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Lee WC, Chang WT, Fang HY, Chen HC, Chen MC, Liu PY. Incidence, Risk Factors, and Outcomes of Left Atrial Enlargement in Patients Requiring Right Ventricular Pacing: A Retrospective Study of 461 Cases from 2012 to 2020. Med Sci Monit 2024; 30:e944114. [PMID: 38776271 PMCID: PMC11129602 DOI: 10.12659/msm.944114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/21/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Long-term right ventricular (RV) pacing has been linked to left atrial enlargement (LAE). The incidence and risk factors associated with significant LAE after RV pacing remain unknown. This retrospective study included 461 patients requiring RV pacing at 2 centers between 2012 and 2020 and aimed to evaluate the incidence, risk factors, outcomes, and complications of LAE. MATERIAL AND METHODS A total of 461 patients with normal-sized pre-implant left atrial dimension and dual-chamber pacing pacemaker implantation for complete atrioventricular block were enrolled. Patients were grouped based on a ≥20% increase from their baseline left atrial dimension by echocardiography, indicating significant LAE, and initial characteristics, echocardiographic data, and outcomes were compared. RESULTS During a mean 7.0±4.9 years follow-up period, 96 patients (20.8%) developed significant LAE, whereas 365 patients did not. In multivariate logistic regression analysis, smaller pre-implant left atrial dimension (OR, 0.776; 95% CI, 0.728-0.828; P<0.001), lower post-implant left ventricular ejection fraction (OR, 0.976; 95% CI, 0.957-0.995; P=0.014), post-implant development of moderate to severe mitral regurgitation (OR, 2.357; 95% CI, 1.172-4.740; P=0.016), and RV pacing duration ≥3.3 years (OR, 1.576; 95% CI, 1.039-2.646; P=0.045) were independent predictors of significant LAE after RV-dependent pacing. There was a significant difference in the incident stroke events between patients without and with significant LAE (9.9% vs 17.7%; log-rank P=0.047). CONCLUSIONS Long-term RV pacing was linked to significant LAE in 20.8% of patients with complete atrioventricular block, with those affected experiencing a higher stroke rate during follow-up.
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Affiliation(s)
- Wei-Chieh Lee
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Cardiology, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Wei-Ting Chang
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Cardiology, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Hsiu-Yu Fang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Division of Cardiology, Department of Internal Medicine, Jen-Ai Hospital, Taichung, Taiwan
| | - Huang-Chung Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mien-Cheng Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ping-Yen Liu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Noetscher GM, Serano PJ, Horner M, Prokop A, Hanson J, Fujimoto K, Brown J, Nazarian A, Ackerman J, Makaroff SN. An in silico testbed for fast and accurate MR labeling of orthopedic implants. eLife 2023; 12:RP90440. [PMID: 38096104 PMCID: PMC10721214 DOI: 10.7554/elife.90440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
One limitation on the ability to monitor health in older adults using magnetic resonance (MR) imaging is the presence of implants, where the prevalence of implantable devices (orthopedic, cardiac, neuromodulation) increases in the population, as does the pervasiveness of conditions requiring MRI studies for diagnosis (musculoskeletal diseases, infections, or cancer). The present study describes a novel multiphysics implant modeling testbed using the following approaches with two examples: (1) an in silico human model based on the widely available Visible Human Project (VHP) cryo-section dataset; (2) a finite element method (FEM) modeling software workbench from Ansys (Electronics Desktop/Mechanical) to model MR radio frequency (RF) coils and the temperature rise modeling in heterogeneous media. The in silico VHP-Female model (250 parts with an additional 40 components specifically characterizing embedded implants and resultant surrounding tissues) corresponds to a 60-year-old female with a body mass index of 36. The testbed includes the FEM-compatible in silico human model, an implant embedding procedure, a generic parameterizable MRI RF birdcage two-port coil model, a workflow for computing heat sources on the implant surface and in adjacent tissues, and a thermal FEM solver directly linked to the MR coil simulator to determine implant heating based on an MR imaging study protocol. The primary target is MR labeling of large orthopedic implants. The testbed has very recently been approved by the US Food and Drug Administration (FDA) as a medical device development tool for 1.5 T orthopedic implant examinations.
