Current trends in the use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology member countries: 2015 report from the European Heart Rhythm Association

Background Subclinical atrial fibrillation (SCAF) is often asymptomatic nonetheless harmful. In patients with cardiac implantable electronic devices, we evaluated the combined performance of homocysteine and uric acid (UA) biomarkers to discriminate high‐risk patients for SCAF. Methods and Results We enrolled 1224 consecutive patients for evaluation of SCAF in patients with cardiac implantable electronic devices in Dalian, China, between January 2013 and December 2019. Clinical data and blood samples were obtained from patients selected according to the absence or presence of atrial high‐rate episodes >6 minutes. Blood samples were obtained, and homocysteine and UA biomarkers were tested in all patients to distinguish their prognostic performance for SCAF. Homocysteine and UA biomarkers were significantly different in SCAF versus no SCAF. On multivariable Cox regression analysis with potential confounders, elevated homocysteine and UA biomarkers were significantly associated with an increased risk of SCAF. A rise of 1 SD in homocysteine (5.7 μmol/L) was associated with an increased risk of SCAF in men and women regardless of their UA levels. Similarly, a 1‐SD increase in UA (91 μmol/L) was associated with an increased risk of SCAF among the patients with high levels of homocysteine in men (hazard ratio, 1.81; 95% CI, 1.43–2.30) and women (hazard ratio, 2.11; 95% CI, 1.69–2.62). The addition of homocysteine and UA to the atrial fibrillation risk factors recommended by the 2020 European Society of Cardiology Guidelines significantly improved risk discrimination for SCAF. Conclusions Homocysteine and UA biomarkers were strongly associated with SCAF. The prediction performance of the European Society of Cardiology model for SCAF was increased by the addition of the selected biomarkers. Registration URL: https://www.chictr.org.cn ; Unique identifier: Chi‐CTR200003837.

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Consensus document on radiotherapy in patients with implantable pacemakers and cardioverter – defibrilators

In a good rythm ◽

10.5604/01.3001.0012.0395 ◽

2018 ◽

Vol 2 (47) ◽

pp. 27-31

Author(s):

Lidia Chmielewska-Michalak ◽

Ewelina Konstanty ◽

Przemysław Mitkowski

Keyword(s):

Current Knowledge ◽

Clinical Status ◽

Electronic Devices ◽

Heart Rhythm ◽

Complex Care ◽

Consensus Document ◽

Cardiac Implantable Electronic Devices ◽

Number Of Patients ◽

High Level ◽

Emergency Mode

The number of patients with cardiac implantable electronic devices (CIED), who require oncological management including radiotherapy (RT) is still increasing. According to current knowledge the most frequent device dysfunction related to exposition to ionizing radiation is reprogramming to emergency mode (soft reset). There are uncommon cases of complete, irreversible device damage. CIED dysfunction during RT can be observed in approximately 3% of patients. In majority of cases they are asymptomatic, although in literature there are descriptions of deterioration of clinical status due to bradycardia or exacerbation of heart failure. The most important factor of device malfunction is radiotherapy with photons of energy >10 MV or protons despite energy used. So far there were no cases published with inadequate ICD therapies due to the presence of electromagnetic field interference during RT. Because patients with CIED undergoing RT need complex care to achieve high level of safety, experts of Heart Rhythm Society establish document, published in 2017 which summarized current knowledge about this group of patients. The document contains guidelines on peri-radiotherapy care of patients with CIED.

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Impact of the COVID-19 pandemic on electrophysiological procedures at a national referral center

EP Europace ◽

10.1093/europace/euab116.042 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

A Cueva-Parra ◽

G Munoz-Benavides ◽

W Ortiz-Solis ◽

J Gomez-Flores ◽

MF Marquez ◽

...

Keyword(s):

