ICD Shocks and Mortality: “The Chicken or the Egg?” March 8, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: Antitachycardia pacing, ICD
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Do implantable cardioverter defibrillator (ICD) shocks increase mortality?
There is now some data to suggest that shocks are associated with increased mortality. Is this because “shocks are bad,” or are these shocks just markers for the severity of underlying heart disease? In addition, can we infer that “painless” therapy using antitachycardia pacing will be beneficial by reducing shocks? (more…)
How do we Define a High Quality Electrophysiologist? March 3, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Health Policy.Tags: CVRP, Quality & outcomes, Reimbursement
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The current practice environment is rapidly changing for all cardiovascular practitioners, including electrophysiologists, and these changes affect reimbursement for health care delivery.
As we move away from a fee-for-service to a pay-for-performance model of reimbursement, public and private payers are motivated to improve quality while controlling costs. To this end, many payers are developing mechanisms to identify quality physicians through specialty designation programs or tiered networks. (more…)
Contemporary ICD Therapy Discussions at Heart Rhythm 2010 February 25, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: AF, Atrial fibrillation, Defibrillation, ICD, Implantable Cardioverter Defibrillator
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The Heart Rhythm Society’s 2010 Scientific Sessions will present exciting discussions on state-of-the-art arrhythmia management and device therapy, including highlights on controversial topics with emphasis on quality-related issues.
Featured topics include:
- Programming Devices to Optimize Patient Outcomes
- Minimizing and Managing Device Complications
- Risk Stratification for ICD Implantation and Non-Conventional Indications
- Lead extraction in 2010
- Implantable Device Therapy for Atrial Fibrillation
- Pacing Lead Positioning and Simplifying Implantable Lead Systems (more…)
Sudden Cardiac Death Risk Stratification: Are We Making Progress? February 18, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: ICD, Implantable Cardioverter Defibrillator, Risk stratification, SCD, Sudden Cardiac Death
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Are we making any headway in the evaluation and treatment of sudden cardiac death?
Up to now, indications for implantable cardioverter defibrillators (ICDs) and risk stratification criteria have been based primarily on left ventricular function. Enrollment criteria in the major clinical trials evaluating the benefit of prophylactic ICD therapy have used left ventricular ejection fraction (LVEF) criteria of ≤30 to 40% as requisites for enrollment. However, most individuals who die suddenly in the population have an LVEF of >40%. In addition, many patients who receive ICDs based on current eligibility criteria may not receive appropriate ICD therapy for several years of follow-up post-implantation. (more…)
The Totally Subcutaneous ICD System: Hype or Hope? February 11, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: ICD, Implantable Cardioverter Defibrillator, Leads
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The “weakest link” of the implantable cardioverter defibrillator (ICD) system has been demonstrated to be the endocardial lead system. These leads require specialized training and skill to implant.
What if there was no need for an endovascular lead? Perhaps systems might last longer and more physicians would be able to perform the procedure, potentially allowing more patients to receive these life-saving devices.
On the other hand, a “totally subcutaneous” ICD lead system still includes a “lead,” which is implanted underneath the skin. In fact, it is unclear whether this lead system, which is closer to the skin, would withstand trauma and if it would truly “last longer” than current transvenous systems. (more…)
Is Defibrillation Testing Still Necessary At the Time of ICD Implantation? February 5, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: ICD, Ventricular fibrillation, VF
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With modern Implantable Cardioverter Defibrillator (ICD) technology, should we really still be doing defibrillation testing at the time of initial ICD implantation?
There is clearly a small, but real mortality rate related to the induction of ventricular fibrillation (VF), not to mention other potential complications such as stroke related to defibrillation testing. In addition, this testing adds to the cost of the procedure, which is an important concern. (more…)
Heart Rhythm Society
Laurie Racenet, RN, MSN, ANP
Michael Giudici, MD, FACC, FACP, FHRS
Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS
Anne Dubin, MD, FHRS
John D. Day, MD, FHRS
Andrea M. Russo, MD, FACC, FHRS
Joshua M. Cooper, MD, FACC
Amit J. Shanker, MD, FHRS, FACC
Bruce Stambler, MD
David Wiggins, RN, BS BME, CEPS
Fred M. Kusumoto, MD, FHRS
Leonard Ganz, MD, FHRS
christinechiuman
Craig Delaughter, MD, PhD
Ariana Del Negro, Heart Rhythm 2010 Quality
Peng-Sheng Chen, MD, FHRS
MSKremers MD,FHRS
Ann C. Garlitski, MD, FACC, FHRS
Alan Cheng, MD, FHRS
Ulrika Birgersdotter-Green, MD
Christopher Clyne, MD, FHRS
Kathleen Blake, MD, MPH, FHRS
David Scher, MD, FHRS
Sanjay Deshpande, MD, FHRS
Thomas F. Deering, MD, FHRS