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Affiliation(s)
- Gregory M Noetscher
- Electrical & Computer Eng. Dept, Worcester Polytechnic InstituteWorcesterUnited States
| | | | | | | | | | | | - James Brown
- Micro Systems Enigineering, Inc, an affiliate of BiotronikLake OswegoUnited States
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonUnited States
| | - Jerome Ackerman
- Harvard Medical SchoolBostonUnited States
- Athinoula A Martinos Center for Biomed. Imaging, Massachusetts General HospitalCharlestownUnited States
| | - Sergey N Makaroff
- Electrical & Computer Eng. Dept, Worcester Polytechnic InstituteWorcesterUnited States
- Athinoula A Martinos Center for Biomed. Imaging, Massachusetts General HospitalCharlestownUnited States
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3
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Inzunza-Cervantes G, Díaz-Dávalos JDJ, Flores-Anguiano A, Ornelas-Aguirre JM, Peralta-Figueroa IC, Zazueta-Armenta V. [Follow-up of the patient with pacemakers: Interrogation and basic programming]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:809-818. [PMID: 37995347 PMCID: PMC10721337 DOI: 10.5281/zenodo.10064399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/06/2023] [Indexed: 11/25/2023]
Abstract
Permanent pacemakers are a frequently used therapeutic modality. Its use has had a great impact on the morbidity and mortality and quality of life of patients with heart rhythm disturbances, with an exponential increase observed in recent decades. The use of this strategy presents different phases, in which follow-up throughout the useful life of the device is a fundamental and determinant pillar of the efficacy and safety of this therapeutic modality. This review seeks to provide a clear and structured update of the fundamental aspects to consider in the follow-up of all patients with pacemakers. The follow-up of the patient with a pacemaker must follow a complete, systematic and periodic protocol, evaluating aspects and parameters related to the patient and the pacemaker, in order to ensure the proper and safe operation of the device adapted to the person.
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Affiliation(s)
- Gustavo Inzunza-Cervantes
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Grupo de Investigación Cardiovascular del Centro Médico Nacional del Noreste. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Jose de Jesús Díaz-Dávalos
- Instituto Mexicano del Seguro Social, Centro Médico Nacional de Occidente, Hospital de Especialidades “Ignacio García Téllez", Servicio de Electrofisiología, Clínica de marcapasos. Guadalajara, Jalisco, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Arturo Flores-Anguiano
- Instituto Mexicano del Seguro Social, Centro Médico Nacional de Occidente, Hospital de Especialidades “Ignacio García Téllez", Servicio de Electrofisiología, Clínica de marcapasos. Guadalajara, Jalisco, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - José Manuel Ornelas-Aguirre
- Universidad de Sonora, Departamento de Ciencias de la Salud. Ciudad Obregón, Sonora, MéxicoUniversidad de SonoraMéxico
| | - Isabel Cristina Peralta-Figueroa
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Grupo de Investigación Cardiovascular del Centro Médico Nacional del Noreste. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Verónica Zazueta-Armenta
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste, Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Grupo de Investigación Cardiovascular del Centro Médico Nacional del Noreste. Ciudad Obregón, Sonora, MéxicoInstituto Mexicano del Seguro SocialMéxico
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4
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Noetscher GM, Serano PJ, Horner M, Prokop A, Hanson J, Fujimoto K, Brown JE, Nazarian A, Ackerman J, Makaroff SN. An In-Silico Testbed for Fast and Accurate MR Labeling of Orthopaedic Implants. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.16.549234. [PMID: 37649909 PMCID: PMC10465017 DOI: 10.1101/2023.07.16.549234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
One limitation on the ability to monitor health in older adults using Magnetic Resonance (MR) imaging is the presence of implants, where the prevalence of implantable devices (orthopedic, cardiac, neuromodulation) increases in the population, as does the pervasiveness of conditions requiring MRI studies for diagnosis (musculoskeletal diseases, infections, or cancer). The present study describes a novel multiphysics implant modeling testbed using the following approaches with two examples: - an in-silico human model based on the widely available Visible Human Project (VHP) cryo-section dataset; - a finite element method (FEM) modeling software workbench from Ansys (Electronics Desktop/Mechanical) to model MR radio frequency (RF) coils and the temperature rise modeling in heterogeneous media. The in-silico VHP Female model (250 parts with an additional 40 components specifically characterizing embedded implants and resultant surrounding tissues) corresponds to a 60-year-old female with a body mass index (BMI) of 36. The testbed includes the FEM-compatible in-silico human model, an implant embedding procedure, a generic parameterizable MRI RF birdcage two-port coil model, a workflow for computing heat sources on the implant surface and in adjacent tissues, and a thermal FEM solver directly linked to the MR coil simulator to determine implant heating based on an MR imaging study protocol. The primary target is MR labeling of large orthopaedic implants. The testbed has very recently been approved by the US Food and Drug Administration (FDA) as a medical device development tool (MDDT) for 1.5 T orthopaedic implant examinations.