Electronic Devices ◽

Referral Center ◽

Funding Sources ◽

Cardiac Implantable Electronic Devices ◽

Electrophysiological Studies ◽

Electrophysiological Procedures ◽

The Impact ◽

Large Groups ◽

Made In ◽

Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background - Introduction: The COVID-19 pandemic has generated serious repercussions on the health system, reducing the number of all cardiology procedures worldwide. Objectives Describe the impact of the COVID-19 pandemic on the procedures performed by the electrophysiology department in a national referral center. Methods We made a retrospective review of our data base and we compared procedures made in the last 3 years since 2017 to 2019 with the procedures made in the 2020. We divide the procedures into two large groups: Cardiac Implantable Electronic Devices (CIED) related procedures (which included implants, revisions, changes, upgrades and extractions) and electrophysiological studies and ablations (which included conventional and complex procedures). Other types of procedures were no included. Results There was a significant reduction in all procedures, the average of procedures performed in the last 3 previous years was 467 (there were 479 in 2017, 411 in 2018 and 511 in 2019), while in 2020 we performed only 319 (p = 0.01); this represents a reduction of 33.4% in the total number of procedures performed in our center. There was no statistical difference regarding the CIED related procedures, the average of procedures of the last 3 previous years was 174 (there were 186 in 2017, 148 in 2018 and 188 in 2019), and in 2020 we performed 189 procedures, this value is near to the average of the last 3 previous years and very close to the value of the 2019 (p = 0.46). Regarding the electrophysiological studies and ablations, the average of procedures of the last 3 previous years was 293 (there were 293 in 2017, 263 in 2018 and 323 in 2019), while in 2020 we performed only 129 procedures, considerably decreasing compared to the previous years (p < 0.01). The reduction in the electrophysiological studies and ablations was 55.97%. The most affected months were April, May and June. Conclusions The COVID-19 pandemic considerably affected the number of electrophysiological procedures in our center, reducing it by 33.4% compared to the previous years. The reduction of procedures fundamentally affected the electrophysiological studies and ablations, reducing them by 55.97%. The number of CIED related procedures were no affected. Electrophysiological procedures Procedures2017201820192017-2019 average2020CIED related procedures186148188174189Electrophysiological studies and ablations293263323293129Total479411511467319Comparative table of the electrophysiological procedures performed in our center in recent years.Abstract Figure. Comparison of the procedures.

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Corrigendum to: 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC

European Heart Journal ◽

10.1093/eurheartj/ehab648 ◽

2021 ◽

Cited By ~ 4

Author(s):

Gerhard Hindricks ◽

Tatjana Potpara ◽

Nikolaos Dagres ◽

Elena Arbelo ◽

Jeroen J Bax ◽

...

Keyword(s):

Atrial Fibrillation ◽

Thoracic Surgery ◽

European Society ◽

European Association ◽

Task Force ◽

Heart Rhythm ◽

Special Contribution ◽

Diagnosis And Management ◽

Esc Guidelines ◽

European Society Of Cardiology

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Lead-Related Infective Endocarditis in Latvia: A Single Centre Experience

Medicina ◽

10.3390/medicina55090566 ◽

2019 ◽

Vol 55 (9) ◽

pp. 566

Author(s):

Nesterovics ◽

Stradins ◽

Kalejs ◽

Ansabergs ◽

...

Keyword(s):

Infective Endocarditis ◽

Electronic Devices ◽

Positive Culture ◽

Major Complication ◽

Heart Rhythm ◽

University Hospital ◽

Lead Extraction ◽

Coagulase Negative Staphylococci ◽

Cardiac Implantable Electronic Devices ◽

Common Location

Background and Objectives: Over the last five decades cardiac implantable electronic devices (CIED) have become established as the mainstay for the treatment of permanent bradycardias, chronic heart failure and dangerous heart rhythm disturbances. These devices improve survival and quality of life in many patients. However, infections associated with CIED implantation, particularly lead-related infective endocarditis (LRIE), can offset all benefits and make more harm than good for the patient. To date, there are no other studies in Latvia, addressing patients with lead-related infective endocarditis. The objective of this study was to identify the most common pathogens associated with LRIE and their antimicrobial resistance and to identify possible risk factors of patients who present with LRIE. Materials and Methods: The study was performed retrospectively at Pauls Stradins Clinical University Hospital (PSCUH). The study included patients who were referred to PSCUH due to LRIE for lead extraction. Patients were identified from procedural journals. Information about isolated microorganisms, patient comorbidities and visual diagnostics data was taken from patient records. Results: Forty-nine patients with CIED related infective endocarditis were included in the study, 34 (69.4%) were male, median age of all patients was 65.0 (50.5–73.0) years, median hospital stay was 15.5 (22.0–30.5) days. Successful and complete lead extraction was achieved in all patients. Thirty-two (65.3%) had received antibiotics prior to blood sample. Only in 31 (63.3%) positive culture results were seen. The most common isolated pathogens were Staphylococcus aureus (23.5%) and coagulase negative staphylococci (23.5%). Other bacteria were isolated considerably less often. The atrial lead was most common location for lead vegetations, seen in 50.0% of cases. Five (10.2%) patients have died due to the disease. Conclusions: Lead-related infective endocarditis is a major complication of cardiac implantable electronic devices with considerable morbidity and mortality, which in our study was as high as 10.2%.

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Executive Summary: European Heart Rhythm Association Consensus Document on the Management of Supraventricular Arrhythmias

Arrhythmia & Electrophysiology Review ◽

10.15420/aer.2016:5.3.gl1 ◽

2016 ◽

Vol 5 (3) ◽

pp. 210 ◽

Cited By ~ 3

Author(s):

Demosthenes G Katritsis ◽

Giuseppe Boriani ◽

Francisco G Cosio ◽

Pierre Jais ◽

Gerhard Hindricks ◽

...

Keyword(s):

European Society ◽

Patient Management ◽

Heart Rhythm ◽

Supraventricular Arrhythmias ◽

Executive Summary ◽

Consensus Document ◽

European Society Of Cardiology

This paper is an executive summary of the full European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, published in Europace. It summarises developments in the field and provides recommendations for patient management, with particular emphasis on new advances since the previous European Society of Cardiology guidelines. The EHRA consensus document is available to read in full at http://europace.oxfordjournals.org

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