In EP Lab Digest®’s December 2014 issue, we feature three fantastic case studies. Editor-in-Chief Emeritus Todd J. Cohen, MD and colleagues highlight the potential applications of the Reveal LINQ™ Insertable Cardiac Monitor (Medtronic, Inc.) for the diagnosis and treatment of syncope of unknown etiology. James Kneller, MD, MSc, PhD, FHRS, CCDS discusses his approach to PVC ablation and presents a successful case combining the principles of this workflow. Hanscy Seide, MD and Hae W. Lim, PhD examine the potential efficiencies that may be possible with the Arctic Front Advance cryoballoon system (Medtronic, Inc.) through short and predictable time usage to help maximize staff and EP lab utilization.
We also hear from an array of new voices! Michael McCullough, author of the blog Afibrunner.com, shares his experience living with persistent atrial fibrillation. Jerry W. Jones, MD, FACEP, FAAEM discusses courses available at the Medicus of Houston, a provider of continuing education for physicians and other medical personnel specializing in advanced ECG interpretation and dysrhythmia analysis. We also feature the EP program at Washington Regional Medical Center in a Spotlight Interview.
In addition, don’t miss our newly redesigned EP Lab Digest® website, including an online-exclusive multimedia section of videos from your favorite EP Lab Digest® articles. Take a look and let us know what you think!
In a new case study, Christopher R. Ellis, MD, FACC from Vanderbilt Heart and Vascular Institute in Nashville, Tennessee, discusses how patients with a left ventricular assist device (LVAD) pose unique considerations when considering left-sided ablation procedures. He describes a 48-year-old male patient with a biventricular ICD who had also previously undergone implantation of a HeartMate II (Thoratec Corporation) LVAD in May 2010. When the patient came to the clinic in sustained ventricular tachycardia (VT) at 156 bpm, it was discussed to have the patient undergo possible VT mapping and radiofrequency (RF) ablation. Dr. Ellis writes that RF ablation of sustained VT in patients with the LVAD is feasible, but typically best performed with minimal sedation and a transseptal approach. Also, due to a high rate of underlying conduction system disease in these patients, bundle branch re-entry VT should always be considered as the underlying mechanism, and will typically have a high rate of success with ablation of either the right or left bundle branch.
Mount Sinai Medical Center, which has one of the largest LVAD programs in the U.S., recently announced it was the first medical center in New York City to offer the newly FDA approved HeartMate II® Pocket Controller™ to help its advanced heart failure patients maintain more active lifestyles. Mount Sinai started using LVAD technology in 2006 for advanced heart failure patients. This latest generation controller for the HeartMate II left ventricular assist device is a light-weight external controller about the size of a smart phone that easily fits in a patient’s front pocket and powers the heart to pump. The Pocket Controller is available for new advanced heart failure patients in need who receive HeartMate II as well as for current HeartMate II patients who wish to upgrade their existing system controllers.