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5
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Milan HFM, Almazloum AA, Bassani RA, Bassani JWM. Membrane polarization at the excitation threshold induced by external electric fields in cardiomyocytes of rats at different developmental stages. Med Biol Eng Comput 2023; 61:2637-2647. [PMID: 37405671 DOI: 10.1007/s11517-023-02868-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023]
Abstract
External electric fields (E), used for cardiac pacing and defibrillation/cardioversion, induce a spatially variable change in cardiomyocyte transmembrane potential (ΔVm) that depends on cell geometry and E orientation. This study investigates E-induced ΔVm in cardiomyocytes from rats at different ages, which show marked size/geometry variation. Using a tridimensional numerical electromagnetic model recently proposed (NM3D), it was possible: (a) to evaluate the suitability of the simpler, prolate spheroid analytical model (PSAM) to calculate amplitude and location of ΔVm maximum (ΔVmax) for E = 1 V.cm-1; and (b) to estimate the ΔVmax required for excitation (ΔVT) from experimentally determined threshold E values (ET). Ventricular myocytes were isolated from neonatal, weaning, adult, and aging Wistar rats. NM3D was constructed as the extruded 2D microscopy cell image, while measured minor and major cell dimensions were used for PSAM. Acceptable ΔVm estimates can be obtained with PSAM from paralelepidal cells for small θ. ET, but not ΔVT, was higher for neonate cells. ΔVT was significantly greater in the cell from older animals, which indicate lower responsiveness to E associated with aging, rather than with altered cell geometry/dimensions. ΔVT might be used as a non-invasive indicator of cell excitability as it is little affected by cell geometry/size.
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Affiliation(s)
- Hugo F M Milan
- Department of Electronics and Biomedical Engineering, School of Electrical and Computer Engineering, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Av. Albert Einstein 400, Campinas, SP, 13083-852, Brazil.
| | - Ahmad A Almazloum
- Department of Electronics and Biomedical Engineering, School of Electrical and Computer Engineering, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Av. Albert Einstein 400, Campinas, SP, 13083-852, Brazil
| | - Rosana A Bassani
- Department of Electronics and Biomedical Engineering, School of Electrical and Computer Engineering, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Av. Albert Einstein 400, Campinas, SP, 13083-852, Brazil
- LabNECC, Center for Biomedical Engineering (CEB), University of Campinas (UNICAMP), R. Alexander Fleming 163, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-881, Brazil
| | - José W M Bassani
- Department of Electronics and Biomedical Engineering, School of Electrical and Computer Engineering, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Av. Albert Einstein 400, Campinas, SP, 13083-852, Brazil
- LabNECC, Center for Biomedical Engineering (CEB), University of Campinas (UNICAMP), R. Alexander Fleming 163, Cidade Universitária Zeferino Vaz, Campinas, SP, 13083-881, Brazil
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Alachkar MN, Schnupp S, Eichelsdoerfer A, Milzi A, Mady H, Salloum B, Bisht O, Cheikh-Ibrahim M, Forkmann M, Krygier L, Mahnkopf C. Feasibility and Efficacy of Transcatheter Tricuspid Valve Repair in Patients with Cardiac Implanted Electrical Devices and Trans-Tricuspid Leads. J Clin Med 2023; 12:4930. [PMID: 37568330 PMCID: PMC10420306 DOI: 10.3390/jcm12154930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Transcatheter tricuspid valve repair using the edge-to-edge-technique (TEER) has emerged as an alternative therapy in patients with severe tricuspid regurgitation (TR) and high surgical risk. This study aimed to evaluate the feasibility and efficacy of tricuspid valve TEER in patients with cardiac implanted electric devices (CIEDs). METHODS All patients who underwent tricuspid valve TEER at our center were retrospectively included. Patients were classified according to the presence of CIEDs. Procedure success was defined as implantation of at least one clip and the reduction of TR of at least one grade. Procedure success and intrahospital outcome were compared between the two groups. RESULTS One-hundred and six consecutive patients underwent tricuspid TEER (age 80.1 ± 6.4 years, male = 42; 39.6%). Among them, 25 patients (23.6%, age 80.6 ± 7.3 years, male = 14; 56%) had CIEDs. Patients with CIEDs had a significantly lower left ventricular ejection fraction (LV-EF) compared to those without CIEDs (47.2 ± 15% vs. 56.2 ± 8.2%, p = 0.004, respectively). Moreover, arterial hypertension was more common in patients with CIEDs (96% vs. 79%, p = 0.048). The success of the procedure did not differ between the non-CIED vs. CIED group (93.8% vs. 92%, p = 0.748). Furthermore, the number and position of implanted clips, the duration of the procedure, the post-procedural pressure gradient across the tricuspid valve, and post-procedural TR severity were comparable between both groups. CONCLUSION Tricuspid valve TEER is feasible and efficient in patients with CIEDs. The success of the procedure, as well as the intrahospital outcome were comparable between patients with and without CIEDs.
