Tag Archives: ICD

Following the article by Drs Inderjeet Bharaj et al.4 asking whether the medical profession is doing enough to give patients appropriate advice about driving after certain cardiac conditions, we are writing to share our own protocol. Hereford County Hospital is a 208-bed district general hospital that implants around 200–250 cardiac devices yearly, including complex cardiac devices, such as implantable cardiac defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices. Many implants are in emergency inpatients and our aim was to increase the provision of appropriate driving advice upon discharge. Method and measurements Baselin

A CT scan of his diseased knee was sent to Boston USA, where they created two 3D models, one of his diseased knee and another of a computer generated perfect knee. The former was used to plan the minimally invasive cutting of his actual knee to reduce blood loss and damage, the latter was used to mold his knee replacement. I know what I will want when my knees reach their sell-by-date. So, it was fascinating to read John Pepper’s account of their ‘bespoke’ Personalised External Aortic Root Support ExoVasc mesh, not least because the second author Tal Golesworthy invented it and was the first recipient. Still on the patient involvement t

A new portable monitoring device (CardioMessenger Smart, Biotronik) has been launched in the USA. Roughly the size of a smartphone, the device keeps pacemaker, implantable cardioverter defibrillator, and insertable cardiac monitor patients connected to their physician remotely. The device automatically transmits daily reports of cardiac activity via worldwide cellular networks to physicians without intervention from the patient. It also provides fully customisable alerts that can be programmed to the physician’s specifications. Studies have found that home monitoring can significantly reduce hospitalisation, stroke and mortality. The manuf

Editors: Burri H, Deharo J-C, Israel C Publisher: Oxford University Press, Oxford, 2015 ISBN: 978-0-19-872777-4 Price: £59.99 This case-based study guide for implantable device troubleshooting is composed of 70 ‘real-life’ cases involving pacemakers, implantable cardio-defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) devices. It is aimed at all physicians and physiologists involved in the management of patients with implantable devices, and is the first in a series of specialist ‘handbooks’ produced by the European Heart Rhythm Association (EHRA). As such it particularly geared towards those sitting the EHRA affilia

Dr Nick Linker (President, British Heart Rhythm Society) Despite the need to implant more devices in patients and to develop new, innovative, devices there remain major obstacles. The recent report from the Cardiovascular Round Table4 highlights some of these barriers. Delays in implementation of guidelines, and in dissemination of new devices, vary throughout Europe, and are related to a number of factors such as funding, complex R&D lifecycles and regulatory issues. The cumulative result is inconsistent delivery both across Europe and within the UK. In Germany, hospitals can access an innovation fund set up by health insurers to exploit

Introduction Cardiac sarcoidosis can present in a broad spectrum of entities ranging from a benign condition, which is diagnosed incidentally, to a potentially serious disease leading to sudden cardiac death, which only becomes apparent at autopsy, as is the case in 5% of the affected population.1 Due to its subtle, but also sometimes fatal presentation, cardiac sarcoid is hugely underdiagnosed, and awareness of such cases should be brought to light whenever possible. This case report highlights the importance of being aware of the potential presentations of cardiac involvement in patients with sarcoidosis and the general investigations and m

FREEDOM: CABG beats PCI in diabetes patients with multi-vessel disease Coronary artery by-pass graft (CABG) surgery was associated with better outcomes than percutaneous coronary intervention (PCI) in patients with diabetes with multi-vessel coronary artery disease in the FREEDOM (Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial. Senior FREEDOM investigator, Dr Valentin Fuster (Mount Sinai School of Medicine, New York, USA), said the results (table 1) would change practice. He estimated that patients in this study represent about a quarter of patients undergoing PCI. In

Introduction The implantable cardioverter defibrillator (ICD) implant rate within the UK remains significantly lower than that across Europe; furthermore, there is marked inequity in access to ICD implant between regions within the UK.1 The need for an ICD is self-evident in secondary prevention patients successfully resuscitated from ventricular tachycardia (VT) or ventricular fibrillation (VF). Intuitively, therefore, it would seem most likely that underperformance and inequity of access in the UK resides chiefly within the primary prevention patient group. A number of international randomised-controlled trials have identified patient subgr

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