EP Lab Digest - October 2007 - (Page 1)

HMP Communications New ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy The European Society of Cardiology (ESC) has released new guidelines for cardiac pacing and cardiac resynchronization therapy. These new guidelines cover two main areas: 1) permanent pacing in bradyarrhythmias, syncope and other specific conditions like hypertrophic obstructive cardiomyopathy, and 2) ventricular resynchronization as an adjunct therapy in patients with heart failure. www.eplabdigest.com A PRODUCT, NEWS AND CLINICAL UPDATE FOR THE ELECTROPHYSIOLOGY PROFESSIONAL OCTOBER 2007 page 28 National ICD Registry’s First-Year Data Show Few Complications, Not All Physicians Formally Trained While few complications were found last year with implantable cardioverterdefibrillators (ICDs), a number of implanting physicians had no formal training with the medical procedure, according to first-year data from the National ICD Registry. Finally! The New Registered Cardiac Electrophysiology Specialist (RCES) Credential: Interview with Christopher M. Nelson, RN, RCIS, FSICP Interview by Jodie Elrod he new Registered Cardiac Electrophysiology Specialist (RCES) credential is now available. In this interview, we speak with Christopher M. Nelson, RN, RCIS, FSICP who serves as , Director of Cardiac Education & Technology for Sentara Healthcare and President-Elect/Executive Examination Chair of CCI, to get more information about this new exam. T page 29 Treating Depression May Improve Recovery of Heart Rate Variability Following Coronary Syndromes Patients with depression appear to have an impaired ability to recover their heart rate variability following acute coronary syndromes such as heart attack, a factor that could increase their risk of coronary death, according to a recent report. However, patients who are treated with antidepressants or whose mood lifts may experience more of an improvement in heart rate variability than those who are untreated or remain depressed. Why was there a need for this new RCES credential? Tell us about how the exam was created. How will it help benefit those in the EP lab? Two years ago we were approached by Dr. Seth Worley and Letitia Esbenshade-Smith, RCIS (both of Lancaster, Pennsylvania), who inquired about creating a credential for the EP technologist. They shared with us that Electrophysiology Technology is not a recognized profession and that hospitals are finding it difficult to hire and retain individuals qualified to work in this area. The lack of professional recognition also makes it difficult for hospital administrators to negotiate competitive salaries. Credentialing brings recognition to a field of practice — in our case, cardiovascular technology. So, we felt there was justification to begin the process of surveying the field and preparing to create a new credential. continued on page 6 ECG 101: Closing the Gap Phenomenon Chirag Sandesara, MD and Brian Olshansky, MD University of Iowa Hospitals and Clinics Iowa City, Iowa I See our Spotlight Interview on The Community Healthcare System n the next installment of EP Lab Digest’s “ECG 101” section, the authors describe the gap phenomenon. Keep reading to learn more about this often misunderstood mechanism. The Gap Phenomenon The gap phenomenon, sometimes confused with supernormal conduction, was first described in 1965 by Moe in dogs and later by Ahktar in humans as a condition in which premature impulses fail to conduct but conduction resumes with even earlier premature extrastimuli.The mechanism has been well studied and is related to the inherent electrophysiological properties of conduction tissue responsible for functional and effective refractory periods of the tissues involved. The effective refractory period is the longest premature coupling interval during fixed rate pacing that fails to activate tissue.The functional refractory period is the shortest coupling interval that can result in conduction after delivery of premature extrastimuli during a fixed rate pacing. continued on page 8 page 30 http://www.eplabdigest.com

Table of Contents Feed for the Digital Edition of EP Lab Digest - October 2007

Finally! The New Registered Cardiac Electrophysiology Specialist (RCES) Credential: Interview with Christopher M. Nelson, RN, RCIS, FSICP ECG 101: Closing the Gap Phenomenon Contents Letter from the Editor ICD Patient Support Group: St. Peter’s Hospital Spotlight Interview: Community Healthcare System Use of Magnetic Catheter Navigation for Ablation of Focal Tachycardias Echocardiography: The Preeminent Front Line Screening and Diagnostic Tool for Cardiovascular Imaging and Physiological Assessment First Annual EP Lab Digest Salary Survey: Last Chance! Clinical Trial Update: 2007 Email Discussion Group Adopting and Implementing the AF Ablation Consensus Statement Electrophysiology in the West Summit Events Calendar The Sustained Treatment of Paroxysmal Atrial Fibrillation (STOP AF) Clinical Trial: Interview with Kevin Wheelan, MD Industry News and Products

EP Lab Digest - October 2007

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