Document Detail

Innovation focus: the patient with arrhythmia.
MedLine Citation:
PMID:  20559933     Owner:  NLM     Status:  MEDLINE    
Great strides have been made over the last two decades in the management of patients with rhythm disorders. Despite this, however, the remaining critical problems of stroke related to atrial fibrillation or as a result of radiofrequency ablation require innovative solutions to fully realize the potential of these recent advances. Similarly, implanted cardiac devices have revolutionized the care of patients with bradyrhythmias and tachyarrhythmias. Dyssynchronus ventricular pacing associated with present devices; however, results in heart failure, tricuspid regurgitation, and inappropriate device therapy once again create a demand for creative solutions. While not technically an arrhythmia, epilepsy management today is riddled with many of the problems that plagued cardiac arrhythmia management previously, and thus an appreciation of the similarities in requirement for investigative solutions may yield groundbreaking solutions. In this paper, we describe some novel methods to reduce complications associated with rhythm disorders and their treatment and apply the lessons learned from cardiovascular arrhythmia management to the brain. These include: a method to reduce coagulum formation and thus subsequent thromboembolism with indwelling catheters specifically during radiofrequency ablation procedures; a technique to ligate the left atrial appendage through percutaneous subxiphoid pericardial access; development and testing of a novel intramyocardial pace-sense lead, particularly used in a unique anatomic location (the atrioventricular septum) to allow pacing the ventricles in a relatively synchronous manner without crossing the tricuspid valve or entering the coronary sinus; finally, novel modifications of the cardiovascular mapping and ablation techniques used for the management of the central nervous system disorders primarily via the venous drainage of the brain. Innovative and potential solutions to treat the patient with arrhythmia are presented.
Samuel J Asirvatham
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Publication Detail:
Type:  Journal Article     Date:  2008-09-30
Journal Detail:
Title:  Journal of cardiovascular translational research     Volume:  1     ISSN:  1937-5395     ISO Abbreviation:  J Cardiovasc Transl Res     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101468585     Medline TA:  J Cardiovasc Transl Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  258-72     Citation Subset:  IM    
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Arrhythmias, Cardiac / radiography,  therapy*,  ultrasonography
Atrial Appendage / surgery
Blood Coagulation Disorders / prevention & control
Brain Diseases / diagnosis*,  physiopathology,  surgery*
Brain Mapping
Cardiac Pacing, Artificial* / methods
Catheter Ablation
Cerebral Veins / physiopathology
Equipment Design
Ligation / instrumentation
Seizures / diagnosis,  surgery
Stroke / diagnosis,  prevention & control,  surgery
Therapies, Investigational*

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