Deborah L. Paul

Pacemaker and Implantable Cardioverter Defibrillator Implantation Without Reversal of Warfarin Therapy

The study evaluated all patients undergoing permanent pacemaker and ICD implantation over a 4‐year period to determine if anticoagulated patients required normalization of coagulation factors in the periprocedural period. The study included 1,025 (597 men, 428 women, age 24–100 years, mean 72 years) consecutive patients who underwent device implantation using mostly a percutaneous subclavian approach. The procedures were performed without reversal of anticoagulation in 470 patients with INRs ≥ 1.5 at the time of the procedure (mean INR 2.6 ± 1.0, range 1.5–7.5). The complication rate in the anticoagulated group was similar to those in patients with a normal INR. Routine normalization of coagulation factors prior to pacemaker/ICD placement may not be necessary. (PACE 2004; 27:358–360)

Active-Can Implantable Cardioverter Defibrillator Placement from a Femoral Approach

This report describes a case of an active‐can ICD placed in the thigh. A 74‐year‐old man on chronic renal dialysis had no venous access from cephalic, subclavian, or jugular approaches. Using long active‐fixation leads the device was placed from a femoral approach with good sensing, pacing, and defibrillation parameters. (PACE 2003; 26:1297–1298)

Electrocardiographic patterns during : Pacing the great cardiac and middle cardiac veins

Background: The electrocardiogram (ECG) patterns during pacing from the great cardiac vein (GCV) and the middle cardiac vein (MCV) are not well known.

Submammary Device Implantation in Women: A Step-by-Step Approach

Submammary Device Implantation in Women. Introduction: The frequency of device implantation is increasing in younger patients as our ability to diagnose long‐QT syndrome, hypertrophic cardiomyopathy, Brugada Syndrome, and other life‐threatening disorders earlier has improved. Similarly, use of cardiac resynchronization therapy and ICD therapies has increased in cardiomyopathy patients.