A retrospective analysis of proceduralist-directed, nurse-administered propofol sedation for implantable cardioverter-defibrillator procedures.


BACKGROUND:There is controversy whether proceduralist-directed, nurse-administered propofol sedation (PDNAPS) is safe. OBJECTIVE:To assess the frequency of adverse events when PDNAPS is used for implantable cardioverter-defibrillator (ICD)-related procedures and to determine the patient and procedural characteristics associated with adverse events. METHODS:Consecutive ICD-related procedures using PDNAPS from May 2006 to July 2009 at a tertiary-care hospital were evaluated. Serious adverse events were defined as procedural death, unexpected transfer to an intensive care unit, respiratory failure requiring intubation/bag-mask ventilation, or hypotension requiring vasoconstrictor/inotrope support. Nonserious adverse events were defined as hypotension requiring fluid resuscitation or hypoxemia requiring augmented respiratory support with non-rebreather mask, oral airway, or jaw lift. RESULTS:Of 582 patients (age 64 ± 14 years, 72.3% males) undergoing ICD-related procedures using PDNAPS, 58 (10.0%) patients had serious adverse events with no procedural death and 225 (38.7%) had nonserious adverse events. Longer procedure duration (relative risk [RR] = 2.1 per hour; 95% confidence interval [CI] = 1.6-2.8; P < .001) and biventricular implant (RR = 2.7; CI = 1.4-5.3; P = .003) were independent predictors of serious adverse events. A longer procedure duration (RR = 1.4 per hour; CI = 1.1-1.7; P = .001), heart failure class (RR = 1.4 per 1 class; CI = 1.1-1.7; P = .002), and use of propofol infusion (RR = 3.5; CI = 2.2-5.7; P < .001) were independent predictors of nonserious adverse events. CONCLUSION:PDNAPS for shorter ICD procedures including single- and dual-chamber implants, generator changes, and defibrillation threshold testing have acceptable rates of serious adverse events and manageable nonserious adverse events and should be considered for further study. Biventricular implants and other complex procedures should be done with an anesthesiologist.


Heart Rhythm


Heart rhythm


Sayfo S,Vakil KP,Alqaqa'a A,Flippin H,Bhakta D,Yadav AV,Miller JM,Groh WJ




Has Abstract


2012-03-01 00:00:00














  • Targeted nonviral gene-based inhibition of Gα(i/o)-mediated vagal signaling in the posterior left atrium decreases vagal-induced atrial fibrillation.

    abstract:BACKGROUND:Pharmacologic and ablative therapies for atrial fibrillation (AF) have suboptimal efficacy. Newer gene-based approaches that target specific mechanisms underlying AF are likely to be more efficacious in treating AF. Parasympathetic signaling appears to be an important contributor to AF substrate. OBJECTIVE:...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Aistrup GL,Cokic I,Ng J,Gordon D,Koduri H,Browne S,Arapi D,Segon Y,Goldstein J,Angulo A,Wasserstrom JA,Goldberger JJ,Kadish AH,Arora R

    更新日期:2011-11-01 00:00:00

  • Utility and limitations of long-term monitoring of atrial fibrillation using an implantable loop recorder.

    abstract::Atrial fibrillation (AF) is the most common cardiac arrhythmia diagnosed and treated in the world. The treatment of patients' symptoms as well as the prevention of stroke and heart failure is dependent on accurate detection and characterization of AF. A variety of electrocardiographic (ECG) monitoring techniques are b...

    journal_title:Heart rhythm

    pub_type: 杂志文章,评审


    authors: Lee R,Mittal S

    更新日期:2018-02-01 00:00:00

  • Cardiac sympathectomy for refractory ventricular arrhythmias in cardiac sarcoidosis.

    abstract:BACKGROUND:Ventricular arrhythmias (VAs) in cardiac sarcoidosis (CS) are frequently refractory to both antiarrhythmic drug (AAD) therapy and catheter ablation (CA). Cardiac sympathetic denervation (CSD) has been shown to reduce VA burden and implantable cardioverter-defibrillator (ICD) shocks in patients with nonischem...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Okada DR,Assis FR,Gilotra NA,Ha JS,Berger RD,Calkins H,Chrispin J,Mandal K,Tandri H

    更新日期:2019-09-01 00:00:00

  • Bodyweight fluctuation is associated with increased risk of incident atrial fibrillation.

