Current state of the art for use of pacemakers and defibrillators in patients with congenital cardiac malformations

2006 ◽  
Vol 16 (S3) ◽  
pp. 151-156 ◽  
Author(s):  
Elizabeth A. Stephenson ◽  
Jonathan R. Kaltman
Keyword(s):  
Cardiac Disease ◽  
State Of The Art ◽  
Therapeutic Interventions ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Malformations ◽  
Current State ◽  
Congenital Cardiac Disease ◽  
History Of ◽  
Key Features ◽  
Cardioverter Defibrillators

As patients with congenital cardiac malformations increasingly survive therapeutic interventions, and our understanding of primary electrical diseases increases, the landscape of paediatric and congenital electrophysiology is expanding. Electrophysiologic abnormalities, both tachycardic and bradycardic, are commonly seen in post-operative patients with congenital cardiac disease, as well as being part of the natural history of congenital malformations and cardiomyopathies. Disturbances of rhythm represent an increasing morbidity in this population, and therapies using devices in the form of pacemakers and implantable cardioverter-defibrillators have taken on a correspondingly important role. In this review, we discuss some of the key features and recent advances in pacing for bradycardia, resynchronization pacing, anti-tachycardia pacing, and use of implantable cardioverter-defibrillators.

Endocrinal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

2008 ◽  
Vol 18 (S2) ◽  
pp. 256-264 ◽  
Author(s):  
Heather Dickerson ◽  
David S. Cooper ◽  
Paul A. Checchia ◽  
David P. Nelson
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Healthcare Intervention ◽  
Time Interval ◽  
Quality Reporting ◽  
Cardiac Malformations ◽  
Comprehensive List ◽  
Congenital Cardiac Disease

AbstractA complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the endocrine system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of endocrinal complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.

scholarly journals Defining research priorities in dystonia

Neurology ◽  
2020 ◽  
Vol 94 (12) ◽  
pp. 526-537 ◽  
Author(s):  
Codrin Lungu ◽  
Laurie Ozelius ◽  
David Standaert ◽  
Mark Hallett ◽  
Beth-Anne Sieber ◽  
...  
Keyword(s):  
Research Priorities ◽  
Large Data ◽  
Therapeutic Interventions ◽  
Research Progress ◽  
Data Sets ◽  
Cellular Mechanisms ◽  
Research Technology ◽  
Current State ◽  
History Of ◽  
New Research

ObjectiveDystonia is a complex movement disorder. Research progress has been difficult, particularly in developing widely effective therapies. This is a review of the current state of knowledge, research gaps, and proposed research priorities.MethodsThe NIH convened leaders in the field for a 2-day workshop. The participants addressed the natural history of the disease, the underlying etiology, the pathophysiology, relevant research technologies, research resources, and therapeutic approaches and attempted to prioritize dystonia research recommendations.ResultsThe heterogeneity of dystonia poses challenges to research and therapy development. Much can be learned from specific genetic subtypes, and the disorder can be conceptualized along clinical, etiology, and pathophysiology axes. Advances in research technology and pooled resources can accelerate progress. Although etiologically based therapies would be optimal, a focus on circuit abnormalities can provide a convergent common target for symptomatic therapies across dystonia subtypes. The discussions have been integrated into a comprehensive review of all aspects of dystonia.ConclusionOverall research priorities include the generation and integration of high-quality phenotypic and genotypic data, reproducing key features in cellular and animal models, both of basic cellular mechanisms and phenotypes, leveraging new research technologies, and targeting circuit-level dysfunction with therapeutic interventions. Collaboration is necessary both for collection of large data sets and integration of different research methods.

A History of the Fractography of Brittle Materials

2009 ◽  
Vol 409 ◽  
pp. 1-16 ◽  
Author(s):  
George D. Quinn
Keyword(s):  
Fracture Mechanics ◽  
Failure Analysis ◽  
State Of The Art ◽  
Brittle Materials ◽  
Fractographic Analysis ◽  
Current State ◽  
History Of ◽  
Scientists And Engineers ◽  
Work Done ◽  
Study Of Fracture Surfaces

The evolution of the science of fractography of brittle materials initially was driven by failure analysis problems. Early analyses focused on general patterns of fracture and how they correlated to the loading conditions. Many early documents are simply descriptive, but the curiosity of some key scientists and engineers was aroused. Scientific or engineering explanations for the observed patterns gradually were developed. Advances in microscopy and flaw based theories of strength and fracture mechanics led to dramatic advances in the state of the art of fractographic analysis of brittle materials. Introduction: This author was drawn backwards in time as he researched the current state of the art of fractographic analysis of brittle materials for his fractography guide book.[ ] Others have written about how the fractographic analysis of metals evolved (e.g., [ , , , ]), but there is no analogue for ceramics and glasses. The key scientists, engineers, and analysts who contributed to our field are shown in Fig. 1. Other work done by industry workers who were unable or loathe to publish is now lost, inaccessible, forgotten, or even discarded. It is the goal of this paper to review the key publications and mark the noteworthy advances in the field. Some deem fractography as the study of fracture surfaces, but this author takes a broader view. Fractography is the means and methods for characterizing fractured specimens or components and, for example, a simple examination of the fragments and how they fit together to study the overall breakage pattern is a genuine fractographic analysis.

