is associated with fewer lead-related complications than a transvenous ICD; however, the subcutaneous ICD cannot provide bradycardia and antitachycardia pacing. Whether a modular pacing-defibrillator system comprising a leadless pacemaker in wireless communication with a subcutaneous ICD to provide antitachycardia and bradycardia pacing is safe remains unknown.

Methods: We conducted a multinational, single-group study that enrolled patients at risk for sudden death from ventricular arrhythmias and followed them for 6 months after implantation of a modular pacemaker-defibrillator system.

Design and rationale of the MODULAR ATP global clinical trial: A novel intercommunicative leadless pacing system and the subcutaneous implantable cardioverter-defibrillator.

Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) has demonstrated safety and efficacy for the treatment of malignant ventricular arrhythmias. However, a limitation of the S-ICD lies in the inability to either pace-terminate ventricular tachycardia or provide prolonged bradycardia pacing support.

Objective: The rationale and design of a prospective, single-arm, multinational trial of an intercommunicative leadless pacing system integrated with the S-ICD will be presented.

Postapproval Study of a Subcutaneous Implantable Cardioverter-Defibrillator System.

Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to avoid complications related to transvenous implantable cardioverter-defibrillator (TV-ICD) leads. Device safety and efficacy were demonstrated previously with atypical clinical patients or limited follow-up.

Objectives: The S-ICD PAS (Subcutaneous Implantable Cardioverter-Defibrillator System Post Approval Study) is a real-world, multicenter, registry of U.

Transcatheter Leadless Pacing in Children: A PACES Collaborative Study in the Real-World Setting.

Background: Transcatheter Leadless Pacemakers (TLP) are a safe and effective option for adults with pacing indications. These devices may be an alternative in pediatric patients and patients with congenital heart disease for whom repeated sternotomies, thoracotomies, or transvenous systems are unfavorable. However, exemption of children from clinical trials has created uncertainty over the indications, efficacy, and safety of TLP in the pediatric population.

Predictors of Early and Late Atrioventricular Block Requiring Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Single-Center Experience.

Purpose: Complete heart block requiring permanent pacemaker can occur early following transcatheter aortic valve replacement (TAVR) due to mechanical compression of the aortic valve annulus and associated atrio-ventricular (AV) conduction system. Data are limited regarding late PM implantation after TAVR. The purpose of this study was to determine predictors of early vs.

Clinical In-Hospital Outcomes of Acute Myocardial Infarction in Patients With Hematological Malignancies.

Introduction The purpose of our study is to determine in-hospital outcomes of acute myocardial infarction in patients with hematological malignancies and their subtypes. Method Patient data were obtained from the nationwide inpatient sample (NIS) database between the years 2009-2014. Patients with hematological cancer subtypes and acute MI (non-ST segment elevation myocardial infarction and ST-segment elevation myocardial infarction (NSTEMI/STEMI) were identified using validated international classification of diseases (ninth revision) and clinical modification (ICD-9-CM) codes.

Cardiac pseudoaneurysm as a complication of native mitral valve infective endocarditis.

Background: The delayed development of a mitral valve annulus pseudoaneurysm is a rare and late complication of a native mitral abscess cavity.

Case Summary: Currently, there are no documented cases of a pseudoaneurysm developing from an abscess cavity of the posterior annulus of the native mitral valve. We report a case of a patient who presented with worsening progressive shortness of breath that was found to be secondary to a pseudoaneurysm.

An unusual case of orthodeoxia.

Progressive hypoxia in hospitalized patients can be due to many etiologies, especially in patients with multiple comorbidities. More unusual causes of hypoxia, such as patent foramen ovale (PFO) with a right to left shunting in the absence of elevated right atrial pressures, should be considered when workup does not reveal a specific etiology. < Hypoxemia due to a right-to-left atrial shunt with normal pulmonary arterial pressures can be seen in the aortic aneurysm patients.

Association of atrial fibrillation and various cancer subtypes.

Background: Studies have shown that the incidence of atrial fibrillation (AF) in cancer is most likely due to the presence of inflammatory markers. The purpose of our study is to determine the association of AF with different cancer subtypes and its impact on in-hospital outcomes.

Methods: Data were obtained from the National Inpatient Sample database between 2005 and 2015.

Association between atrial fibrillation and bundle branch block.

Background: The association between atrial fibrillation (Afib) and sinus and AV nodal dysfunction has previously been reported. However, no data are available regarding the association between Afib and bundle branch block (BBB).

Methods: Patient data were obtained from the Nationwide Inpatient Sample (NIS) database between years 2009 and 2015.

Clinical outcomes of atrial fibrillation with hyperthyroidism.

Background: Atrial fibrillation (Afib) is a common cardiac manifestation of hyperthyroidism. The data regarding outcomes of Afib with and without hyperthyroidism are lacking.