    abstract:BACKGROUND:Obesity and weight gain are established risk factors for atrial fibrillation (AF). OBJECTIVE:The purpose of this study was to investigate whether bodyweight variability is also a risk factor for AF development. METHODS:A nationwide population-based cohort of 8,091,401 adults from the Korean National Health...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Lee HJ,Choi EK,Han KD,Lee E,Moon I,Lee SR,Cha MJ,Oh S,Lip GYH

    更新日期:2020-03-01 00:00:00

  • Pediatric survivors of out-of-hospital ventricular fibrillation: Etiologies and outcomes.

    abstract:BACKGROUND:In general, the prognosis is poor for pediatric patients who experience out-of-hospital (OOH) cardiac arrest, with survival rates of 12% to 29%. OBJECTIVE:The purpose of this study was to describe the causes and outcomes of pediatric patients with documented ventricular fibrillation (VF) at resuscitation fr...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Silka MJ,Kobayashi RL,Hill AC,Bar-Cohen Y

    更新日期:2018-01-01 00:00:00

  • Response of right ventricular size to treatment with cardiac resynchronization therapy and the risk of ventricular tachyarrhythmias in MADIT-CRT.

    abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) is increasingly recognized for its ability to reduce ventricular tachyarrhythmias, possibly associated with left ventricular reverse remodeling, but the role of the right ventricle (RV) in this process has not been examined. OBJECTIVE:The purpose of this study was to ...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Doyle CL,Huang DT,Moss AJ,Solomon SD,Campbell P,McNitt S,Polonsky S,Barsheshet A,Aktas M,Tompkins C,Zareba W,Goldenberg I

    更新日期:2013-10-01 00:00:00

  • Prospective, randomized comparison of two biphasic waveforms for the efficacy and safety of transthoracic biphasic cardioversion of atrial fibrillation.

    abstract:OBJECTIVES:The purpose of this study was to determine if there is a difference in commercially available biphasic waveforms. BACKGROUND:Although the superiority of biphasic over monophasic waveforms for external cardioversion of atrial fibrillation (AF) is established, the relative efficacy of available biphasic wavef...

    journal_title:Heart rhythm

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Alatawi F,Gurevitz O,White RD,Ammash NM,Malouf JF,Bruce CJ,Moon BS,Rosales AG,Hodge D,Hammill SC,Gersh BJ,Friedman PA

    更新日期:2005-04-01 00:00:00

  • Focal impulse and rotor modulation: Acute procedural observations and extended clinical follow-up.

    abstract:BACKGROUND:Focal impulse and rotor modulation (FIRM) was based on the premise that atrial fibrillation (AF) is sustained by rotors that are sufficiently stable to be eliminated by targeted ablation. Early experience reported high success as compared to conventional strategies. OBJECTIVE:The purpose of this study was t...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Steinberg JS,Shah Y,Bhatt A,Sichrovsky T,Arshad A,Hansinger E,Musat D

    更新日期:2017-02-01 00:00:00

  • Molecular mechanisms of adrenergic stimulation in the heart.

    abstract::Increased cardiac output in response to beta-adrenergic receptor stimulation is achieved by rapid alteration of the activity of cardiac ion channels, pumps, and exchangers. Over the past decade, the discovery of macromolecular complexes, which include the ion channels and pumps and the kinases that control their level...

    journal_title:Heart rhythm

    pub_type: 杂志文章,评审


    authors: Sampson KJ,Kass RS

    更新日期:2010-08-01 00:00:00

  • Common wearable devices demonstrate variable accuracy in measuring heart rate during supraventricular tachycardia.

    abstract:BACKGROUND:Wearable devices are used as a noninvasive method of monitoring health. The accuracy of wearables for heart rate (HR) monitoring has been extensively studied in sinus rhythm, but evidence for tachyarrhythmias, particularly supraventricular tachycardia (SVT), is sparse. OBJECTIVE:The purpose of this study wa...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Sequeira N,D'Souza D,Angaran P,Aves T,Dorian P

    更新日期:2020-05-01 00:00:00

  • Potential interference of small neodymium magnets with cardiac pacemakers and implantable cardioverter-defibrillators.

