scholarly journals JASTRO/JCS Guidelines for radiotherapy in patients with cardiac implantable electronic devices

2020 ◽  
Vol 62 (1) ◽  
pp. 172-184
Author(s):  
Toshiki Ohno ◽  
Toshinori Soejima ◽  
Yukio Sekiguchi ◽  
Takayuki Hashimoto ◽  
Izumi Koike ◽  
...  
Keyword(s):  
Japanese Society ◽  
Electronic Devices ◽  
Implantable Cardioverter Defibrillators ◽  
Implantable Defibrillators ◽  
English Version ◽  
Cardiac Implantable Electronic Devices ◽  
New Findings ◽  
Multidisciplinary Working ◽  
Medical Physicists ◽  
Cardioverter Defibrillators

ABSTRACT This publication is an English version of the Japanese Society for Radiation Oncology (JASTRO) and The Japanese Circulation Society official guidelines for patients with cardiac implantable electronic devices (CIEDs). Several radiotherapy-associated malfunctions have been reported for CIEDs such as pacemakers and implantable cardioverter-defibrillators. Accordingly, guidelines for radiotherapy in patients with CIEDs have been issued by other countries and societies. In August 2010, JASTRO published the ‘Radiotherapy Guidelines for Patients with Pacemakers and Implantable Defibrillators’ (hereafter referred to as the former guidelines). Given new findings in this decade, a multidisciplinary working group of radiation oncologists, medical physicists, radiation therapists and cardiologists jointly reviewed and revised the former guidelines.

Considerations in Patients With Cardiac Implantable Electronic Devices at End of Life

2015 ◽  
Vol 26 (4) ◽  
pp. 356-363
Author(s):  
Melanie T. Gura
Keyword(s):  
Terminal Illness ◽  
Electronic Devices ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
Cardiac Pacemakers ◽  
Cardiac Implantable Electronic Devices ◽  
Life Saving ◽  
Cardioverter Defibrillators ◽  
Proactive Communication

Since the introduction of implantable cardiac pacemakers in 1958 and implantable cardioverter-defibrillators in 1980, these devices have been proven to save and prolong lives. Pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy are deemed life-sustaining therapies. Despite these life-saving technologies, all patients ultimately will reach the end of their lives from either their heart disease or development of a terminal illness. Clinicians may be faced with patient and family requests to withdraw these life-sustaining therapies. The purpose of this article is to educate clinicians about the legal and ethical principles that underlie withdrawal of life-sustaining therapies such as device deactivation and to highlight the importance of proactive communication with patients and families in these situations.

Local complications in patients with cardiac implantable devices

2019 ◽  
Vol 1 (50) ◽  
pp. 14-18
Author(s):  
Karolina Adamczyk ◽  
Ewa Jędrzejczyk-Patej
Keyword(s):  
Electronic Devices ◽  
Implantable Devices ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Systemic Complications ◽  
Local Complications ◽  
Cardiac Implantable Electronic Devices ◽  
Cardioverter Defibrillators ◽  
Life Prolongation ◽  
Pocket Hematoma

Cardiac implantable electronic devices (CIEDs) such as pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), both with or without cardiac resynchronization therapy (CRT), became one of the fundamental therapies in present-day electrocardiology. The CIED patients population is increasing year by year due to a growing number of CIED implantations annually and a life prolongation among patients with CIEDs through better pharmacology combined with the proper electrotherapy and patient care. Invasive procedures related to CIED such as an implantation, a replacement or an up-grade of any kind electrotherapy device involves the risk of complications. Pocket hematoma or infection, which are local complications, should be recognized rapidly and treat properly in order to avoid more threatening systemic complications.

scholarly journals Practice Advisory for the Perioperative Management of Patients with Cardiac Implantable Electronic Devices: Pacemakers and Implantable Cardioverter–Defibrillators 2020

2020 ◽  
Vol 132 (2) ◽  
pp. 225-252 ◽  
Keyword(s):  
Healthcare Professionals ◽  
Perioperative Management ◽  
Task Force ◽  
Electronic Devices ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Implantable Electronic Devices ◽  
Practice Advisory ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Cardioverter Defibrillators

This practice advisory updates the “Practice Advisory for the Perioperative Management of Patients with Cardiac Implantable Electronic Devices: Pacemakers and Implantable Cardioverter–Defibrillators: An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Cardiac Implantable Electronic Devices,” adopted by the American Society of Anesthesiologists in 2010 and published in 2011. This updated advisory is intended for use by anesthesiologists and all other individuals who deliver or who are responsible for anesthesia care. The update may also serve as a resource for other physicians and healthcare professionals who manage patients with cardiac implantable electronic devices. Supplemental Digital Content is available in the text.