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Affiliation(s)
- Mhd Nawar Alachkar
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | - Steffen Schnupp
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | - Astrid Eichelsdoerfer
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | - Andrea Milzi
- Department of Cardiology, Istituto Cardiocentro Ticino, 6900 Lugano, Switzerland
| | - Hesham Mady
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | - Basem Salloum
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | - Osama Bisht
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | | | - Mathias Forkmann
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | - Lukas Krygier
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
| | - Christian Mahnkopf
- Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany
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Pestrea C, Cicala E, Gherghina A, Ortan F, Pop D. Feasibility of Permanent His Bundle Pacing in the Elderly vs the Very Elderly. A Single-Center Mid-Term Follow-Up Study. Clin Interv Aging 2023; 18:941-949. [PMID: 37332479 PMCID: PMC10276596 DOI: 10.2147/cia.s412808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/08/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose Although feasibility studies have included older patients, specific data for His bundle pacing (HBP) in this population is scarce. The aim of this study was to evaluate the feasibility and mid-term performance of HBP in the elderly (70 to 79 years old) versus the very elderly (80 years old and above) patients with conventional indications for pacing. Patients and Methods About 105 patients older than 70 years of age with attempted HBP from the 1st of January 2019 to the 31st of December 2021 were reviewed. Clinical and procedural characteristics were recorded at baseline, and after a mid-term follow-up period. Results The procedural success rate was similar in both age groups (68.49% vs 65.62%). There was no significant difference in pacing or sensing thresholds, impedance, and fluoroscopy times. For both age intervals, patients with a baseline narrow QRS maintained a similar QRS duration after pacing, while in patients with a wide QRS, the paced QRS was significantly shorter. Baseline QRS duration, left bundle branch block morphology, and ejection fraction, were significantly associated with HBP procedural failure. The mean follow-up period was 830.34 days for the elderly and 722.76 days for the very elderly. After the follow-up period, both sensing and pacing thresholds were similar between the groups. Compared to the baseline values, there were no significant changes in both pacing and sensing parameters, irrespective of the age interval. During follow-up, no lead dislodgements were recorded. There were two cases of significant pacing threshold rise in the elderly (4%) and three cases in the very elderly group (14.2%) which were managed conservatively, without lead revision. Conclusion In elderly and very elderly patients, HBP is a feasible procedure associated with constant pacing and sensing parameters and with low complication rates over mid-term follow-up.