    abstract:BACKGROUND:Magnetic fields may interfere with the function of cardiac pacemakers and implantable cardioverter-defibrillators (ICDs). Neodymium-iron-boron (NdFeB) magnets, which are small in size but produce strong magnetic fields, have become widely available in recent years. Therefore, NdFeB magnets may be associated ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Wolber T,Ryf S,Binggeli C,Holzmeister J,Brunckhorst C,Luechinger R,Duru F

    更新日期:2007-01-01 00:00:00

  • Autoimmune and inflammatory K+ channelopathies in cardiac arrhythmias: Clinical evidence and molecular mechanisms.

    abstract::Cardiac K+ channelopathies account for a significant proportion of arrhythmias and sudden cardiac death (SCD) in subjects without structural heart disease. It is well recognized that genetic defects are key factors in many cases, and in practice, the term cardiac channelopathies currently coincides with inherited card...

    journal_title:Heart rhythm

    pub_type: 杂志文章,评审


    authors: Capecchi PL,Laghi-Pasini F,El-Sherif N,Qu Y,Boutjdir M,Lazzerini PE

    更新日期:2019-08-01 00:00:00

  • Genetic testing and cascade screening in pediatric long QT syndrome and hypertrophic cardiomyopathy.

    abstract:BACKGROUND:The efficacy of cascade screening for the inherited heart conditions long QT syndrome (LQTS) and hypertrophic cardiomyopathy (HCM) is incompletely characterized. OBJECTIVE:The purpose of this study was to examine the use of genetic testing and yield of cascade screening across diverse regions in the United ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Knight LM,Miller E,Kovach J,Arscott P,von Alvensleben JC,Bradley D,Valdes SO,Ware SM,Meyers L,Travers CD,Campbell RM,Etheridge SP

    更新日期:2020-01-01 00:00:00

  • Epicardial organization of human ventricular fibrillation.

    abstract:OBJECTIVE:The objective of this study was to test the hypothesis that on the epicardium of the in vivo human heart, ventricular fibrillation (VF) consists of chaotic small wavefronts that constantly change paths. BACKGROUND:Despite the significance of VF to cardiovascular mortality, little is known about the wavefront...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Nanthakumar K,Walcott GP,Melnick S,Rogers JM,Kay MW,Smith WM,Ideker RE,Holman W

    更新日期:2004-05-01 00:00:00

  • Human KCNQ1 S140G mutation is associated with atrioventricular blocks.

    abstract:BACKGROUND:We recently reported that an S140G mutation in human KCNQ1, an alpha subunit of potassium channels, was involved in the pathogenesis of familial atrial fibrillation (AF), but it is not clear whether the mutation is associated with other cardiac arrhythmias. OBJECTIVE:The purpose of this study was to further...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Yang Y,Liu Y,Dong X,Kuang Y,Lin J,Su X,Peng L,Jin Q,He Y,Liu B,Pan Z,Li L,Zhu Q,Lin X,Zhou Q,Pan Q,Eurlings PM,Fei J,Wang Z,Chen YH

    更新日期:2007-05-01 00:00:00

  • A common missense variant in the neuregulin 1 gene is associated with both schizophrenia and sudden cardiac death.

    abstract:BACKGROUND:Both schizophrenia and epilepsy have been linked to increased risk of sudden cardiac death (SCD). We hypothesized that DNA variants within genes previously associated with schizophrenia and epilepsy may contribute to an increased risk of SCD. OBJECTIVE:To investigate the contribution to SCD susceptibility o...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究


    authors: Huertas-Vazquez A,Teodorescu C,Reinier K,Uy-Evanado A,Chugh H,Jerger K,Ayala J,Gunson K,Jui J,Newton-Cheh C,Albert CM,Chugh SS

    更新日期:2013-07-01 00:00:00

  • Patient plus partner trial: A randomized controlled trial of 2 interventions to improve outcomes after an initial implantable cardioverter-defibrillator.

    abstract:BACKGROUND:Interventions to improve physical and psychological outcomes in recipients with an initial implantable cardioverter-defibrillator (ICD) and their intimate partners are largely unstudied, though likely to have a major impact on adjustment to the ICD and general well-being. OBJECTIVE:The purpose of this study...

    journal_title:Heart rhythm

    pub_type: 杂志文章,随机对照试验


    authors: Dougherty CM,Thompson EA,Kudenchuk PJ

    更新日期:2019-03-01 00:00:00

  • Epicardial left atrial appendage and biatrial appendage accessory pathways.

