Air Pollution and Repolarization Heterogeneity

Lampert, Rachel

doi:10.1016/j.jacc.2010.07.044

Cited by 5 publications

(11 citation statements)

References 32 publications

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“…1 Defibrillation is painful and can be distressing to patients and caregivers. [1][2][3] Evidence for psychological harm includes clinically significant increases in anxiety and distress associated with end-of-life shocks. [1][2][3] Facing terminal illness, patients may decide that resuscitation conflicts with their goals of care.…”

Section: Teachable Momentmentioning

confidence: 99%

“…[1][2][3] Evidence for psychological harm includes clinically significant increases in anxiety and distress associated with end-of-life shocks. [1][2][3] Facing terminal illness, patients may decide that resuscitation conflicts with their goals of care. [1][2][3] The resulting DNR order is widely understood to mean that a patient should not receive external defibrillation.…”

Section: Teachable Momentmentioning

confidence: 99%

“…[1][2][3] Facing terminal illness, patients may decide that resuscitation conflicts with their goals of care. [1][2][3] The resulting DNR order is widely understood to mean that a patient should not receive external defibrillation. Unfortunately, internal defibrillation often gets overlooked.…”

Section: Teachable Momentmentioning

confidence: 99%

“…4 Aside from the physical and psychological harm theseshockscause,undesireddefibrillationofadyingpatientcantrade a relatively rapid death for a prolonged deterioration. [1][2][3] Such a tradeoff imposes futile adversity for the patient and fruitless expenditure for the health care system. A similar pattern is seen among ICD recipients in hospice care.…”

Section: Teachable Momentmentioning

confidence: 99%

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Implantable Cardioverter Defibrillator Management at the End of Life

2020

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Section: Teachable Momentmentioning

confidence: 99%

Section: Teachable Momentmentioning

confidence: 99%

Section: Teachable Momentmentioning

confidence: 99%

Section: Teachable Momentmentioning

confidence: 99%

See 2 more Smart Citations

Implantable Cardioverter Defibrillator Management at the End of Life

2020

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“…Refraining from replacing a CRT-D device may be viewed in the same light as deactivating a currently functioning one and then the doctors are faced with morality issues. Some patients or physicians might consider nonreplacement equivalent to either physician-assisted suicide or euthanasia, despite consensus statements that clearly reject this view [28,29].…”

mentioning

confidence: 99%

Decision making for upgrading or downgrading a CRT device regarding ethical, medical, and economic issues

Kallergis

Simantirakis

Nakou

et al. 2016

Continuing Cardiol Educ

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There are limited data about the management of patients presenting for elective generator replacements in the setting of previously implanted implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) devices that are nearing end of life. Over a patient's life span, clinical situations evolve and previously present conditions that merited CRT implantation may change. The individual patient's clinical status and concomitant illnesses may evolve so that considerations may include not only replacement of the pulse generator but also potentially changing the type of device [e.g., downgrading CRT-defibrillator (CRT-D) to CRT-pacemaker (CRT-P) or ICD or upgrading of CRT-P to CRT-D]. Moreover, the clinical evidence for CRT-D/ CRT-P placement may evolve over time, with ongoing research and availability of new trial data. In this review we discuss the ethical, medical, and financial implications related to CRT generator replacements and the need for additional clinical trials to better understand which patients should undergo downgrading or upgrading.

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Evaluation and Treatment of Patients With Bradycardia and Cardiac Conduction Delay

2019

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The 2018 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Rhythm Society (HRS) Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay offers guidance to clinicians for the treatment of adult patients with bradycardia or symptoms thought to be associated with bradycardia or cardiac conduction system delay. 1 Recommendations for permanent pacing are reviewed in this synopsis.The ACC, the AHA, and the HRS developed this guideline. The writing committee performed an extensive review of Englishlanguage human subject literature indexed in MEDLINE (through PubMed), EMBASE, the Cochrane Library, the Agency for Health-care Research and Quality, and other selected relevant databases. The guideline underwent independent peer review and the approval process required by each professional society. 2,3 Permanent Pacing Long-term management strategies for bradycardia will depend on specific etiology and the consequences (ie, symptoms) of dysfunction, and are almost never related to an arbitrary heart rate or pause duration.Permanent pacing for sinus node dysfunction (SND) should be reserved for symptoms directly attributable to irreversible/ nonphysiologic SND (Class of Recommendation [COR] I). The

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Air Pollution and Repolarization Heterogeneity

Cited by 5 publications

References 32 publications

Implantable Cardioverter Defibrillator Management at the End of Life

Implantable Cardioverter Defibrillator Management at the End of Life

Decision making for upgrading or downgrading a CRT device regarding ethical, medical, and economic issues

Evaluation and Treatment of Patients With Bradycardia and Cardiac Conduction Delay

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