scholarly journals Repositioning and Extraction of Stylet-Driven Pacing Leads with Extendable Helix used for Left Bundle Branch Area Pacing.

2021 ◽  
Author(s):  
Jean-Benoit le Polain de Waroux ◽  
Jean-Yves Wielandts ◽  
Kris Gillis ◽  
Gabriela Hilfiker ◽  
Antonio Sorgente ◽  
...  
Keyword(s):  
Complication Rate ◽  
Unsuccessful Attempt ◽  
Acute Complication ◽  
Pacing Lead ◽  
Pacing Leads

Abstract: Conventional stylet-driven leads with extendable helix can be implanted successfully for Left Bundle Branch Area Pacing (LBBAP) with a low acute complication rate. However, removal and repositioning techniques of these leads haven’t been yet described. We report 2 cases in which lead repositioning after a first unsuccessful attempt to LBBAP was associated with fracture of the helix rotating mechanism and failure to fully extract the pacing lead.

scholarly journals Admission and Acute Complication Rate for Outpatient Lumbar Microdiscectomy

2010 ◽  
Vol 37 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Aria Fallah ◽  
Eric M. Massicotte ◽  
Michael G. Fehlings ◽  
Stephen J. Lewis ◽  
Yoga Raja Rampersaud ◽  
...  
Keyword(s):  
Complication Rate ◽  
Admission Rate ◽  
Complication Rates ◽  
Chi Square ◽  
Lumbar Microdiscectomy ◽  
Acute Complication ◽  
Admission Data ◽  
Improved Outcomes ◽  
Significant Difference ◽  
Revision Operations

Objective:Specialization is generally independently associated with improved outcomes for most types of surgery. This is the first study comparing the immediate success of outpatient lumbar microdiscectomy with respect to acute complication and conversion to inpatient rate. Long term pain relief is not examined in this study.Methods:Two separate prospective databases (one belonging to a neurosurgeon and brain tumor specialist, not specializing in spine (NS) and one belonging to four spine surgeons (SS)) were retrospectively reviewed. All acute complications as well as admission data of patients scheduled for outpatient lumbar microdiscectomy were extracted.Results:In total, 269 patients were in the NS group and 137 patients were in the SS group. The NS group averaged 24 cases per year while the SS group averaged 50 cases per year. Chi-square tests revealed no difference in acute complication rate [NS(6.7%), SS(7.3%)] (p>0.5) and admission rate [NS(4.1%), SS(5.8%)] (p=0.4) while the SS group had a significantly higher proportion of patients undergoing repeat microdiscectomy [NS(4.1%), SS(37.2%)] (p<0.0001). Excluding revision operations, there was no statistically significant difference in acute complication [NS(5.4%), SS(1.2%)] (p=0.09) and conversion to inpatient [NS(4.3%), SS(4.6%)] (p>0.5) rate. The combined acute complication and conversion to inpatient rate was 6.9% and 4.7% respectively.Conclusion:Based on this limited study, outpatient lumbar microdiscectomy can be apparently performed safely with similar immediate complication rates by both non-spine specialized neurosurgeons and spine surgeons, even though the trend favored the latter group for both outcome measures.

Impact of Structural Heart Disease on the Acute Complication Rate in Atrial Fibrillation Ablation: Results from the German Ablation Registry

2013 ◽  
Vol 25 (3) ◽  
pp. 242-249 ◽  
Author(s):  
BORIS A. HOFFMANN ◽  
KARL-HEINZ KUCK ◽  
DIETRICH ANDRESEN ◽  
STEFAN G. SPITZER ◽  
ELLEN HOFFMANN ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Complication Rate ◽  
Structural Heart Disease ◽  
Atrial Fibrillation Ablation ◽  
Acute Complication

Acquired Tricuspid Valve Stenosis Associated with Two Ventricular Endocardial Pacing Leads in a Dog