Cardiac Implantable Electronic Device Implantation

2015 ◽  
Vol 26 (4) ◽  
pp. 312-319 ◽  
Author(s):  
Melissa E. Harding
Keyword(s):  
Health Care Providers ◽  
Electronic Device ◽  
Electronic Devices ◽  
Implantable Cardioverter Defibrillators ◽  
Care Providers ◽  
Cardiac Implantable Electronic Devices ◽  
Device Implantation ◽  
Number Of Patients ◽  
History Of ◽  
Cardioverter Defibrillators

Implantation of cardiac implantable electronic devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators, and biventricular pacemakers/cardioverter-defibrillators, is becoming increasingly common with new implants now exceeding 1.5 million per year globally. As a result, health care providers in all disciplines are caring for an increasing number of patients with CIEDs. Although the risk of complications associated with implantation of CIEDs is relatively low, the sequela can be catastrophic. Management requires an understanding of an individual patient’s indication for CIED implant, the steps of implant procedures, device function, and natural history of each complication.

Recent Advances in Pacing and Defibrillation

2011 ◽  
Vol 3 (1) ◽  
pp. 74
Author(s):  
Kathy L Lee ◽  
Keyword(s):  
Cardiac Death ◽  
Electronic Devices ◽  
Implantable Defibrillators ◽  
Cardiac Pacemakers ◽  
Cardiac Implantable Electronic Devices ◽  
Treatment And Prevention ◽  
Recent Advances ◽  
Pacing Lead ◽  
Leadless Pacing ◽  
Device Complications

Cardiac pacemakers have been the standard therapy for patients with bradyarrhythmias for several decades. The pacing lead is an integral part of the system, serving as a conduit for the delivery of energy pulses to stimulate the myocardium. However, it is also the Achilles’ heel of pacemakers, being the direct cause of most device complications both acutely during implant and chronically years afterwards. Leadless pacing with ultrasound-mediated energy has been demonstrated in animals and humans to be safe and feasible in acute studies. Implantable defibrillators revolutionised the treatment and prevention of sudden cardiac death. Subcutaneous implantable defibrillators have been under development for more than 10 years. A permanent implantable system has been shown to be feasible in treating induced and spontaneous ventricular tachyarrhythmias. These developments and recent advances in pacing and defibrillation will arouse further interest in the research and development of leadless cardiac implantable electronic devices.

Results of remote follow-up and monitoring in young patients with cardiac implantable electronic devices

2015 ◽  
Vol 26 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Massimo S. Silvetti ◽  
Fabio A. Saputo ◽  
Rosalinda Palmieri ◽  
Silvia Placidi ◽  
Lorenzo Santucci ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Heart Defects ◽  
Electronic Devices ◽  
Young Patients ◽  
Implantable Cardioverter Defibrillators ◽  
Wireless Devices ◽  
Cardiac Implantable Electronic Devices ◽  
System Inclusion ◽  
To Receive

AbstractBackgroundRemote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to follow-up young patients both in-hospital and remotely to enhance device surveillance.MethodsThis is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient’s willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD).ResultsA total of 221 patients with a device – 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders – were enrolled (median age of 17 years, range 1–40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4–18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6±2 minutes (mean±standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16–150) earlier than the next scheduled in-office follow-up.ConclusionsRemote follow-up/monitoring with the CareLink system is useful to enhance device surveillance in young patients. The majority of events were not clinically relevant, and the remaining led to timely management of problems.

scholarly journals The New Challenge for Heart Endocarditis: From Conventional Prosthesis to New Devices and Platforms for the Treatment of Structural Heart Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Francesco Nappi ◽  
Adelaide Iervolino ◽  
Sanjeet Singh Avtaar Singh
Keyword(s):  
Inflammatory Responses ◽  
Clinical Success ◽  
Electronic Devices ◽  
Structural Heart Disease ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Noticeable Increase ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Resynchronization Therapy Devices ◽  
Transcatheter Heart Valve

Infective endocarditis is a sinister condition with considerable morbidity and mortality. Its relevance in the current era is compounded by the increased use of implanted devices such as replacement valves or cardiac implantable electronic devices. These infections are caused by multiple different bacteria with different virulence, pathogenicity, and antimicrobial resistance. Unlike in native endocarditis, the presence of foreign tissue permits sustenance by inflammatory and thrombotic processes as the artificial surfaces promote inflammatory responses and hypercoagulability. Prevention of these infections has been suggested with the use of homografts in combination with antibiotics. Others have attempted to use “low fouling coats” with little clinical success thus far. The use of antibiotic prophylaxis plays a pivotal part in reducing the incidence of prosthesis-related endocarditis. This remains especially crucial with the increasing use of transcatheter heart valve therapies. The widespread use of cardiac implantable electronic devices such as permanent pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices has also heralded a noticeable increase in cases of infectious endocarditis affecting complex equipment which can be difficult to treat. Multimodality strategies are needed with input from surgeons and cardiologists to ensure treatment is both prompt and successful, tailored to the individual needs of the patients.

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