    abstract:BACKGROUND:Acute success rates of accessory pathway ablation for Wolff-Parkinson-White (WPW) syndrome can exceed 95%, with rare failures attributed to anatomically complex epicardial connections. Right atrial appendage to right ventricle pathways have been reported, but their left-sided counterparts have only recently ...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Mah D,Miyake C,Clegg R,Collins KK,Cecchin F,Triedman JK,Mayer J,Walsh EP

    更新日期:2010-12-01 00:00:00

  • Surface electrocardiogram characteristics of atrial tachycardias occurring after pulmonary vein isolation.

    abstract:OBJECTIVE:The purpose of this study was to describe the surface electrocardiogram (ECG) morphology of common atrial tachycardias (ATs) that occur after pulmonary vein (PV) isolation. BACKGROUND:Focal ATs from reconnected PVs and macroreentrant mitral annular (MA) flutter are the most common form of ATs occurring after...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Gerstenfeld EP,Dixit S,Bala R,Callans DJ,Lin D,Sauer W,Garcia F,Cooper J,Russo AM,Marchlinski FE

    更新日期:2007-09-01 00:00:00

  • Quadripolar versus bipolar leads in cardiac resynchronization therapy: An analysis of the National Cardiovascular Data Registry.

    abstract:BACKGROUND:The introduction of quadripolar (QP) cardiac resynchronization therapy (CRT) leads aimed to improve procedural and clinical outcomes. OBJECTIVE:The National Cardiovascular Data Registry was analyzed to characterize the use as well as the procedural and clinical outcomes of QP leads in comparison with unipol...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Hakemi EU,Doukky R,Parzynski CS,Curtis JP,Madias C

    更新日期:2020-01-01 00:00:00

  • Ablation Index as a predictor of long-term efficacy in premature ventricular complex ablation: A regional target value analysis.

    abstract:BACKGROUND:The effectiveness of radiofrequency catheter ablation (RFCA) in atrial tachyarrhythmias correlates with lesion transmurality. Ablation Index (AI) is an index that incorporates contact force, time, and radiofrequency power simultaneously and is able to predict lesion size and outcomes in RFCA of atrial fibril...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究


    authors: Casella M,Gasperetti A,Gianni C,Zucchelli G,Notarstefano P,Al-Ahmad A,Burkhardt JD,Soldati E,Della Rocca D,Catto V,Majocchi B,Carbucicchio C,Bongiorni MG,Dello Russo A,Natale A,Tondo C

    更新日期:2019-06-01 00:00:00

  • Antitachycardia pacing reduces appropriate and inappropriate shocks in children and congenital heart disease patients.

    abstract:BACKGROUND:Antitachycardia pacing (ATP) can reduce implantable cardioverter-defibrillator shocks, but its use in children and patients with congenital heart disease (CHD) is not well described. OBJECTIVE:To review the efficacy of ATP in children and patients with CHD. METHODS:We reviewed implantable cardioverter-defi...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Kalra Y,Radbill AE,Johns JA,Fish FA,Kannankeril PJ

    更新日期:2012-11-01 00:00:00

  • A balanced translocation disrupting SCN5A in a family with Brugada syndrome and sudden cardiac death.

    abstract:BACKGROUND:Brugada syndrome (BrS) is a primary arrhythmia syndrome affecting 1 in 2000 of the general population. Genetic testing identifies pathogenic variants in the sodium voltage-gated channel α-subunit 5 gene (SCN5A) in up to 25% of familial BrS. Balanced translocations, which involve the exchange of the ends of 2...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Yeates L,Ingles J,Gray B,Singarayar S,Sy RW,Semsarian C,Bagnall RD

    更新日期:2019-02-01 00:00:00

  • Long-term reduction of atrial tachyarrhythmia recurrences in patients paced for bradycardia-tachycardia syndrome.

    abstract:BACKGROUND:Atrial tachyarrhythmias (AT) are considered progressive diseases. Several rhythm control therapies for treatment of AT have been proposed. OBJECTIVES:The Italian AT500 Registry was designed to prospectively study long-term AT evolution in patients paced for the brady-tachy form of sinus node disease (BT-SND...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Padeletti L,Santini M,Boriani G,Botto G,Gulizia M,Molon G,Luzzi G,Senatore G,Giraldi F,Zolezzi F,Pieragnoli P,Pro F,Desanto T,Grammatico A,Italian AT500 Registry Investigators.

