In our April 2014 issue of EP Lab Digest®, Gregory Woo, MD, FHRS, FACC et al discuss some obstacles and anatomic variations encountered during cardiac device implantation that can make a routine case challenging: (1) venous stenosis with chronic leads, and (2) a persistent left superior vena cava. Venous stenosis is often discovered at the time of system revision or upgrade; a persistent left superior vena cava generally occurs in about 0.3% of the population. The authors note that physicians must be able to recognize these challenges during cardiac device implantation and apply the appropriate techniques for the situation. They also write that a well-equipped lab and staff trained in EP and interventional procedures will ensure the best success with minimal risk to the patient.
In another featured case this month, Scott Kaufman, DO et al describe the value that device-based monitoring brings to their patient’s individualized plan of care. In this case, the Lumax 740 VR-T DX, when coupled with the BIOTRONIK Home Monitoring® system, identified, discriminated, and promptly transmitted data on atrial and ventricular arrhythmias in a 50-year-old male patient. The authors were able to evaluate device performance, determine actionable events and interventions, and avoid in-clinic visits and rehospitalizations.
Check out EPLD’s upcoming May issue for more case studies from the electrophysiology lab!