Latest Updates

Pacemaker Therapy

    • The number of permanent pacemakers implanted per year increased by 55.6% between 1993 and 2009, and is continuing to rise. Accordingly, the number of patients treated in the emergency department who have permanent pacemakers is increasing, and it is important for physicians in the emergency department to be familiar with the operation and potential complications of these devices.
    • Genetic testing of first-degree relatives is recommended according to 2018 ACC/AHA/HRS guidelines on evaluation of bradycardia and conduction delay.
    • Permanent pacing is reasonable intervention for patients with tachy-brady syndrome and symptoms attributable to bradycardia.
    • 2018 ACC/AHA/HRS specific guideline considerations for genetic disorders, neuromuscular disorders, and infiltrative disorders (e.g., cardiac sarcoidosis and amyloidosis).

Supraventricular Tachycardia

    • The REVERT trial concluded that a modified valsalva maneuver has a higher rate of cardioversion than historical vagal maneuvers.
    • In a patient with stable SVT where vagal maneuvers have failed, IV adenosine remains the first-line pharmacologic agent.
    • Combining adenosine and saline in a single syringe, rather than administration of adenosine followed by a saline flush, has been proven to be an effective form of administration.

Atrial Fibrillation

    • Latest available ACC/AHA guidelines and ongoing controversy around optimal heart rate targets
    • Updated classification for patients with valvular and nonvalvular AF algorithm for maintenance of sinus rhythm
    • 2019 AHA/ACC/HRS and 2020 ESC/EACTS practice guidelines delineated new and modified anticoagulation recommendations pertaining to NOACs.

Supraventricular Tachycardia

    • Radiofrequency ablation as a treatment modality has revolutionized therapy for many SVTs; acts as a first-line alternative to drug therapy in some circumstances, with a high acute success rate and relatively low complication rate.
    • Cryoablation therapy emerging as an alternative in ablative therapies. Investigation of this modality for SVTs is ongoing.
    • Detailed drug regimens optimized for acute and chronic management of specific SVTs; detailed in the 2015 ACC/AHA/HRS practice guidelines.

Pacemaker Therapy

    • The number of permanent pacemakers implanted per year increased by 55.6% between 1993 and 2009, and is continuing to rise. Accordingly, the number of patients treated in the emergency department who have permanent pacemakers is increasing, and it is important for physicians in the emergency department to be familiar with the operation and potential complications of these devices.
    • Genetic testing of first-degree relatives is recommended according to 2018 ACC/AHA/HRS guidelines on evaluation of bradycardia and conduction delay.
    • Permanent pacing is reasonable intervention for patients with tachy-brady syndrome and symptoms attributable to bradycardia.
    • 2018 ACC/AHA/HRS specific guideline considerations for genetic disorders, neuromuscular disorders, and infiltrative disorders (e.g., cardiac sarcoidosis and amyloidosis).

Cardiac Arrhythmias, Acute Coronary Syndromes, and Heart Failure in the Surgical Patient

    • To recognize and treat important cardiac arrhythmias in the surgical patient using the latest advances
    • Most up to date guidelines in management of Acute Coronary Syndrome (ACS) in Surgical Patients
    • Recent progress in management ofheart failure in postoperative and traumatic patients

Pacemaker Therapy

    • The number of permanent pacemakers implanted per year increased by 55.6% between 1993 and 2009, and is continuing to rise. Accordingly, the number of patients treated in the emergency department who have permanent pacemakers is increasing, and it is important for physicians in the emergency department to be familiar with the operation and potential complications of these devices.
    • Genetic testing of first-degree relatives is recommended according to 2018 ACC/AHA/HRS guidelines on evaluation of bradycardia and conduction delay.
    • Permanent pacing is reasonable intervention for patients with tachy-brady syndrome and symptoms attributable to bradycardia.
    • 2018 ACC/AHA/HRS specific guideline considerations for genetic disorders, neuromuscular disorders, and infiltrative disorders (e.g., cardiac sarcoidosis and amyloidosis).

Allergic Response

    • Radiofrequency ablation as a treatment modality has revolutionized therapy for many SVTs; acts as a first-line alternative to drug therapy in some circumstances, with a high acute success rate and relatively low complication rate.
    • Cryoablation therapy emerging as an alternative in ablative therapies. Investigation of this modality for SVTs is ongoing.
    • Detailed drug regimens optimized for acute and chronic management of specific SVTs; detailed in the 2015 ACC/AHA/HRS practice guidelines.
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