Using CRM devices as forensic clues

Pacemakers and other cardiac rhythm management devices could help solve forensic cases by revealing a time and cause of death in cases where an autopsy is inadequate, according to a study presented today at EHRA Europace Cardiostim 2017. Lead author Dr. Philipp Lacour said in a statement that using CRM devices as clues could help satisfy an unmet need – nearly 30% of forensic cases remain unsolved because the autopsy does not clarify the cause or time of death. “The number of implanted cardiac devices with sophisticated diagnostic functions is increasing and we thought interrogating them might help to shed light on these unclear deaths,” Lacour said. “Currently, device interrogation is not routinely performed after autopsy.” Lacour teamed up with the Dept. of Forensic Medicine at the Charite-Medical University of Berlin, which performed more than 5,000 autopsies in a 5-year period. Of the 5,000 cases, 150 of them involved an implantable cardiac device. The devices included 107 pacemakers, 22 implantable cardioverter defibrillators, 14 cardiac resynchronization therapy systems and 6 implantable loop recorders. Electrophysiologists were able to determine the time of death in 76% of cases using data from the device. The team also reported that they could identify – to the minute – when the patient suffered tachycardia. The researchers were able to identify the cause of death, which included things like bradycardia and device malfunctions...
Source: Mass Device - Category: Medical Devices Authors: Tags: Cardiovascular Health Information Technology Software / IT Source Type: news

Related Links:

Conclusions BAF resulted in noninferior clinical outcome and CRT responders’ rate in comparison to QPL. Moreover, BAF ensured more precise and stable placement in cardiac veins, with comparable electrical performance and less than 1% patients with unsolved PNS.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research
ConclusionVentricular and supraventricular arrhythmias are common findings in the MZ of ICD patients. Programming an MZ is valuable in the diagnosis of arrhythmias and may be a useful tool in clinical practice.ResumoIntroduçãoA zona de monitorização (ZM) de cardioversor desfibrilhador implantável (CDI) permite uma funcionalidade passiva que não interfere com o funcionamento das zonas de tratamento ativo. Contudo, não é perfeitamente conhecido se a programação de ZM afeta a deteção de arritmias pelo CDI. O objetivo do presente estudo é...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
AbstractBackgroundSacubitril/valsartan reduced the occurrence of sudden cardiac death in the PARADIGM-HF trial. However, limited information is available about the mechanism.MethodsHeart failure (HF)-patients receiving sacubitril/valsartan for a class-I indication equipped with an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) with remote tele-monitoring were retrospectively analyzed. Device-registered arrhythmic-events were determined [ventricular tachycardia/fibrillation (VT/VF), appropriate therapy, non-sustained VT (NsVT;>  4beats and
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
Authors: Martens P, Dupont M, Mullens W Abstract BACKGROUND: Absence of beta-blocker use independently predicts appropriate therapy. Following cardiac resynchronisation therapy (CRT) implant, reverse remodelling and protection against bradycardia allows for beta-blocker dose uptitration. The differential dosing effects on the occurrence of a first episode of appropriate therapy in primary prevention CRT-defibrillator (CRT-D) patients remains unstudied. METHODS AND RESULTS: Changes in beta-blocker dose following CRT-D in consecutive primary prevention patients implanted between 2008 and 2015 were retrospectively...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
Abstract BACKGROUND: While a multicentre trial has demonstrated that the SonR™ contractibility sensor is as effective as echocardiography-guided optimization at improving response to cardiac resynchronization therapy, an association between SonR™ values and clinical endpoints has not been established. AIMS: The primary objective was to assess the predictive value of SonR™ signal evolution regarding cardiovascular events in patients implanted with a cardiac resynchronization therapy device. The secondary objective was to evaluate whether SonR™ signal evolution was associated with cardio...
Source: Archives of Cardiovascular Diseases - Category: Cardiology Authors: Tags: Arch Cardiovasc Dis Source Type: research
CONCLUSION: cQLV is a simple measure that can identify a vulnerable cohort of CRT patients at increased risk for atrial tachyarrhythmias, and hence can predict reverse remodeling and clinical response to CRT treatment. PMID: 30570402 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - Category: Cardiology Tags: Scand Cardiovasc J Source Type: research
ConclusionQuadripolar leads improve the management of phrenic nerve stimulation at no trade-off with pacing threshold and lead stability. Quadripolar leads seems to be associated with a lower incidence of VT/VF and pulmonary congestion, when compared with bipolar leads, but further investigations are necessary to confirm that this positive effect is associated with better LV reverse remodeling.
Source: Indian Heart Journal - Category: Cardiology Source Type: research
ConclusionIn patients with sustained VTA and LBBB upgraded from conventional ICDs to CRT ‐defibrillators, concomitant amiodarone use is associated with less QRS narrowing, less LVEF improvement, greater risk of death, transplant, or VAD, and similar risk of recurrent VTA.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsAtrial arrhythmias occur frequently, and significant underutilization of anticoagulation is suggested in single ‐chamber ICD recipients. Routine screening for AF should be considered among single‐chamber ICD recipients.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
Conclusions: Remote monitoring of ICDs, CRT-Ds, and pacemakers plus clinic visits resulted in improved outcomes without increasing the risk of major adverse events compared with clinic visits alone. Remote monitoring is a cost-effective option for patients implanted with cardiac electronic devices. Patients reported positive experiences using remote monitoring, and perceived that the device provided important medical and safety benefits. PMID: 30443279 [PubMed - in process]
Source: Ontario Health Technology Assessment Series - Category: General Medicine Tags: Ont Health Technol Assess Ser Source Type: research
More News: Arrhythmia | Cardiac Resynchronization Therapy | Cardiology | Cardiovascular | Forensic Medicine | Heart | Information Technology | Study