Prevalence and predictors of Twiddler's syndrome.

Background: Twiddler's syndrome is a poorly understood clinical phenomenon when patients either consciously or subconsciously rotate their cardiac device resulting in lead dislodgement. We aimed to determine the true prevalence and risk factors associated with Twiddler's syndrome in a real-world population.

Methods: A retrospective chart review was performed on all patients who underwent cardiac device implantation from January 1st 2017 until Jan 1st 2022.

Patients' and family members' views on pacemaker reuse: An international survey.

Introduction: The reuse of cardiac implantable electronic devices may help increase access to these therapies in low- and middle-income countries (LMICs). No published data exist regarding the views of patients and family members in LMICs regarding this practice.

Methods And Results: An article questionnaire eliciting attitudes regarding pacemaker reuse was administered to ambulatory adult patients and patients' family members at outpatient clinics at Centro Nacional Cardiologia in Managua, Nicaragua, Indus Hospital in Karachi, Pakistan, Hospital Carlos Andrade Marín, and Hospital Eugenio Espejo in Quito, Ecuador, and American University of Beirut Medical Center in Beirut, Lebanon.

Association Between Body Mass Index and Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement (TAVR) with Edwards SAPIEN™ 3 TAVR Valves: A Single-Center Experience.

Background:  Transcatheter aortic valve replacement (TAVR) can be complicated with a high-degree atrioventricular block requiring a permanent pacemaker (PPM) in 5% - 25% of patients. Association between body mass index (BMI) and pacemaker implantation has not been extensively studied. We compared standard BMI classes with the odds of requiring a PPM implantation in patients undergoing TAVR with Edwards SAPIEN™ 3 valves (ESV3) (Edwards Lifesciences, Irvine, CA, USA).

Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Cost Analysis.

Background Transcatheter aortic valve replacement (TAVR) can be complicated with a complete atrioventricular block requiring permanent pacemaker (PPM) implantation. The cost of index hospitalization for such patients is higher than usual. However, the magnitude of this increased cost is uncertain.

Larger Valve Size is Associated with Permanent Pacemaker Implantation in Edwards SAPIEN 3™ Transcatheter Aortic Valves.

Background: Transcatheter aortic valve replacement (TAVR) can be complicated with a high-degree atrioventricular (AV) block requiring a permanent pacemaker (PPM) in 5% - 25% of patients. TAVR valve size is a modifiable risk factor for permanent pacemaker implantation (PPI) after TAVR. We studied the association of valve size in PPI with Edwards SAPIEN 3™ (ESV3) (Edwards Lifesciences LLC, Irvine, CA, USA) TAVR valves.

Disparities Regarding Inadequate Automated External Defibrillator Training and Potential Barriers to Successful Cardiac Resuscitation in Public School Systems.

Installation of automated external defibrillators (AEDs) in public schools has been shown to improve outcomes for children with sudden cardiac arrest (SCA). However, the adequacy of faculty AED training and potential barriers to successful cardiac resuscitation remain unknown. A questionnaire was mailed to all public schools in the state of Illinois (n = 3796).

Cleaning and Sterilization of Used Cardiac Implantable Electronic Devices With Process Validation: The Next Hurdle in Device Recycling.

Objectives: This study sought to develop a validated, reproducible sterilization protocol, which could be used in the reprocessing of cardiac implantable electronic devices (CIEDs).

Background: Access to cardiac CIED therapy in high-income and in low- and middle-income countries varies greatly. CIED reuse may reduce this disparity.

Prevalence and predictors of inappropriate anticoagulation in patients with a CHADS-VASc score of 0 and atrial fibrillation.

Background: Previous studies have shown underutilization of anticoagulation therapy in patients with atrial fibrillation and a CHADS-VASc score ≥2; however there exists little data regarding the inappropriate use of anticoagulation in patients with a CHADS-VASc score of 0. We aimed to determine the true prevalence and predictors of inappropriate anticoagulation therapy in patients with atrial fibrillation and a CHADS-VASc score of 0.

Methods: A retrospective chart review was performed on all patients with atrial fibrillation and a CHA2DS2-VASc score of 0 in our institution from January 2009 to January 2016.

Pacemaker recycling: A notion whose time has come.

The purpose of this paper is to summarize the need, feasibility, safety, legality, and ethical perspectives of pacemaker reutilization in low- and middle-income countries (LMICs). It will also describe, in-depth, Project My Heart Your Heart (PMHYH) as a model for pacemaker reuse in LMICs. The primary source of the discussion points in this paper is a collection of 14 publications produced by the research team at the University of Michigan and its collaborative partners.

Patients' and Physicians' Perceptions Regarding the Benefits of Atrial Fibrillation Ablation.