Hypothesis: We hypothesized that patients with Afib and hyperthyroidism have better clinical outcomes, compared with Afib patients without hyperthyroidism.

Shock Secondary to Aortic Root Abscess With Sterile Blood Culture.

Shock caused by an aortic root abscess is a rare phenomenon. Due to its rarity, it is commonly not diagnosed on time to have a favorable prognosis for the patient. Our case involves an 80-year-old male presenting with leukocytosis, lactic acidosis, and hypoglycemia.

Outcomes of subcutaneous implantable cardioverter-defibrillator in dialysis patients: Results from the S-ICD post-approval study.

Background: Patients with chronic renal disease on hemodialysis (HD) have limited vascular access and are at high risk of bacteremia. The subcutaneous implantable cardioverter-defibrillator (S-ICD) avoids vascular access, so it may be advantageous in this patient population.

Objective: The purpose of this study was to report outcomes of patients with end-stage renal disease enrolled in the multicenter S-ICD post-approval study (PAS).

Prophylactic use of the implantable cardioverter-defibrillator and its effect on the long-term survival, cardiovascular and sudden cardiac death in nonischemic cardiomyopathy patients-a systematic review and meta-analysis.

Implantable cardioverter-defibrillator (ICD) has shown to reduce sudden cardiac death and overall mortality in patients with dilated cardiomyopathy. The recently published DANISH trial has shown conflicting outcomes on the long-term survival in patients with prophylactic implantation of ICD in Non-Ischemic Cardiomyopathy (NICM). Two independent reviewers searched MEDLINE, PUBMED, Ovid, CINAHL, clinicaltrials.

Feasibility of extravascular pacing with a novel substernal electrode configuration: The Substernal Pacing Acute Clinical Evaluation study.

Background: Subcutaneous implantable cardioverter-defibrillators provide an alternative to transvenous defibrillation but require higher shock outputs and offer no antitachycardia pacing. The Substernal Pacing Acute Clinical Evaluation (SPACE) study evaluated the feasibility of pacing from an extravascular substernal location.

Objectives: The primary purpose of the SPACE study was to characterize pacing from the substernal space.

Subcutaneous implantable cardioverter-defibrillator Post-Approval Study: Clinical characteristics and perioperative results.

Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to reduce short- and long-term complications associated with transvenous ICD leads. Early multicenter studies included younger patients with less left ventricular systolic dysfunction and fewer comorbidities than cohorts with traditional ICD.

Objective: The purpose of this study was to characterize patient selection and the acute performance of the S-ICD in a contemporary real-world setting.

Outcomes of subcutaneous implantable cardioverter-defibrillator implantation in patients on hemodialysis.

Background: Subcutaneous implantable cardioverter-defibrillator (S-ICD) provides potential benefits in patients on hemodialysis (HD) by reducing the risk of blood stream infection and preserving vascular access sites. We evaluated the safety and efficacy of S-ICD in patients with end-stage renal disease (ESRD) on HD.

Methods: All consecutive patients implanted with S-ICD between October 2012 and April 2015 at our high-volume center were included in this retrospective, single-center study.

Differences of Mortality Rates between Pocket and Nonpocket Cardiovascular Implantable Electronic Device Infections.

Background: A steady rise in the use of cardiovascular implantable electronic devices (CIEDs), particularly in the elderly, has led to an increase in device-related infections. Although often studied and reported as a single entity, these complications in fact comprise a heterogeneous group. Specific subgroups may be associated with distinct mortality risks.

Superior vena cava echocardiography as a screening tool to predict cardiovascular implantable electronic device lead fibrosis.

Background: Currently there is no noninvasive imaging modality used to risk stratify patients requiring lead extractions. We report the novel use of superior vena cava (SVC) echocardiography to identify lead fibrosis and complex cardiac implantable electronic device (CIED) lead extraction. With an aging population and expanding indications for cardiac device implantation, the ability to deal with the complications associated with chronically implanted device has also increased.

Subcutaneous implantable cardioverter-defibrillator implantation in a patient with a left ventricular assist device already in place.

A 56-year-old man with ischemic cardiomyopathy, a biventricular implantable cardioverter-defibrillator (ICD), and a left ventricular assist device (LVAD) developed a pocket hematoma and infection after an ICD generator change. The biventricular ICD was extracted, and the patient was given a full course of antibiotics. Because he had no indications for bradycardia pacing or biventricular pacing, he was implanted with a subcutaneous ICD under full anticoagulation.

Multicenter experience with extraction of the Riata/Riata ST ICD lead.

Background: In November 2011, the Food and Drug Administration issued a class I recall of Riata and Riata ST implantable cardioverter-defibrillator leads. Management recommendations regarding the recall have remained controversial.

Objective: Data regarding the safety and feasibility of extraction of Riata implantable cardioverter-defibrillator leads are limited.