2015 ◽  
Vol 51 (3) ◽  
pp. 167-170 ◽  
Author(s):  
Emily Tompkins ◽  
Michelle I. Dulake ◽  
Shadie Ghaffari ◽  
Reid K. Nakamura
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Rare Complication ◽  
Tricuspid Valve Annulus ◽  
Pacing Lead ◽  
Spectral Doppler ◽  
Valve Annulus ◽  
Endocardial Pacing ◽  
Tricuspid Valve Stenosis ◽  
Pacing Leads

Acquired tricuspid valve stenosis (TVS) is a rare complication of endocardial pacing lead implantation in humans that has only been described once previously in the veterinary literature in a dog with excessive lead redundancy. A 12 yr old terrier presented with right-sided congestive heart failure 6 mo after implantation of a second ventricular endocardial pacing lead. The second lead was placed due to malfunction of the first lead, which demonstrated abnormally low impedance. Transthoracic echocardiography identified hyperechoic tissue associated with the pacing leads as they crossed the tricuspid valve annulus as well as a stenotic tricuspid inflow pattern via spectral Doppler interrogation. Medical management was ultimately unsuccessful and the dog was euthanized 6 wk after TVS was diagnosed. The authors report the first canine case of acquired TVS associated with two ventricular endocardial pacing leads.

scholarly journals Single-Pass VDD Pacing Lead for Cardiac Resynchronization Therapy: A Reliable Alternative

Micromachines ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 978
Author(s):  
Silvius-Alexandru Pescariu ◽  
Raluca Şoşdean ◽  
Bogdan Enache ◽  
Răzvan I. Macarie ◽  
Mariana Tudoran ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Complication Rate ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Venous Anatomy ◽  
Safe Alternative ◽  
Functional Parameters ◽  
Lower Complication ◽  
Pacing Lead ◽  
Group B

(1) Background: Cardiac resynchronization therapy (CRT) systems can be simplified by excluding the atrial lead and using a Ventricular-Dual-Dual (VDD) pacing lead. Possible disadvantages might include atrial undersensing and Ventricular-Ventricular-Inhibition (VVI) pacing. Because literature data concerning these systems are scarce, we analyzed their benefits and technical safety. (2) Methods: this retrospective study compared 50 patients implanted with VDD–CRT systems (group A), mainly because of unfavorable venous anatomy concerning the complication rate, with 103 subjects with Dual-Dual-Dual (DDD)–CRT systems (group B) implanted during 2000–2016 and 49 (group C) during 2016–2020. To analyze the functional parameters of the devices, we selected subgroups of 27 patients (subgroup A) and 47 (subgroup B) patients with VDD–CRT in 2000–2016, and 36 subjects (subgroup C) with DDD–CRT implanted were selected in 2017–2020. (3) Results: There was a trend of a lower complication rate with VDD–CRT systems, especially concerning infections during 2000–2016 (p = 0.0048), but similar results were obtained after rigorous selection of patients and employment of an upgraded design of devices/leads. With a proper device programing, CRT pacing had similar results, atrial undersensing being minimal (p = 0.65). For VDD-systems, VVI pacing was recorded only 1.7 ± 2.24% of the time. (4) Conclusions: In patients with a less favorable venous anatomy, VDD–CRT systems may represent a safe alternative regarding complications rates and functional parameters.

scholarly journals MRI safety wih abandoned or functional epicardial pacing leads

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
AM Vuorinen ◽  
R Paakkanen ◽  
J Karvonen ◽  
J Sinisalo ◽  
M Holmstrom ◽  
...  
Keyword(s):  
Adverse Events ◽  
Atrial Pacing ◽  
Mri Safety ◽  
Mri Scan ◽  
Cardiac Stimulation ◽  
Mri Scans ◽  
Pacing Lead ◽  
Epicardial Pacing ◽  
Clinically Significant ◽  
Pacing Leads

