Home Monitoring for Cardiovascular Implantable Electronic Devices

2015 ◽  
Vol 26 (4) ◽  
pp. 343-355 ◽  
Author(s):  
Robin A. Leahy ◽  
Elizabeth E. Davenport
Keyword(s):  
Electronic Devices ◽  
Home Monitoring ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
Cardiovascular Implantable Electronic Devices ◽  
Technological Advances ◽  
Cardiac Resynchronization Therapy Devices ◽  
Cardioverter Defibrillators

Recent technological advances in the management of patients with cardiovascular implantable electronic devices (CIEDs) have expanded clinicians’ ability to remotely monitor patients with CIEDs. Remote monitoring, in addition to periodic in-person device evaluation, provides many advantages to patients and clinicians. Aside from the therapeutic and diagnostic benefits of pacemakers, implantable cardioverter-defibrillators, cardiac resynchronization therapy devices, and implantable loop recorders, improvement in clinical outcomes, clinical efficiencies, and patient experience can be realized with the adoption of remote CIED monitoring. These advantages create significant value to both patients and CIED follow-up centers.

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.

scholarly journals Cardiac implantable electronic device related chest pain: A focused review

2021 ◽  
Vol 4 (1) ◽  
pp. 50-54
Author(s):  
Jahanzeb Malik ◽  
Kashif Khan
Keyword(s):  
Chest Pain ◽  
Cardiac Resynchronization Therapy ◽  
Electronic Device ◽  
Cardiac Resynchronization ◽  
Common Symptom ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Implantable Electronic Device ◽  
Resynchronization Therapy ◽  
Cardiac Resynchronization Therapy Devices ◽  
Cardioverter Defibrillators

More than 600,000 patients undergo cardiac implantable electronic device (CIED) implantation in a year, which comprise of pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices (CRT). The most common symptom experienced after a CIED implantation is chest pain. In this review, we describe CIED implantation and associated complications causing chest pain.

scholarly journals Cardiac resynchronization therapy: Interventricular delay during ventricular and supraventricular tachyarrhythmia

2021 ◽  
Author(s):  
Stroobandt Roland ◽  
Kucher Andreas ◽  
Roland Stroobandt
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Home Monitoring ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Simultaneous Occurrence ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
The Right ◽  
Supraventricular Tachycardias ◽  
Cardioverter Defibrillators

Introduction Implantable cardioverter-defibrillators (ICDs) for cardiac resynchronization therapy (CRT-D) with the capability of LV sensing enable the assessment of interventricular delays in ventricular (VT) and supraventricular tachycardias (SVT). Methods and Results In total, 1078 EGM recordings of VT or VF episodes were investigated that have been transmitted via Home Monitoring. Only those EGM recordings showing the onset of the tachyarrhythmia were used for investigation. In the 623 cases eligible for evaluation leftsided VTs could be identified in 349 cases, right-sided VTs in 252 cases. SVTs with a 1:1 antegrade conduction were found in 22 cases. VT can present three different interventricular delays whereby the right-ventricular sensed event (RVs) is either preceding the left-ventricular sensed event (LVs), or the LVs is preceding RVs, or there can be a simultaneous occurrence of RVs and LVs. In SVTs, either the LVs events were delayed or occurred simultaneously with the RVs events. SVT cases with LVs preceding the RVs events were not found. Conclusion The LV-EGM channel enables to distinguish between left- and right-sided premature ventricular complexes. The assessment of the interventricular delay in VTs is useful to differentiate between a possible apical-, left- or right-sided origin of the VT but not to identify SVTs.

Anesthetic Management of Laser Lead Extraction for Cardiovascular Implantable Electronic Devices

2017 ◽  
Vol 21 (4) ◽  
pp. 302-311 ◽  
Author(s):  
Meena Bhatia ◽  
Payam Safavi-Naeini ◽  
Mehdi Razavi ◽  
Charles D. Collard ◽  
Daniel A. Tolpin ◽  
...  
Keyword(s):  
Anesthetic Management ◽  
Electronic Devices ◽  
Cardiac Resynchronization ◽  
Lead Extraction ◽  
Lead Removal ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiovascular Implantable Electronic Devices ◽  
Number Of Patients ◽  
Cardioverter Defibrillators

Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death. Traditionally, CIEDs have been reliant on the use of transvenous endocardial leads to directly connect with the heart. Over time, these endovascular leads may become endothelialized rendering removal extremely difficult. As the indications for CIEDs expands and with the continuing evolution of these devices, the number of patients requiring explantation for device recall, malfunction, and infection continues to increase. In this manuscript, we review the most common CIEDs, the indications and process of lead removal/device explantation, potential complications associated with the procedure and the anesthetic management of these patients.

scholarly journals Cardiac resynchronization therapy: Interventricular delay during ventricular and supraventricular tachyarrhythmia

2021 ◽  
Author(s):  
Stroobandt Roland ◽  
Kucher Andreas
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Home Monitoring ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Simultaneous Occurrence ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
The Right ◽  
Supraventricular Tachycardias ◽  
Cardioverter Defibrillators

Introduction Implantable cardioverter-defibrillators (ICDs) for cardiac resynchronization therapy (CRT-D) with the capability of LV sensing enable the assessment of interventricular delays in ventricular (VT) and supraventricular tachycardias (SVT). Methods and Results In total, 1078 EGM recordings of VT or VF episodes were investigated that have been transmitted via Home Monitoring. Only those EGM recordings showing the onset of the tachyarrhythmia were used for investigation. In the 623 cases eligible for evaluation leftsided VTs could be identified in 349 cases, right-sided VTs in 252 cases. SVTs with a 1:1 antegrade conduction were found in 22 cases. VT can present three different interventricular delays whereby the right-ventricular sensed event (RVs) is either preceding the left-ventricular sensed event (LVs), or the LVs is preceding RVs, or there can be a simultaneous occurrence of RVs and LVs. In SVTs, either the LVs events were delayed or occurred simultaneously with the RVs events. SVT cases with LVs preceding the RVs events were not found. Conclusion The LV-EGM channel enables to distinguish between left- and right-sided premature ventricular complexes. The assessment of the interventricular delay in VTs is useful to differentiate between a possible apical-, left- or right-sided origin of the VT but not to identify SVTs.

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