Shock efficacy of single and dual coil electrodes —new insights from the NORDIC ICD Trial

AbstractAimsDual coil (DC) electrodes are preferred to single coil (SC) electrodes because of an assumed higher shock efficacy. However, DC-electrodes may be associated with an increased difficulty and risk of lead extraction. We aimed to compare SC- and DC-electrodes with respect to the first shock efficacy (FSE) after implantable cardioverter defibrillator (ICD) implantation.Methods and resultsOne thousand and seventy-seven patients of the NORDIC ICD trial were randomly assigned to first time ICD implantation with or without defibrillation (DF) testing. The electrode configuration was determined before randomization. One thousand and sixty-seven patients eventually received an ICD, 516 (48.4%) with a SC- and 551 (51.6%) with a DC-electrode. DC-electrodes were preferentially selected in older patients, renal failure, atrial fibrillation, dual chamber, Cardiac Resynchronization Therapy (CRT) devices, angiotensin-converting-enzyme (ACE) inhibitors/angiotensin (AT) receptor blockers and without Sotalol. However, the preference of the investigational site was dominant over clinical parameters. The DF energy at the final electrode position was higher in SC-electrodes (adjusted difference  +1.15 J;P = 0.005; only patients tested). Less patients with DC-electrodes required intra-operative system reconfiguration (adjusted difference −3.9;P = 0.046; only patients tested). Using mixed logistic regression, the FSE was 92.6% in SC- and 97.8% in D...
Source: Europace - Category: Cardiology Source Type: research

Related Links:

Abstract Dabigatran etexilate is a direct oral anticoagulant (thrombin inhibitor) used for the prevention of stroke and systemic thromboembolic events in patients with permanent atrial fibrillation; prevention of venous thromboembolic events and deep veins thrombosis; treatment and prevention of pulmonary embolism. Dabigatran is a relatively new drug, and as a result, its interactions with other medications and their significance are not fully known. A 72 years old male, having a medical history of heart and renal failure, was hospitalized for pneumonia treatment. The patient was taking several drugs, including da...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
ConclusionsSeptal myectomy, performed in a tertiary referral center, had a 30-day mortality rate of 0% and low morbidity rate. There was no difference between observed myectomy mortality and STS Calculator predicted risk for AVR and MV repair. It is possible that a larger sample could reveal lower mortality than STS prediction.
Source: American Heart Journal - Category: Cardiology Source Type: research
Authors: Jha VK, Jairam A, Mahapatra D Abstract Oral anticoagulants are commonly prescribed in patients with kidney diseases having atrial fibrillation and thromboembolic risk. It is very important to understand their clinical pharmacology and changes that may occur as GFR declines. Risks and benefits of newer oral anticoagulants are different in patients with CKD and patients with ESRD. Patients with GFR
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Introduction: Pulmonary embolism (PE) is described in 25% of Chronic Obstructive Pulmonary Disease (COPD) hospitalized patients and may simulate or worsen an episode of acute exacerbation. It should be taken into account in COPD patients with clinical worsening.Aim: To assess whether COPD may be an independent risk factor for PE.Methods: We investigated 91 patients (M:F=1:2, mean age of 69 years) hospitalized for PE at our department from January 2014 to February 2016 and divided them in two groups according to the presence of COPD defined according to GOLD guideline: Group1, PE with COPD (54 patients); Group2, PE without ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary embolism Source Type: research
CONCLUSIONS: In BIOSTAT-CHF, patients with HF of an ischemic etiology, and those with worsening HF precipitated by renal failure (irrespective of the underlying HF etiology), had the highest rates of death and HF hospitalization, but still benefited equally from treatment up-titration. PMID: 31708361 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Publication date: Available online 2 November 2019Source: Heart &LungAuthor(s): Rajkumar Doshi, Sailaja Pisipati, Mohamed Taha, Mihir Dave, Jay Shah, Devina Adalja, Nageshwara GullapalliAbstractIntroductionNew onset Atrial Fibrillation (NOAF) is frequently seen post transcatheter aortic valve replacement (TAVR). NOAF in the setting of TAVR has also been recognized as predictor of worse outcomes, including higher readmission rates. Data assessing the effect and predictors of NOAF on 30-day readmission rates post TAVR is limited.ObjectiveTo assess the incidence, 30-day readmission rate and predictors of NOAF in patients ...
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
CONCLUSION:  Longitudinally measured PAI-1, uPA, and suPAR are strongly associated with adverse cardiac events during the course of CHF. If future research confirms our results, these fibrinolytic factors may carry potential for improved, and personalized, heart failure surveillance and treatment monitoring. PMID: 31659734 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
Publication date: Available online 9 September 2019Source: Indian Heart JournalAuthor(s): Rajkumar Doshi, Mohamed Taha, Mihir Dave, Rupak Desai, Nageshwara GullapalliAbstractBackgroundThe aim of this study is to analyze sex-specific readmission rates, etiology, and predictors of readmission after transcatheter aortic valve replacement (TAVR). Readmissions after TAVR are common, contributing to increased health care utilization and costs. Many factors have been discovered as predictors of readmission; however, sex-specific disparities in readmission rates are limited.MethodsBetween January 2012 and September 2015, adult pat...
Source: Indian Heart Journal - Category: Cardiology Source Type: research
In this study, we aimed to investigate the superiority of right pericardial window (RPW) versus posterior pericardial drain placing for the parameters of pericardial effusion and the postoperative complications at the patients who has undergone cardiac surgery.Materials and methodsBetween July and September 2018, 120 adult patients (mean age 50.30  ± 14.61) who underwent cardiac surgery without the necessity of opening the pleura were included in the study. In Group 1, the RPW was opened (n = 60), and Group 2 posterior pericardial drainage tube was placed without RPW (n = 60...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Post cardiac surgery AF – Cardiology MCQ – Answer Peak incidence of atrial fibrillation after cardiac surgery is on:  Correct answer: 2. Day 2 Peak incidence of post cardiac surgery AF is on second post operative day [1]. European guidelines on the prevention of post operative AF after cardiac surgery give a class I recommendation with level of evidence A for perioperative administration of beta blockers [2]. It may be noted that AF is one of the most common complications after cardiac surgery and it can increase morbidity and mortality. They may need prolonged ventilatory support and increase length of ho...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiac Surgery Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
More News: Atrial Fibrillation | Cardiac Resynchronization Therapy | Cardiology | Heart | Renal Failure