    更新日期:2005-10-01 00:00:00

  • Sudden cardiac arrest in intercollegiate athletes: detailed analysis and outcomes of resuscitation in nine cases.

    abstract:BACKGROUND:Public access defibrillation programs have demonstrated a survival benefit in persons with out-of-hospital cardiac arrest. However, little is known about the effectiveness of early defibrillation in young competitive athletes with sudden cardiac arrest (SCA). OBJECTIVES:The purpose of this study was to inve...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Drezner JA,Rogers KJ

    更新日期:2006-07-01 00:00:00

  • Management of atrial fibrillation in patients with heart failure.

    abstract::Atrial fibrillation is a marker for worse outcomes in patients with heart failure and requires careful, individualized management. Anticoagulation and rate control are important. Routine use of antiarrhythmic drug therapy for maintenance of sinus rhythm carries concerns of risk and limited efficacy. Catheter ablation ...

    journal_title:Heart rhythm

    pub_type: 杂志文章,评审


    authors: Stevenson WG,Tedrow U

    更新日期:2007-03-01 00:00:00

  • Inside-out access: a new method of lead placement for patients with central venous occlusions.

    abstract:BACKGROUND:Physicians will increasingly encounter patients who require rhythm management devices but have venous obstructions that prevent conventional access. Alternate access options, such as thoracotomy or transiliac approaches, exist but are associated with greater cost and morbidity. OBJECTIVE:The purpose of this...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Elayi CS,Allen CL,Leung S,Lusher S,Morales GX,Wiisanen M,Aikat S,Kakavand B,Shah JS,Moliterno DJ,Gurley JC

    更新日期:2011-06-01 00:00:00

  • Common and rare susceptibility genetic variants predisposing to Brugada syndrome in Thailand.

    abstract:BACKGROUND:Mutations in SCN5A are rarely found in Thai patients with Brugada syndrome (BrS). Recent evidence suggested that common genetic variations may underlie BrS in a complex inheritance model. OBJECTIVE:The purpose of this study was to find common and rare/low-frequency genetic variants predisposing to BrS in pe...

    journal_title:Heart rhythm

    pub_type: 杂志文章


    authors: Makarawate P,Glinge C,Khongphatthanayothin A,Walsh R,Mauleekoonphairoj J,Amnueypol M,Prechawat S,Wongcharoen W,Krittayaphong R,Anannab A,Lichtner P,Meitinger T,Tjong FVY,Lieve KVV,Amin AS,Sahasatas D,Ngarmukos T,Wichada

    更新日期:2020-12-01 00:00:00

  • Prevalence, characteristics, and prognosis role of type 1 ST elevation in the peripheral ECG leads in patients with Brugada syndrome.

    abstract:BACKGROUND:Despite isolated reports of Brugada syndrome (BrS) in the inferior or lateral leads, the prevalence and prognostic value of ST elevation in the peripheral electrocardiographic (ECG) leads in patients with BrS remain poorly known. OBJECTIVE:To study the prevalence, characteristics, and prognostic value of ty...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究


    authors: Rollin A,Sacher F,Gourraud JB,Pasquié JL,Raczka F,Duparc A,Mondoly P,Cardin C,Delay M,Chatel S,Derval N,Denis A,Sadron M,Davy JM,Hocini M,Jaïs P,Jesel L,Haïssaguerre M,Probst V,Maury P

    更新日期:2013-07-01 00:00:00

  • Endocardial (Watchman) vs epicardial (Lariat) left atrial appendage exclusion devices: Understanding the differences in the location and type of leaks and their clinical implications.

    abstract:BACKGROUND:Watchman and Lariat left atrial appendage (LAA) occlusion devices are associated with LAA leaks postdeployment. OBJECTIVE:The purpose of this study was to compare the incidence, characteristics, and clinical significance of these leaks. METHODS:We performed a multicenter prospective observational study of ...

    journal_title:Heart rhythm

    pub_type: 杂志文章,多中心研究


    authors: Pillarisetti J,Reddy YM,Gunda S,Swarup V,Lee R,Rasekh A,Horton R,Massumi A,Cheng J,Bartus K,Badhwar N,Han F,Atkins D,Bommana S,Earnest M,Nath J,Ferrell R,Bormann S,Dawn B,Di Biase L,Mansour M,Natale A,Lakkired

    更新日期:2015-07-01 00:00:00