Background-The effect of moderate left ventricular systolic dysfunction (LVSD) on ventricular/vascular coupling and the aortic pressure waveform (AoPW) has been well described, but the effect of severe LVSD has not. Methods and Results-We used noninvasive, high-fidelity tonometry of the radial artery and a mathematical transfer function to generate the AoPW in 25 treated patients with LVSD (mean LV ejection fraction, 24Ϯ8.8%; range, 11% to 40%; 21 patients Ͻ30%). Pulse wave analysis of the AoPW was used to characterize ventricular/vascular coupling and compared with pulse wave analysis performed in 25 normal subjects matched for age, gender, height, body mass index, and heart rate.
Infected and contaminated cardiac pulse generators and leads must be removed entirely in order to effect a cure. We have shown through our experience with 68 consecutive cases that explantation of the offending system and replacement of a new device on the opposite side can be safely accomplished in one sitting--a side-to-side replacement--as long as there is appropriate case selection. There were no early or late infections of the new operative site.
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