Cardiac Rhythm Devices

The rapid pace of device development and complexity in applications along with a lack of concise, problem-oriented references has made it difficult for non-electrophysiologists to confidently manage patients with implanted cardiac rhythm devices (ICRDs). Cardiac Rhythm Devices: A Case-Based Approach to Management provides a practical, problem-oriented, and case-based guide to assist in troubleshooting and management of the common complications of ICRDs. Readers will gain fundamental understanding of the applications and clinical indications, procedural techniques, pre- and post-procedure management, and common complications and their management. Nearly fifty in-depth case presentations provide real-world examples of issues associated with IRCDs and the many factors involved in clinical decision-making and effective management. The cases can be studied individually and in any order. Also included are handy indexes of "key points" that make it easy to quickly locate cases and discussions of any specific topic. This practical book is an indispensable resource and quick reference for the clinical cardiologist, cardiology fellow or any practitioner needing to improve understanding and skills in the application of IRCDs. Contents Preface; Teaching Points ; Pacemakers PM 1 Recurrent Syncope after Pacemaker Implantation; PM 2 Palpitations after Dual-chamber Pacemaker ; PM 3 A 72-year-old Man with Pacemaker and Presyncope ; PM 4 A 52-year-old Man with Possible Pacemaker ; Malfunction and Syncope ; PM 5 Device Management after Atrioventricular Node Ablation in an 82-year-old Man ; PM 6 A 75-year-old Woman with a Pacemaker and Syncope during Prayer ; PM 7 54-year-old Man with Permanent Pacemaker Presents with Fever ; PM 8 A 56-year-old Man with Possible Device Malfunction 31 ; PM 9 A 73-year-old Woman with Possible Pacemaker Noncapture ; PM 10 Multiple Pacing Artifacts in a Critically Ill Patient 35 ; PM 11 A 74-year-old Man with Dual-chamber Pacemaker and Shortness of Breath ; PM 12 Ventricular Tachycardia in a Patient with a Dual-chamber Pacemaker ; PM 13 Ventricular Tachycardia Detected during Pacemaker Interrogation ; PM 14 Intermittent Atrial Pacing in a 62-year-old Man with a Dual-chamber Pacemaker ; PM 15 Tachycardia during Pacing ; PM 16 Onset of Ventricular Tachycardia during Pacemaker Threshold Testing ; PM 17 Dual-chamber Pacemaker with Possible Lead Malfunction ; PM 18 Inflammatory Reaction on Device Site ; Implantable Cardiac Defibrillators ; ICD 1 Exercise-induced Implantable Cardioverter Defibrillators Shocks ; ICD 2 Multiple Implantable Cardioverter Defibrillators Shocks in a 45-year-old Man ; ICD 3 Interrogation of a Dual-chamber Implantable Cardioverter Defibrillator ; ICD 4 Long-QT Syndrome and Multiple Implantable Cardioverter Defibrillator Shocks ; ICD 5 Frequent Palpitations in a Patient with Implantable Cardioverter Defibrillator ; ICD 6 Palpitations in a Patient with a Dual-chamber Implantable Cardioverter Defibrillator ; ICD 7 Variable Pacing in a Patient with Congenital Atrioventricular Block ; ICD 8 Multiple Implantable Cardioverter Defibrillator Shocks ; ICD 9 Rapid Analysis of Shock Etiology ; ICD 10 Wide Complex Tachycardia with Periodic Oscillation ; ICD 11 Ventricular Ectopy on a Rhythm Strip ; ICD 12 Ventricular Pacing and Atrial Flutter ; ICD 13 Ventricular Tachycardia Undersensing in Dual-chamber Implantable Cardioverter Defibrillator ; ICD 14 A 52-year-old Man with a Beeping Implantable Cardioverter Defibrillator ; Biventricular Device Troubleshooting ; BiV Case Series 1 ; Case 1.1 Locating the Left Ventricular Pacing Lead - Electrocardiographic Fluoroscopic Correlation ; Case 1.2 Will Offset Help? ; Case 1.3 Not Allowing Cardiac Resynchronization ; Case 1.4 Role of the Atrial Lead ; BiV Case Series ; Case 2.1 Why Does the Morphology Change? ; Case 2.2 Capture with Delay ; BiV Case Series ; Case 3.1 Troubleshooting Difficulty with Left Ventricular Lead Implantation ; Case 3.2 Difficulties Continued. . . ; BiV Case Series ; Case 4.1 Troubleshooting Failure to Improve- Electrocardiographic Correlation ; Case 4.2 Programming Atrioventricular Interval ; BiV Case Series ; Case 5.1 Cardiac Resynchronization-Handling Complexity ; Case 5.2 Handling Complexity ; Case 5.3 Still Not Responding ; Case 5.4 Epicardial Pacing ; Case 5.5 Varying QRS Width and Morphology ; BIV 6 Analysis of Tracings during Device Interrogation in a Patient with a Biventricular Implantable Cardioverter Defibrillator ; BIV 7 Fusion and Pseudofusion ; BIV 8 Multiple Leads on Chest Radiography Further Reading; Index About the Authors Mehdi Razavi, MD - Mehdi Razavi, MD is Director Clinical Arrhythmia Research, Texas Heart Institute and Assistant Clinical Professor of Medicine, Baylor College of Medicine, Houston, Texas Alizera Nazeri, MD is Senior Cardiology Research Fellow, Texas Heart Institute, Houston Texas Ali Massumi, MD is Director, Center for Cardiac Arrhythmias and Electrophysiology, Texas Heart Institute, Houston, Texas Samuel J. Asirvatham, MD is Consultant, Division of Cardiovascular Diseases and Internal Medicine, and Professor of Medicine and Pediatrics, Division of Pediatric Cardiology, Mayo Clinic College of Medicine, Rochester, Minnesota David Hayes, MD, Division of Cardiovascular Diseases, Professor of Medicine, Mayo Clinic College of Medicine , Mayo Clinic, Rochester, Minnesota