Pulmonary complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

2008 ◽  
Vol 18 (S2) ◽  
pp. 215-221 ◽  
Author(s):  
David S. Cooper ◽  
Jeffrey P. Jacobs ◽  
Paul J. Chai ◽  
James Jaggers ◽  
Paul Barach ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Pulmonary Complications ◽  
Healthcare Intervention ◽  
Quality Reporting ◽  
Cardiac Malformations ◽  
Comprehensive List ◽  
Congenital Cardiac Disease

AbstractA complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the pulmonary system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of pulmonary complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.

Inequitable distribution of implantable cardioverter defibrillators in Ontario

2007 ◽  
Vol 23 (3) ◽  
pp. 354-361 ◽  
Author(s):  
Jacob A. Udell ◽  
David N. Juurlink ◽  
Alexander Kopp ◽  
Douglas S. Lee ◽  
Jack V. Tu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Fold Increase ◽  
Population Based ◽  
Implantable Cardioverter Defibrillators ◽  
Icd Implantation ◽  
Coronary Syndrome ◽  
Patients With Heart Failure ◽  
History Of ◽  
And Gender ◽  
Cardioverter Defibrillators

Objectives:Implantable cardioverter defibrillator (ICD) therapy reduces the risk of sudden death in patients with ischemic cardiomyopathy, but their novelty and cost may represent barriers to utilization. The objective of this study was to examine the influence of age, gender, place of residence, and socioeconomic status on rates of ICD implantation for the primary prevention of death.Methods:We conducted a population-based retrospective cohort study involving the entire province of Ontario, Canada. Patients were eligible if they had survived following hospitalization for heart failure from 1 January 1993, to 31 March 2004, and previously sustained an acute coronary syndrome within 5 years. Patients with an existing ICD or a documented history of cardiac arrest were excluded, as were patients who died in the hospital. Primary outcome was ICD implantation.Results:We identified 48,426 patients hospitalized for heart failure who survived to hospital discharge. Of these, 440 received an ICD, with a gradual 30-fold increase in implantation rates over the study period (.12–3.9 percent). ICD recipients were more likely to be men (odds ratio [OR] = 4.14; 95 percent confidence interval [CI], 3.24–5.30), younger than 75 years of age (OR = 3.19; 95 percent CI, 2.57–3.96), reside in a metropolitan area (OR = 1.42; 95 percent CI, 1.04–1.9), and live in a higher socioeconomic neighborhood (OR = 1.32; 95 percent CI, 1.08–1.61).Conclusions:Among patients with heart failure and a previous myocardial infarction, ICD use is increasing in Ontario. However, the application of this technology is characterized by major sociodemographic inequities. The causes and consequences of the pronounced age and gender discrepancies, in particular, warrant further investigation.

scholarly journals Digital Archiving in Archaeology: The State of the Art. Introduction

2021 ◽  
Author(s):  
Julian D. Richards ◽  
Ulf Jakobsson ◽  
David Novák ◽  
Benjamin Štular ◽  
Holly Wright
Keyword(s):  
State Of The Art ◽  
The State ◽  
History Of Archaeology ◽  
Special Issue ◽  
Digital Archiving ◽  
Current State ◽  
The World ◽  
History Of

The articles in this special issue demonstrate significant differences in digital archiving capacity in different countries. In part these reflect differences in the history of archaeology in each country, its relationship to the state, whether it is centralised or decentralised, state-led or commercially driven. They also reflect some of the different attitudes to archaeology across the world, most recently explored in a survey conducted under the auspices of the NEARCH project. They reflect a snapshot in time, but our aim is to record the current state-of-the-art in each country, to inform knowledge, stimulate discussion, and to provoke change.

scholarly journals Robotic Observatories: Past, Present and Future

1993 ◽  
Vol 136 ◽  
pp. 188-197
Author(s):  
Russell M. Genet ◽  
David R. Genet
Keyword(s):  
Future Development ◽  
State Of The Art ◽  
Current State ◽  
History Of

AbstractWe briefly describe the history of robotic observatories, give details on an example of the current state-of-the-art in robotic observatories, and suggest several key areas for future development.

Congenital cardiac surgical complications of the integument, vascular system, vascular-line(s), and wounds: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

2008 ◽  
Vol 18 (S2) ◽  
pp. 245-255 ◽  
Author(s):  
Henry L. Walters ◽  
Howard E. Jeffries ◽  
Gordon A. Cohen ◽  
Thomas Klitzner
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Vascular System ◽  
Healthcare Intervention ◽  
Quality Reporting ◽  
Cardiac Malformations ◽  
Comprehensive List ◽  
Congenital Cardiac Disease

AbstractA complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to a collection of loosely related topics that include the following groups of complications: 1) Complications of the Integument, 2) Complications of the Vascular System, 3) Complications of the Vascular-Line(s), 4) Complications of Wounds. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.

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