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Pacemaker reuse isn't permitted within the US, but it is legal for Americans to donate devices with substantial remaining battery life after the patient dies for use in less affluent countries. It's been happening on a small scale for years. A University of Michigan program is trying to make it common.
Mortality continued to drop in patients with primary-prevention defibrillators, even after they showed a significant survival benefit out to four years, suggests a post hoc analysis of the seminal trial.
Investigators presented extended follow-up data for the Watchman left atrial appendage closure device and showed similar results to the overall study findings. They hinted that the confidence intervals are narrowing with longer follow-up, suggesting the device might prove superior to warfarin with sufficient patient-years accrued.
The consensus statement is intended to clarify important issues, such as indications, techniques, and outcomes, so that patient care can be optimized and areas of improvement identified.
There is hope, say investigators, that the advantages of the device, which is eight years in development, might lower the risk barriers for some patients indicated for ICD therapy and increase referrals and patient acceptance.
The drug is a chemical analog of amiodarone, and investigators say it is "user friendly," with good efficacy and a positive side-effect profile. Larger, definitive studies, however, are still needed.
An ablation strategy that combines pulmonary vein isolation with substrate-based ablation works best for eliminating atrial fibrillation at one year when compared with ablation techniques targeting only the pulmonary veins or substrate, a new study has shown.
High survival rates in the analysis may reflect contemporary clinical practice more accurately than do the clinical trials that established primary-prevention defibrillator therapy, researchers say.
UPDATED // Patients with pacemakers are not allowed in an MR scanner because of concerns about induced arrhythmias and overheated leads, but this study showed no complications and no changes in temperature at the tip of the lead. Investigators say this is good news, considering the growing number of pacemaker-implanted patients who require an MRI scan.
One crucial goal of the newly minted document is to foster realistic expectations for lead capabilities among regulators, industry, clinicians, and even patients.
Physicians trained in lead extraction should extract a minimum of 40 leads as the primary operator under the supervision of a qualified training physician and should extract a minimum of 20 leads annually as the lead operator. These numbers, however, are a "bare-bones" minimum, say researchers, stressing that patient care should always be individualized.
