deep brain stimulation (dbs) is a neurosurgical procedure that enables brain structures to be stimulated electrically by a pacemaker implanted under the skin. in the 1980s, over a decade after its first use in pain, implantable dbs of the thalamus was performed to suppress tremor in parkinson’s disease (pd) refractory to drug treatments. primate-based research soon afterwards identified the sub...

Axel Müller1, Thomas M. Helms2, Hans-Jürgen Wildau3, Jörg Otto Schwab4 and Christian Zugck5 1Klinik für Innere Medizin I der Klinikum Chemnitz gGmbH Bürgerstr. 2, D-09113 Chemnitz, 2Deutsche Stiftung für chronisch Kranke, Alexanderstraße 26, D-90762 Fürth, 3BIOTRONIK SE Co,Woermannkehre 1, D-12359 Berlin, 4Universitätsklinikum Bonn, Medizinische Klinik und Poliklinik II, Sigmund-Freud-Str. 25, ...

Routine implantation of pacemakers and implantable cardioverter defibrillators is not commonly associated with complications. However, in some cases we see misplacement of pacemaker leads which is most often related to the presence of underlying cardiac anomalies. We report the case of misplacement of a pacemaker lead into the left ventricle of a 56-year-old patient paced in VVI/R mode and with...

In April 2005, the US Food and Drug Administration (FDA) commented on the current research regarding the use of magnetic resonance imaging (MRI) on patients with a pacemaker or implantable cardioverter-defibrillator (ICD).1 Pacemaker and ICD labeling currently cautions physicians against the use of MRI, and MRI manufacturers contraindicate MRI for pacemaker and ICD patients. As discussed in our...

Background Imaging patients with a pacemaker or AICD has always been taboo in the MRI environment. However, with current improvements in pacemaker lead and generator development along with very vigilant and knowledgeable personnel in pacemaker safety, MRI procedures can be implemented successfully. However, safe performance, not withstanding the risks, leads one to question if the results from ...

Cardiac sarcoidosis is a rare but important differential diagnosis in patients who present with progressive heart failure and arrhythmia. It may be diagnosed on endomyocardial biopsy. An excellent response can be achieved with steroid therapy in the early acute inflammatory stage. Progression of the disease may lead to end-stage heart failure that requires implantation of a permanent pacemaker,...

A 79-year-old woman who underwent catheter ablation for paroxysmal atrial fibrillation presented with Torsades de Pointes (TdP). Aggravation of prolonged QT interval which is most likely due to neural modulation by catheter ablation, played major role in the initiation of TdP. The patient was successfully treated with isoproterenol during acute stage and discharged after stabilization without i...

OPINION STATEMENT It is our belief that a well-designed cardiac device management program should include end-of-life patient and family planning, addressing potential decisions regarding withdrawal of pacemaker and/or implantable cardioverter defibrillator therapy. Guided by the basic ethical and legal principles outlined in the article, it is the responsibility of the electrophysiologist and o...