Background: It is unclear whether patients and physicians understand that atrial fibrillation ablation (AFA) has been shown to only improve symptomology and not reduce morbidity or mortality.

Methods: Note that 177 of 445 (40%) consecutive patients referred to an electrophysiology clinic for atrial fibrillation (AF) management responded anonymously to our survey via mail. Note that 105 of 656 (15%) physicians responded to our survey via email.

Accelerated Implantable Defibrillator Battery Depletion Secondary to Lithium Cluster Formation: A Case Series.

Background: Device failure from unanticipated and precipitous battery depletion is uncommon but can be life-threatening. Multiple mechanisms of battery failure have been previously described in the medical literature.

Methods: However, in this current case series, we describe the largest cohort of patients (n = 4) with St.

Project My Heart Your Heart: An Idea Whose Time Has Come.

It is estimated that nearly 1 million patients in low-income countries die every year from bradyarrhythmias coupled with no access to a pacemaker. At the same time, it is estimated that tens of thousands of used devices could be harvested from hospitals, funeral homes, and crematories in wealthy nations if such a practice was legal and proven to be safe and efficacious. Project My Heart Your Heart is a collaborative, multinational effort with a goal of making pacemaker recycling a reality.

Heart Rhythm Society members' views on pacemaker and implantable cardioverter-defibrillator reuse.

Background: Reuse of cardiac implantable electronic devices (CIEDs) may help address the unmet need among patients in low- and middle-income countries (LMICs).

Methods: To examine Heart Rhythm Society (HRS) physicians' opinions regarding CIED reuse, an online survey eliciting attitudes toward CIED reuse was sent to all 3,380 HRS physician members.

Results: There were 429 responses (response rate 13%).

Cardiac implantable electronic device reutilization: battery life of explanted devices at a tertiary care center.

Introduction: Prior studies have suggested that pacemaker reuse may be a reasonable alternative to provide device therapy in the low- and middle-income countries. We studied explant indications and remaining battery life of cardiac implantable electronic devices (CIEDs) at a tertiary medical center.

Methods And Results: We conducted a retrospective review of all CIEDs extracted at the University of Michigan between 2007 and 2011.

Intra-atrial conduction block mimicking atrioventricular nodal block after multiple catheter ablation procedures for atrial tachycardia in a patient with cardiomyopathy.

A 42-year-old woman with a history of cardiomyopathy and multiple ablation procedures for atrial tachycardia developed intra-atrial conduction block that mimicked atrioventricular (AV) nodal block during radiofrequency ablation at the cavotricuspid isthmus. She was treated with atrial pacing (from the coronary sinus), which overcame intra-atrial conduction block and resulted in AV nodal conduction.

Delayed-enhanced MR scar imaging and intraprocedural registration into an electroanatomical mapping system in post-infarction patients.

Post-infarction arrhythmias are most often confined to scar tissue. Scar can be detected by delayed-enhanced cardiac magnetic resonance. The purpose of this study was to assess the feasibility of pre-procedural scar identification and intraprocedural real-time image registration with an electroanatomical map in 23 patients with previous infarction and ventricular arrhythmias (VAs).

Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation.

Radiofrequency catheter ablation (RFA) has evolved as an effective treatment modality in patients with atrial fibrillation (AF). However, complication rates associated with RFA of AF have been cited in the range of 3.5 - 5% with the majority consisting of cardiac tamponade, vascular complications, and thromboembolic phenomena.

Feasibility of postmortem device acquisition for potential reuse in underserved nations.

Objectives: The purpose of the present study was to examine the feasibility and efficacy of a program to acquire devices with adequate battery life from crematories and funeral homes for potential reutilization in underserved nations.

Background: There exists a great health-care disparity between the industrialized world and underserved nations--specifically in the frequency of pacemaker implantation.

Methods: Flyers were mailed to all 1057 members of the Michigan Funeral Directors Association providing information to download a consent-for-explant form and request a postage-paid envelope from www.

Safety of pacemaker reuse: a meta-analysis with implications for underserved nations.

Background: A large disparity in medical health care is clearly evident between developed and underserved nations in the field of cardiac electrophysiology, specifically pacemaker implantation. This study aimed to assess the safety of pacemaker reuse.

Methods And Results: A computerized search from January 1, 1970, to September 1, 2010, identified 18 studies with outcomes of pacemaker reuse.

The role of interpolation in PVC-induced cardiomyopathy.

Background: Frequent premature ventricular complexes (PVCs) can cause cardiomyopathy. The mechanism is not known and may be multifactorial.

Objective: This study assessed the role of PVC interpolation in PVC-induced cardiomyopathy.