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Affiliation(s)
- Catalin Pestrea
- Department of Interventional Cardiology, Brasov County Clinical Emergency Hospital, Brasov, 500326, Romania
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, 400012, Romania
- Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, 400347, Romania
| | - Ecaterina Cicala
- Department of Interventional Cardiology, Brasov County Clinical Emergency Hospital, Brasov, 500326, Romania
| | - Alexandra Gherghina
- Department of Interventional Cardiology, Brasov County Clinical Emergency Hospital, Brasov, 500326, Romania
| | - Florin Ortan
- Department of Interventional Cardiology, Brasov County Clinical Emergency Hospital, Brasov, 500326, Romania
| | - Dana Pop
- 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, 400012, Romania
- Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, 400347, Romania
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Ajibawo T, Okunowo O, Okunade A. Impact of Comorbidity Burden on Cardiac Implantable Electronic Devices Outcomes. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2022; 16:11795468221108212. [PMID: 35783108 PMCID: PMC9247999 DOI: 10.1177/11795468221108212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/12/2022] [Indexed: 11/26/2022]
Abstract
Background: There is limited data on the impact of comorbidity burden on clinical
outcomes of patients undergoing cardiac implantable electronic devices
(CIED) implantation. Objectives: Our aim was to assess trends in CIED implantations and explore the
relationship between comorbidity burden and outcomes in patients undergoing
de novo implantations. Methods: Using the National Inpatient Sample database from 2000 to 2014, we identified
adults ⩾18 years undergoing de novo CIED procedures. Comorbidity burden was
assessed by Charlson comorbidity Index (CCI), and patients were classified
into 4 categories based on their CCI scores (CCI = 0, CCI = 1, CCI = 2, CCI
⩾3). Annual implantation trends were evaluated. Logistic regression was
conducted to measure the association between categorized comorbidity burden
and outcomes. Results: A total of 3 103 796 de-novo CIED discharge records were identified from the
NIS database. About 22.4% had a CCI score of 0, 28.2% had a CCI score of 1,
22% had a CCI score of 2, and 27.4 % had a CCI score ⩾3. Annual de-novo CIED
implantations peaked in 2006 and declined steadily from 2010 to 2014.
Compared to CCI 0, CCI ⩾3 was independently associated with increased odds
of in-hospital mortality, bleeding, pericardial, and cardiac complications
(all P < .05). Length of stay and hospital charges
increased with increasing comorbidity burden. Conclusions: CCI is a significant predictor of adverse outcomes after CIED implantation.
Therefore, comorbidity burden needs to be considered in the decision-making
process for CIED implant candidates.
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Affiliation(s)
- Temitope Ajibawo
- Department of Internal Medicine, Banner University Medical Center, Phoenix, AZ, USA
| | - Oluwatimilehin Okunowo
- Data Science & Biostatistics Unit, Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Adeniyi Okunade
- Department of Medicine, Brookdale University Medical Center, Brooklyn, NY, USA
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9
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Leitch J, Asakai H, Dawson L, Medi C, Norman M, Stevenson I, Toal E, Turnbull S, Young G. Cardiac Society of Australia and New Zealand (CSANZ) Position Statement on the Follow-Up of Cardiovascular Implantable Electronic Devices 2022. Heart Lung Circ 2022; 31:1054-1063. [PMID: 35760743 DOI: 10.1016/j.hlc.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/15/2022]
Abstract
Recognising the need for a national approach for the recommended best practice for the follow-up of implanted cardiac rhythm devices to ensure patient safety, this document has been produced by the Cardiac Society of Australia and New Zealand (CSANZ). It draws on accepted practice standards and guidelines of international electrophysiology bodies. It lays out methodology, frequency, and content of follow-up, including remote monitoring; personnel, including physician, allied health, nursing and industry; paediatric and adult congenital heart patients; and special considerations including magnetic resonance imaging scanning, perioperative management, and hazard alerts.
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Affiliation(s)
| | - James Leitch
- John Hunter Hospital, Newcastle, NSW, Australia.
