September is recognized as the annual Atrial Fibrillation Awareness Month. The StopAfib.org non-profit organization has led the efforts in educating and informing patients and their loved ones about this potentially deadly condition. They recently launched an updated YouTube channel with a new video to explain the condition and show what steps can be taken to fight this condition. Visit http://www.youtube.com/stopafib to view the Atrial Fibrillation Awareness Month video.
Every second Saturday of September is also commemorated as “World AF Awareness Day.” This day is celebrated in several major cities around the world by an organized “World AF Awareness Yoga-Run/Walk” with a focus on patient education, promoting research and access to better care. This year the World AF Awareness Day was held on September 14, 2013. The Global Atrial Fibrillation Alliance Foundation, a not-for-profit grassroots organization, is the force behind this public education and awareness program. It strives to create increased awareness among the general public about atrial fibrillation, which affects more than 20 million people and is a major cause of stroke, heart failure and heart attacks.
Also this month, AtriCure, Inc. encouraged those affected by atrial fibrillation to participate in “ACT Against Afib,” a new campaign focused on raising awareness of the risks and available treatment options. “ACT” is an acronym used to communicate three important steps for AF patients: Assess your risk, Consult with your doctor, and Treat your Afib. Check out their dedicated website, patientsact.atricure.com, for more information.
In the newest issue of EP Lab Digest®, Aysha Arshad, MD, FACC, FHRS tells us about the Lead Extraction Program at the Valley Heart & Vascular Institute, which was established in 2006. Dr. Arshad is the Director of the Lead Extraction Program, Dr. Suneet Mittal serves as Director of the Electrophysiology Lab at Valley, and Dr. Mark Preminger is the Director of the Implantable Device Section. The Lead Extraction Program performs more than 50 extractions a year. Patients are treated effectively with high clinical extraction success rates and <1% major complication rates, which are at par with other experienced extraction centers.
In April 2013, Dr. Mittal and colleagues from the Arrhythmia Institute at the Valley Health System also discussed their early experience with the LARIAT® Suture Delivery Device, developed by SentreHEART. In the initial series of patients treated with this technique, it was demonstrated that complete ligation of the LAA was accomplished immediately in 96% of patients; a TEE performed at one-year follow-up showed complete ligation in 98% of patients. (The authors provided two videos from the case here.) Complications from the procedure were infrequent and the median procedural time was only 45 minutes. They summarize that this novel technological advance provides an option for left atrial appendage closure in patients who are unable to use chronic anticoagulation in the setting of atrial fibrillation.
Check out other recent news from The Valley Hospital:
• The Valley Hospital Enters into a Historic International Collaboration
• Valley Electrophysiologists are the First in Northern New Jersey to Use Newly Approved Implantable Defibrillator That Does not Require a Lead that Connects Directly to the Heart
In the newest issue of EP Lab Digest®, Jeffrey L. Williams, MD, MS, FACC, FHRS tells us about his new book, What is a Pacemaker? A Cardiologist’s Guide for Patients and Care Providers. Dr. Williams is the medical director of electrophysiology at The Good Samaritan Hospital in Lebanon, PA. He explains that patients and their families are often unaware of many critical issues involved in pacemaker implantation, especially when implanted urgently or emergently. The book covers information on the preoperative evaluation and implant procedure, and takes the reader through the post-operative course and long-term follow-up issues. He notes that the sections on indications for pacemaker therapy and complications of pacemaker implantation are at a level that primary care providers will also find useful and informative. We hope you will check out the book!
EP Lab Digest® has showcased several EP books over the last few years that you might find of interest; check out some examples below. In addition, our Practical Electrophysiology book series, written by EP Lab Digest® Editor-in-Chief Emeritus Todd J. Cohen, MD, provides a great overview for those new to the EP lab.
• The Calling, by Blair Grubb, MD
• ICD Connection: Living with an Implantable Cardioverter Defibrillator. A Collection of Patient & Family Stories, by Helen McFarland, RN
• I Can See Your Heart Beat: A Patient’s Guide to the Heart’s Electrical System, by Jeff Schoeben, RCIS
In the newest issue of EP Lab Digest®, we speak with Steven J. Fowler, MD and Larry A. Chinitz, MD about the world-class EP program at New York University Langone Medical Center, featured as our September 2013 Spotlight Interview! Located in the heart of Manhattan, NYU Langone is composed of three hospitals – Tisch Hospital; the Rusk Institute of Rehabilitation Medicine; and the Hospital for Joint Diseases – plus the NYU School of Medicine. There are 4 dedicated EP labs, a 10-bay observation area, and a dedicated patient waiting area at Tisch Hospital; they share a cardiovascular hybrid operative suite as well. The EP program was separated as a distinct entity and functional area from the cath lab in 2009.
We’ve been fortunate to work with Dr. Fowler and Dr. Chinitz several times since EP Lab Digest®’s inception. In April 2013, they provided a case that illustrated the clinical application of a new iteration of technology that has been long known and understood, but recently improved upon: the integrated VDD lead. BIOTRONIK’s DX system, consisting of the Lumax 740 VR-T Dx device and Linox Smart S Dx lead, allows for dual chamber diagnostics within a single ICD lead. Drs. Fowler and Chinitz felt this platform was appropriate for their patient to enable atrial diagnostics and discrimination with less hardware exposure, as the patient had demonstrated an intact and chronotropically competent sinus node with persistent AV block, also necessitating ventricular pacing. This case demonstrated their use of the Lumax 740 DX system, highlighting the advantages of a dual chamber ICD system through a single pass VDD ICD lead and outlining further potential for this improved technology.
In addition, we worked with Dr. Chinitz and the EP lab staff for another article in May 2003, this time on their team approach to atrial fibrillation management. At their institution, each member of the electrophysiology team plays a critical role. Their “bench to bedside” approach was developed over the course of several years. Taking such a complete view of each case has helped to ensure that ablation procedures are successful.
In addition to EP Lab Digest®’s recent update on the Defibrilladies group, we also want to direct you to some other published articles on EP patient perspectives that we’ve offered over the years! EP Lab Digest®’s Patient Perspectives stories shine a light on various EP patients as well as cardiovascular patient advocacy groups. See a sampling of past articles here:
• Heartfelt Cardiac Projects: Update with Holly Morrell | May 2013 Issue: Holly Morrell
• The Patient Perspective: 5 Ways Healthcare Providers Can Partner with Afib Patients | November 2011 Issue: Mellanie True Hills
• Patient Perspectives | November 2008 Issue: Richard H. Hosea, Jr.
• Finding the Humor in Every Situation | October 2008 Issue: Tracey Conway
• Inside the Life of a Young EP Patient | September 2008: Michaela Gagne
Would you like to share your story? Contact EP Lab Digest® — we’d love to hear from you!