Biomedical subjects

Christopher A Rinaldi

Publications and source records attributed to Christopher A Rinaldi.

2 recordsLinked to original sources

PubMed2006

A biventricular ICD system with biventricular defibrillation.

We describe the case of a 59-year-old gentleman with severe dilated cardiomyopathy requiring implantation of a dual-chamber biventricular implantable cardioverter-defibrillator (ICD). High defibrillation thresholds (DFT) were encountered at implant with an inadequate defibrillation safety margin. Testing of all possible shock vectors/polarities with and without the SVC coil and optimization of the distal RV coil position all proved inadequate. A satisfactory defibrillation safety margin was achieved following placement of a second lead in the coronary sinus to enable biventricular defibrillation. This case highlights an additional strategy for combating high DFTs and is an option even in dual-chamber biventricular ICD systems.

Electric Countershock↗

PubMed2002

Treatment of left-sided prosthetic valve thrombosis: thrombolysis or surgery?

Although, traditionally, surgery has been the treatment of choice for left-sided prosthetic valve thrombosis (PVT), there are significant risks associated with re-do surgery. Thrombolysis is an alternative to surgery and has a success rate in excess of 80%, but is associated with an -10% risk of systemic embolism and a 7% mortality rate. Guidelines for the use of thrombolytic therapy for PVT were produced using data acquired from older valves, and largely without the use of transesophageal echocardiography (TEE). Data from more recent studies suggest that thrombolysis should be regarded as first-line therapy for PVT in all NYHA classes. The use of TEE is recommended to visualize thrombus in suspected cases.

Echocardiography, Transesophageal↗