Abstract:
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.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Sayfo S,Vakil KP,Alqaqa'a A,Flippin H,Bhakta D,Yadav AV,Miller JM,Groh WJdoi
10.1016/j.hrthm.2011.10.009subject
Has Abstractpub_date
2012-03-01 00:00:00pages
342-6issue
3eissn
1547-5271issn
1556-3871pii
S1547-5271(11)01211-2journal_volume
9pub_type
杂志文章相关文献
HEART RHYTHM文献大全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
doi:10.1016/j.hrthm.2006.12.003
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:The human ether-à-go-go-related gene (hERG 1a) potassium channel is critical for cardiac repolarization. hERG 1b, another variant subunit, co-assembles with hERG 1a, modulates channel biophysical properties and plays an important role in repolarization. Mutations of hERG 1a lead to type 2 long QT syndrome (L...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2016.01.012
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:This prospective multicenter randomized study aimed to compare the efficacy of 3 common ablation methods used for longstanding permanent atrial fibrillation (AF). METHODS:A total of 144 patients with longstanding permanent AF (median duration 28 months) were randomly assigned to circumferential pulmonary ve...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2008.09.016
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Microvolt T-wave alternans (MTWA) is a valuable tool for stratification of patients at risk for sudden death and has recently been approved for this purpose by Medicare. Although right atrial (RA) pacing has been applied for MTWA testing, the effects of other pacing modalities on MTWA have not been systemati...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.10.032
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Prediction of sustained ventricular tachycardia (VT)/ventricular fibrillation (VF) could help to guide preventive interventions in at-risk patients. The QRST integral (∫QT) reflects intrinsic repolarization properties. OBJECTIVE:The objective of this study was to determine whether intracardiac ∫QT predicts ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.07.029
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The role of atrial-based pacing algorithms in preventing atrial fibrillation (AF) remains controversial. The inconsistent results noted in previous trials may be due in part to differences in endpoints, pacing algorithms, and study design. SAFARI, a worldwide, prospective, randomized clinical trial, was desi...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2008.11.033
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Dofetilide is a class III antiarrhythmic drug approved for the treatment of atrial fibrillation (AF). Dofetilide-induced corrected QT (QTc) interval prolongation is a surrogate for the degree of drug effect, but the relationships between drug-induced QTc interval prolongation, pharmacological cardioversion (...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2016.02.016
更新日期:2016-07-01 00:00:00
abstract::Pulmonary vein antrum isolation offers safe and effective treatment of atrial fibrillation by eliminating the potential triggers of this arrhythmia. The pulmonary vein antra encompass, in addition to the pulmonary veins, the left atrial roof and posterior wall and, in the case of the right pulmonary vein antra, a port...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2006.12.036
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to identify risk markers in patients with Brugada syndrome. BACKGROUND:Patients with Brugada syndrome who experience syncope or aborted sudden death are at high risk for recurrent lethal arrhythmias. The prognosis and therapeutic approaches in asymptomatic individuals with a Br...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2004.11.022
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Therapeutic hypothermia (TH) may increase the susceptibility to ventricular arrhythmias by decreasing ventricular conduction velocity (CV) and facilitating arrhythmogenic spatially discordant alternans (SDA). OBJECTIVE:The purpose of this study was to test the hypothesis that rotigaptide, a gap junction enh...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.07.023
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:To facilitate catheter ablation of ventricular tachycardia (VT), we previously developed an automated method to identify sources of left ventricular (LV) activation in real time using 12-lead electrocardiography (ECG), the accuracy of which depends on acquisition of a complete electroanatomic (EA) map. OBJE...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2019.10.025
更新日期:2020-04-01 00:00:00
abstract::Idiopathic ventricular arrhythmias may arise from anywhere in the heart, and the majority of them can be effectively treated with catheter ablation. The 12-lead electrocardiogram (ECG) is the initial mapping tool to predict the most likely site of origin and is valuable to choose the appropriate ablation strategy. Cru...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2019.04.002
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Standard electroanatomic mapping systems use a single catheter to perform left ventricular substrate mapping. A new mapping system uses a 64-electrode mini-basket catheter to perform rapid automated acquisition of chamber geometry, voltage, and activation. OBJECTIVE:The aim of this study was to compare the ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2014.08.036
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Complex fractionated atrial electrograms have been suggested as important targets for catheter ablation of atrial fibrillation. The etiology and the mechanism of these signals have not been completely elucidated because of limitations of interpretation of these signals in relation to simultaneously acquired ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2008.03.022