| | - Hiroko Asakai
- The Children's Hospital at Westmead, Heart Centre for Children, Sydney, NSW, Australia
| | | | - Caroline Medi
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | | | | | - Edward Toal
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Samual Turnbull
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
| | - Glenn Young
- Royal Adelaide Hospital, Adelaide, SA, Australia
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Alansari W, Mohammed A, Aljohani R, Bakhashwain S, Manlangit JJS, Al-Husayni F, Anajreah N, Almehmadi F, Zagzoog A, AlQubbany A. The Quality of Life in Patients With Implantable Cardiac Devices: A Single-Center Cross-Sectional Study. Cureus 2021; 13:e18542. [PMID: 34765337 PMCID: PMC8575321 DOI: 10.7759/cureus.18542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/05/2022] Open
Abstract
Background Cardiovascular diseases (CVDs) and their complications are one of the most common causes of death worldwide. Implantable cardiac assistive devices (CADs) play a significant role in preventing dreadful outcomes, and the complication rate of these implanting procedures is minimal. These cardiac devices require some adaptation and could affect the patients' quality of life psychosocially and financially. This study is aimed to identify the impact of implantable cardiac assistive devices on patients' quality of life in the National Guard Hospital, Jeddah, Saudi Arabia. Methods This is an observational cross-sectional questionnaire-based study. It was conducted on patients who underwent cardiac assistive device implantation in National Guard Hospital. The patients were interviewed face-to-face and were requested to fill the Implanted Device Adjustment Scale (IDAS). Descriptive statistics were carried out. Chi-square test for independence was conducted to examine the associations between qualitative variables with the level of significance was taken as p-value <0.05. Results There was a statistically significant association between IDAS score and gender (p=0.03), monthly income (p=0.009), and type of cardiac implantation device (p=0.041). Females with an implantable cardiac defibrillator (ICD) and individuals with low socioeconomic status reported alongside divorced participants have higher IDAS scores, which correlates to worse adjustment. However, most of our patients scored 21-50 in IDAS score, which indicates a mild psychosocial effect after the cardiac assistive device implantation. Conclusion This study confirmed that most individuals adjust positively to implanted devices. It showed a significant association of gender, type of device, monthly income, and duration. Attention must be drawn to females and divorced patients in regards to psychological and emotional support.
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Affiliation(s)
- Wasna Alansari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Asmaa Mohammed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Rahaf Aljohani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Shahad Bakhashwain
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Juan Jr S Manlangit
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Faisal Al-Husayni
- Internal Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.,Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Nesreen Anajreah
- Nursing, King Faisal Cardiac Center, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Fahad Almehmadi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Amin Zagzoog
- Cardiology, King Faisal Cardiac Center, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Atif AlQubbany
- Cardiology, King Faisal Cardiac Center, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
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Au SL, Ho CS. Cardiac implantable therapeutic medical devices: A narrative review. JOURNAL OF ACUTE DISEASE 2021. [DOI: 10.4103/2221-6189.316672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Schwartz SM, Pathrose A, Serhal AM, Ragin AB, Charron J, Knight BP, Passman RS, Avery RJ, Kim D. Evaluation of image quality of wideband single-shot late gadolinium-enhancement MRI in patients with a cardiac implantable electronic device. J Cardiovasc Electrophysiol 2020; 32:138-147. [PMID: 33146422 DOI: 10.1111/jce.14798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION While wideband segmented, breath-hold late gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) has been shown to suppress image artifacts associated with cardiac-implanted electronic devices (CIEDs), it may produce image artifacts in patients with arrhythmia and/or dyspnea. Single-shot LGE is capable of suppressing said artifacts. We sought to compare the performance of wideband single-shot free-breathing LGE against the standard and wideband-segmented LGEs in CIED patients. METHODS AND RESULTS We retrospectively identified all 54 consecutive patients (mean age: 61 ± 15 years; 31% females) with CIED who had undergone CMR with standard segmented, wideband segmented, and/or wideband single-shot LGE sequences as part of quality assurance for determining best clinical practice at 1.5 T. Two raters independently graded the conspicuity of myocardial scar or normal myocardium and the presence of device artifact level on a 5-point Likert scale (1: worst; 3: acceptable; 5: best). Summed visual score (SVS) was calculated as the sum of conspicuity and artifact scores (SVS ≥ 6 defined as diagnostically interpretable). Median conspicuity and artifact scores were significantly better for wideband single-shot LGE (F = 24.2, p < .001) and wideband-segmented LGE (F = 20.6, p < .001) compared to standard-segmented LGE. Among evaluated myocardial segments, 72% were deemed diagnostically interpretable-defined as SVS ≥ 6-for standard-segmented LGE, 89% were deemed diagnostically interpretable for wideband-segmented LGE, and 94% segments were deemed diagnostically interpretable for wideband single-shot LGE. CONCLUSIONS Wideband single-shot LGE and wideband-segmented LGE produced similarly improved image quality compared to standard LGE.
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Affiliation(s)
- Sarah M Schwartz
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashitha Pathrose
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ali M Serhal
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ann B Ragin
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jessica Charron
- Department of Internal Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bradley P Knight
- Department of Internal Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rod S Passman
- Department of Internal Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ryan J Avery
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daniel Kim
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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