2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

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It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management,

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ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation

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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

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Authors/Task Force Members: John J.V. McMurray (Chairperson) (UK)*, Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Angelo Auricchio (Switzerland), Michael Böhm (Germany), Kenneth Dickstein (Norway), Volkmar Falk (Switzerland), Gerasimos Filippatos (Greece), Cândida Fonseca (Portugal), Miguel Angel Gomez-Sanchez (Spain), Tiny Jaarsma (Sweden), Lars Køber (Denmark), Gregory Y.H. Lip (UK), Aldo Pietro Maggioni (Italy), Alexander Parkhomenko (Ukraine), Burkert M. Pieske (Austria), Bogdan A. Popescu (Romania), Per K. Rønnevik (Norway), Frans H. Rutten (The Netherlands), Juerg Schwitter (Switzerland), Petar Seferovic (Serbia), Janina Stepinska (Poland), Pedro T. Trindade (Switzerland), Adriaan A. Voors (The Netherlands), Faiez Zannad (France), Andreas Zeiher (Germany).

ESC Guidelines for the Diagnosis And Treatment of Acute And Chronic Heart Failure 2008

We report our preliminary experience with the combined use of implantable cardioverter defibrillators (ICD) and biventricular pacemakers in six patients with heart failure and malignant ventricular arrhythmia. Two patients underwent ICD implantation for malignant ventricular arrhythmia after previous biventricular pacemaker implantation. One patient underwent biventricular pacemaker insertion for NYHA Class III heart failure after previous ICD implantation. Two patients underwent single device implantation. In the sixth patient, a combined implantation failed due to an inability to obtain a satisfactory left ventricular pacemaker lead position. The potential for device interaction was explored during implantation. In two patients a potentially serious interaction was discovered. Subsequent alterations in device configuration and programming prevented these interactions with long-term use. No complication of combined device use has been demonstrated during a mean follow-up of 2 months (range 1-4 months). Satisfactory ICD and pacemaker function has also been demonstrated. We conclude that combined device implantation may be feasible with currently available pacing technology and that further prospective studies are required in this area.

Preliminary results with the simultaneous use of implantable cardioverter defibrillators and permanent biventricular pacemakers: implications for device interaction and development.

Objective—To assess the safety and eYciency of the Excimer laser sheath in extracting chronically implanted pacemaker leads. Patients—Eight patients were studied (one female, mean age 62 years, range 34 to 77) with 17 pacemaker leads (five atrial, 10 ventricular, two implantable defibrillator). The mean implantation time was 65 months (range 23 to 188). The indications for lead extraction were chronic infection (7), superior vena cava obstruction (4), lead malfunction (4), and pain (2). Methods—A prospective analysis of the use of the Excimer laser sheath in extracting chronically implanted pacemaker leads. Laser sheath extraction was undertaken if conventional extraction techniques with simple traction or traction with a locking stylet had failed. If laser sheath extraction was unsuccessful, basket retrieval of the lead from the groin was performed. Results—Complete lead removal was achieved in 16 leads (94%). In one case the electrode tip was left behind without complication. Extraction was achieved with the laser sheath alone in 16 leads. Basket retrieval was required in one case after laser failure. There were no complications. Conclusions—The Excimer laser sheath appears to be an eVective and safe technique for extracting chronically implanted pacemaker leads. It can be used in combination with the currently available techniques for successful lead extraction. (Heart 1999;82:101‐104)

https://heart.bmj.com/content/heartjnl/82/1/101.full.pdf

Initial experience in the extraction of chronically implanted pacemaker leads using the Excimer laser sheath

https://www.internationaljournalofcardiology.com/article/S0167-5273(00)00322-3/pdf

Ablate and pace for drug refractory paroxysmal atrial fibrillation. Is ablation necessary

We report a case of implantable cardioverter defibrillator (ICD) use after previous biventricular pacemaker insertion for end-stage heart failure. A 75-year-old man with inoperable three-vessel coronary artery disease, permanent atrial fibrillation and end-stage heart failure underwent bi-ventricular pacemaker insertion and His bundle ablation for symptomatic control. NYHA class decreased from class III to II after this procedure. Four months after implant the patient developed paroxysmal sustained, symptomatic ventricular tachycardia. ICD implantation was undertaken. No potentially serious ICD-pacemaker interaction was noted during subsequent follow-up. We conclude that ICD implantation is feasible after previous bi-ventricular pacemaker insertion, without the need to explant the bi-ventricular pacing device.

[Simultaneous utilization of an implantable automatic defibrillator in a patient with previously implanted bi-ventricular pacemaker for end-stage heart failure].

Editor,—Marshall et al state that the combined procedure of atrioventricular (AV) node ablation and permanent pacemaker insertion for medically refractory paroxysmal atrial fibrillation (PAF) is justified on the basis of their study results.1 We agree that in many patients with this condition AV node ablation and pacemaker insertion can improve the perceived quality of life; however, we feel that it is in the patient’s best interest that this procedure be performed in a staged manner with at least one month between pacemaker insertion and ablation.

Lau et al previously identified a group of patients with drug resistant PAF in whom DDDR pacing prevented the need for subsequent AV node ablation.2 Their conclusion was that up to a third of patients with drug refractory PAF may derive benefit from sensor driven atrial pacing alone and that this treatment can result in an improvement in patient perceived quality of life, without additional AV node ablation.

Permanent blockade of the AV node results in lifelong ventricular …

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S Walker

Papers

Preliminary results with the simultaneous use of implantable cardioverter defibrillators and permanent biventricular pacemakers: implications for device interaction and development.

Initial experience in the extraction of chronically implanted pacemaker leads using the Excimer laser sheath

Ablate and pace for drug refractory paroxysmal atrial fibrillation. Is ablation necessary

[Simultaneous utilization of an implantable automatic defibrillator in a patient with previously implanted bi-ventricular pacemaker for end-stage heart failure].

AV node ablation and implantation of mode switching dual chamber pacemakers: effective treatment for drug refractory PAF