David L. Hayes

Deactivating Implanted Cardiac Devices in Terminally Ill Patients: Practices and Attitudes

Background: Clinicians may receive requests to deactivate pacemakers and implantable cardioverter‐defibrillators (ICDs) in terminally ill patients.

Cardiovascular Implantable Electronic Device Infection in Patients with Staphylococcus aureus Bacteremia

Background: u2002Staphylococcus aureus bacteremia (SAB) in patients with cardiovascular implantable electronic devices (CIED), including permanent pacemakers (PPMs) and implantable cardioverter‐defibrillators (ICD), can be the sole manifestation of device infection.

No Increased Bleeding Events with Continuation of Oral Anticoagulation Therapy for Patients Undergoing Cardiac Device Procedure

Background: Switching warfarin for heparin has been a practice for managing periprocedural anticoagulation in high‐risk patients undergoing device‐related procedures. We sought to investigate whether continuation of warfarin sodium therapy without heparin bridging is safe and, when it is continued, the optimal international normalized ratio (INR) without increased bleeding risk at time of device‐related procedure.

Cardiac resynchronization therapy: do women benefit more than men?

Gender and Resynchronization Therapy. Introduction: Women are underrepresented in cardiac resynchronization therapy (CRT) trials. Whether there is a gender difference in the benefit derived from CRT has not been well studied.

Cardiac Resynchronization Therapy Upregulates Cardiac Autonomic Control

Objective: To determine the effect of cardiac resynchronization therapy (CRT) on sympathetic nervous function in heart failure (HF).

The Use of Advance Directives among Patients with Implantable Cardioverter Defibrillators

Background: We aimed to determine the prevalence of advance directives (ADs) among patients with implantable cardioverter defibrillators (ICDs) and of ADs that addressed ICD management at the end of life.

Does the Risk-Benefit Analysis Favor the Extraction of Failed, Sterile Pacemaker and Defibrillator Leads?

Transvenous pacemaker and defibrillator (PM‐D) lead failure is an important clinical problem. Lead extraction is routinely performed in patients with transvenous pacemaker and defibrillator (PM‐D) infections. The management of sterile PM‐D leads that have failed or are no longer required is less uniform. While extraction of excess or failed sterile PM‐D leads is often advocated, the risk of lead extraction must be weighed against the risk of abandoning these leads. There are no randomized trials comparing lead extraction with abandoning sterile leads in this setting. What then are the data that are used to advocate the extraction of excess or failed, sterile chronically implanted PM‐D leads, and are the data adequate to make this recommendation?

Impaired Detection of Ventricular Tachyarrhythmias by a Rate-Smoothing Algorithm in Dual-Chamber Implantable Defibrillators: Intradevice Interactions

Rate‐Smoothing Algorithm in ICD. Introduction: Rate smoothing is an algorithm initially designed to prevent rapid changes in pacemaker rates. In this study, we sought to determine the potential of the rate‐smoothing mechanism in preventing detection of ventricular tachyarrhythmias.

Effects of Simultaneous and Optimized Sequential Cardiac Resynchronization Therapy on Myocardial Oxidative Metabolism and Efficiency

Introduction: Cardiac resynchronization therapy (CRT) can improve left ventricular (LV) hemodynamics and function. Recent data suggest the energy cost of such improvement is favorable. The effects of sequential CRT on myocardial oxidative metabolism (MVO2) and efficiency have not been previously assessed.

Newer Clinical Applications of Pacing

Newer Clinical Applications of Pacing. For many years, the indications for permanent cardiac pacing consisted primarily of AV block and sinus node dysfunction. In recent years, the indications for pacing have expanded considerably. This article details recent advances in the application of permanent pacing and the use of permanent pacing for patients with hypertrophic cardiomyopathy, dilated cardiomyopathy, prevention of atrial fibrillation, and pacing in the long QT syndrome. Pacing is now an accepted therapeutic modality in hypertrophic cardiomyopathy and has rapidly gained acceptance in the United States, although there are still many unknowns about selection of patients and long‐term benefits. Even less is known about pacing for dilated cardiomyopathy. Certain patients do respond with definite subjective improvement and improved quality of life, although there are no data to date to suggest improved longevity. Pacing for long QT syndrome is now a well‐accepted indication for this relatively small subset of patients. Pacing for the prevention of atrial fibrillation is still in the very early stages of development. Multiple methods have been tried with the current method of choice being dual site atrial pacing. However, it is too early to predict the long‐term success of this modality.