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): HUS Medical Imaging Center research grant Background The Heart and Rhythm Society’s consensus statement 2017 approves magnetic resonance imaging (MRI) with cardiac implantable electronic devices (CIED), but excludes patients with epicardial and abandoned leads. Potential safety hazards of an MRI with epicardial pacing leads include heating of the tip of the lead and induction of current in the pacing lead resulting in inappropriate cardiac stimulation. Only a few small studies of MRI safety with epicardial pacing leads have been published and adverse events have been rare. The clinical dilemma remains, whether performing an MRI on a patient with CIED and epicardial pacing leads is safe. We have performed MRIs on patients with CIED and epicardial pacing leads when benefits have been considered to outweigh the risks after careful case-by-case evaluation following our institutional MRI with CIED safety protocol.  Purpose The aim of this study was to evaluate the safety of performing an MRI scan on patients with CIED and abandoned or functional epicardial pacing leads.  Methods All the clinically indicated MRI examinations conducted on adult patients with CIED and functional or abandoned epicardial leads (n = 24) performed in our hospital between November 2011 and October 2019 were included in this observational retrospective study. The data were retrospectively collected from electronic medical records.  Results Altogether 24 MRIs were performed to 16 patients with functional or abandoned epicardial pacing leads (Table). 93.8% (15/16) patients had congenital heart disease. Cardiac MRI was the most frequent examination (21/24, 91.7%). 66.7% of the MRI scans (16/24) were conducted on patients with functional epicardial pacing leads. In 5/24 (20.8%) MRIs, the patient was pacemaker-dependent. A clinically significant event occurred in one MRI scan. This was transient elevation of the pacing lead threshold in a patient with functional epicardial ventricular pacing lead, that was implanted 29 years prior to the MRI. In another patient with 30-year-old functional epicardial pacing leads, clinically significant irreversible elevation in atrial pacing lead impedance was detected 6 months after the MRI and unlikely related to previous MRI examination. None of the patients experienced sensations leading to cessation of the MRI scans. No clinically significant pacing lead parameter changes were detected after MRIs performed on patients with modern (implanted year 2000 or later) functional epicardial pacing leads or functional endocardial leads and abandoned epicardial leads.  Conclusions MRI examinations in patients with CIED and modern functional epicardial pacing leads were performed without detectable adverse events. Performing an MRI with old functional epicardial pacing leads may involve more risks.

Fine Structure of Cytochalasin Induced Polyploid Cells

1968 ◽  
Vol 26 ◽  
pp. 122-123
Author(s):  
Awtar Krishan ◽  
Nestor Bohonos
Keyword(s):  
Fine Structure ◽  
Cytochalasin B ◽  
Present Report ◽  
Cell Monolayer ◽  
Polyploid Cell ◽  
Specific Cell ◽  
Nuclear Surface ◽  
Unsuccessful Attempt ◽  
Daughter Cells ◽  
Polyploid Cells

Cytochalasin B, a mould metabolite from Helminthosporium dermatioideum has been shown to interfere with specific cell activities such as cytoplasmic cleavage and cell movement. Cells undergoing nuclear division in the presence of cytochalasin B are unable to complete the separation of the resulting daughter cells. In time-lapse studies, the daughter cells coalesce after an initial unsuccessful attempt at separation and form large multinucleate polyploid cells. The present report describes the fine structure of the large polyploid cells induced in Earle's L-cell monolayer cultures by exposure to cytochalasin B (lγ/ml) for 92 hours.In the present material we have seen as many as 7 nuclei in these polyploid cells. Treatment with cytochalasin B for longer periods of time (6 to 7 days, with one medium change on the 3rd day) did not increase the number of nuclei beyond the 7 nuclei stage. Figure 1 shows a large polyploid cell with four nuclei. These nuclei are indistinguishable in their fine structure from those of the cells from control cultures but often show unusually large numbers of cytoplasmic invaginations and extensions of the nuclear surface (Figure 2).

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