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Mutations in the RyR2-encoded cardiac ryanodine receptor/calcium release channel and in CASQ2-encoded calsequestrin cause catecholaminergic polymorphic ventricular tachycardia (CPVT1 and CPVT2, respectively). OBJECTIVES:The purpose of this study was to evaluate the extent of genotypic and phenotypic heterog...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2006.03.025
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Loss-of-function mutations in SCN5A are associated in ∼20% of Brugada syndrome (BrS) patients. Copy number variations (CNVs) have been shown to be associated with several inherited arrhythmia syndromes. OBJECTIVE:The purpose of this study was to investigate SCN5A CNVs among BrS probands. METHODS:The study ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.03.033
更新日期:2018-08-01 00:00:00
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
doi:10.1016/j.hrthm.2020.02.018
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The incidence of atrial tachycardia following Fontan surgery is high, but access to the pulmonary venous atrium, a frequent site of arrhythmia origin, is limited. OBJECTIVES:The purpose of this study is to report our results with a novel transthoracic percutaneous technique that provides direct access to th...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2005.09.027
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:P wave indices are an intermediate phenotype modulated by atrial conduction and electrophysiology. Their clinical correlates and association with all-cause mortality have received limited scrutiny. OBJECTIVE:To determine the relationship between P wave indices and cardiovascular and all-cause mortality in t...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.09.020
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Indications for pulmonary vein isolation for the treatment of atrial fibrillation (AF) have expanded over the years. OBJECTIVE:We aimed to describe trends in demographic and clinical characteristics of patients undergoing ablation, with a particular focus on sex differences. METHODS:Patients who underwent ...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究
doi:10.1016/j.hrthm.2015.06.029
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Early detection of cardiac involvement in sarcoidosis is difficult but essential to achieve optimal treatment. Signal-averaged electrocardiography (SAECG) can detect subtle cardiac electrical abnormalities termed late potentials (LPs) and would be useful for the early diagnosis of cardiac involvement. OBJEC...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.03.013
更新日期:2018-06-01 00:00:00
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
doi:10.1016/j.hrthm.2019.06.015
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The degree of QT prolongation by drug is highly variable and related to risk for polymorphic ventricular tachycardia due to drugs. OBJECTIVE:The purpose of this study was to determine factors that affect the degree of QT prolongation by drugs. METHODS:QT and QTc were measured before and after administratio...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.03.042
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Bidirectional ventricular tachycardia (BVT), which is characterized by an alternating beat-to-beat ECG QRS axis, is a rare but intriguing arrhythmia associated with digitalis toxicity, familial catecholaminergic polymorphic ventricular tachycardia (CPVT), and several other conditions that predispose cardiac ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2010.11.038
更新日期:2011-04-01 00:00:00
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
doi:10.1016/j.hrthm.2013.07.029
更新日期:2013-10-01 00:00:00
abstract::The autonomic nervous system is known to play a significant role in the genesis and maintenance of arrhythmias. Neuromodulation, mostly designed to increase the parasympathetic tone and suppress the sympathetic tone, has become an emerging therapeutic strategy for the treatment of arrhythmias. Emerging therapeutic app...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2015.10.001
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The concept that the interval between the peak (T(peak)) and the end (T(end)) of the T wave (T(p-e)) is a measure of transmural dispersion of repolarization time is widely accepted but has not been tested rigorously by transmural mapping of the intact heart. OBJECTIVES:The purpose of this study was to test ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2006.11.022
更新日期:2007-03-01 00:00:00
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
doi:10.1016/j.hrthm.2019.01.005
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Several mammalian species display distinct biophysical properties between atrial and ventricular voltage-gated sodium current (INa); however, the potential mechanism behind this phenomenon is unknown. OBJECTIVE:The purpose of this study was to investigate the potential molecular identities of the different ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.11.022
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:The use of radiofrequency identification (RFID) systems is expanding and highlights the need to address electromagnetic interference (EMI) to implantable pacemakers and implantable cardioverter-defibrillators (ICDs). OBJECTIVE:This study sought to examine the electromagnetic compatibility (EMC) between RFID...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2009.09.071
更新日期:2010-01-01 00:00:00