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1. 2024 HRS perspective on advancing workflows for CIED remote monitoring

Author

Slotwiner, David J., Serwer, Gerald A., Allred, James D., Bhakta, Deepak, Clark, Richard, Durand, Julien, Ferrara, Martha G., Hale, Jason, Irving, Chris, Iverson, Andy, Jin, Maobing, Johansen, Jens B., Kalscheur, Matthew, Krisjnen, Dennis, Lerman, Robert, Lippman, Neal, Mendenhall, G. Stuart, Michael, Ryan, Nichols, Steven, Parkash, Ratika, Ray, Noemi, Reister, Craig, Skipitaris, Nicholas T., Solomon, Harry, Steiner, Paul R., Tietz, Marko, Wan, Elaine Y., and Wadhwa, Manish

Published
2024
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5. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices

Author

Slotwiner, David, Varma, Niraj, Akar, Joseph G., Annas, George, Beardsall, Marianne, Fogel, Richard I., Galizio, Nestor O., Glotzer, Taya V., Leahy, Robin A., Love, Charles J., McLean, Rhondalyn C., Mittal, Suneet, Morichelli, Loredana, Patton, Kristen K., Raitt, Merritt H., Pietro Ricci, Renato, Rickard, John, Schoenfeld, Mark H., Serwer, Gerald A., Shea, Julie, Varosy, Paul, Verma, Atul, and Yu, Cheuk-Man

Published
2015
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13. Transtelephonic electrocardiographic monitors for evaluation of children and adolescents with suspected arrhythmias

Author

Saarel, Elizabeth Vickers, Stefanelli, Christopher B., Fischbach, Peter S., Serwer, Gerald A., Rosenthal, Amnon, and Dick, II, Macdonald

Abstract

Symptoms of cardiac rhythm disturbance in children and adolescents may include palpitations or the sensation of a rapid heartbeat, chest discomfort, syncope, or presyncope. Electrocardiographic documentation of cardiac rhythm during [...], Objective. Patient-activated transtelephonic electrocardiographic event monitors (TTMs) are often used for the evaluation of children and adolescents with suspected arrhythmias. Since their introduction 25 years ago, there has been little inquiry quantifying the usefulness of TTMs for pediatric patients. The objective of this study was to measure the utility of TTMs for children and adolescents with symptoms of a possible cardiac rhythm disturbance. Methods. Medical records of all patients who received TTMs from C.S. Mott Children's Hospital Electrocardiography Laboratory between February 1, 1993, and October 31, 2000, were reviewed. Patients with pacemakers, known arrhythmias, or age older than 18 years were excluded. Indications for monitoring included palpitations with or without other symptoms (N = 420), chest discomfort (N = 43), and presyncope or syncope (N = 32). Results. A total of 495 studies (patient mean age: 10.2 ± 4.3 years; range: 0.1-17.9 years; 48% male) met inclusion criteria. Monitoring was performed for 1 to 1021 consecutive days (mean: 103 ± 97). Fifty-two percent (N = 257) of patients failed to transmit an electrocardiogram while experiencing symptoms. Fewer boys transmitted electrocardiograms (N = 100/238). Of 238 symptomatic patients, 15% (N = 35; mean age: 11.4 ± 4.7 years; range: 0.1-17.4 years; 51% male) had supraventricular tachycardia (SVT). No other significant arrhythmia that may warrant treatment was identified. All patients with SVT had palpitations. No patients with isolated chest discomfort, presyncope, or syncope had SVT (N = 75). SVT was documented more frequently in patients with postevent (N = 35/464) than loop recorders (N = 0/31). Of those with SVT, 71% (N = 25) and 91% (N = 33) transmitted events within 4 and 16 weeks, respectively. Follow-up for I to 108 months (mean: 32 ± 25; median: 26) in 53% (243 of 460) of patients without SVT uncovered a 3% (N = 7) rate of subsequent SVT detection. The overall sensitivity of the TTM test was 83% (35 of 42) for detection of SVT. The sensitivity of studies theoretically limited to 4 and 16 weeks would be 60% (25 of 42) and 79% (33 of 42), respectively. The negative predictive value of the TTM study was 99% in our patient population. The negative predictive value of tests theoretically limited to 4 and 16 weeks would be 96% and 98%, respectively. TTM studies of 2 weeks' duration were most cost-effective in terms of total diagnostic yield. In contrast, studies of 4 weeks' duration were most cost-efficient for SVT detection. Conclusions. TTMs are useful for the evaluation of children and adolescents with palpitations but not with isolated chest pain, syncope, or presyncope. In this study, girls were more likely to transmit events. The sensitivity of TTMs for detection of SVT was 83%. The negative predictive value of the TTM test was 99%. Monitoring for longer than 16 weeks did not increase test sensitivity. Studies of 4 weeks' duration proved most cost-effective for SVT detection. Pediatrics 2004;113:248-251; arrhythmia, event monitoring, palpitations, supraventricular tachycardia.

Published
2004

14. The Multicenter Pediatric and Adult Congenital EP Quality (MAP-IT) Initiative—Rationale and Design: Report from the Pediatric and Congenital Electrophysiology Societyʼs MAP-IT Taskforce

Author

Seslar, Stephen P., Kugler, John, Batra, Anjan S., Collins, Kathryn K., Crosson, Jane, Dubin, Anne M., Etheridge, Susan, Kanter, Ronald, Papez, Andrew, Radbill, Andrew E., Serwer, Gerald A., Tanel, Ronn E., Tsao, Sabrina, Webster, Gregory, and Saarel, Elizabeth V.

Published
2013
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17. Contributors

Author

Al-Ahmad, Amin, primary, Auricchio, Angelo, additional, Baranowski, Bryan, additional, Bardy, Gust, additional, Belott, Peter H., additional, Berecki-Gisolf, Janneke, additional, Berne, Paola, additional, Brugada, Josep, additional, Chung, Mina K., additional, Cooper, Joshua M., additional, Crespi, Ann M., additional, Crossley, George H., additional, Donahue, J. Kevin, additional, Dosdall, Derek J., additional, Ellenbogen, Kenneth A., additional, Epstein, Andrew E., additional, Epstein, Laurence M., additional, Exner, Derek V., additional, Gillberg, Jeffrey M., additional, Gillis, Anne M., additional, Grace, Andrew A., additional, Halperin, Henry, additional, Haqqani, Haris M., additional, Hayes, David, additional, Hood, Margaret, additional, Hsia, Henry H., additional, Ideker, Raymond E., additional, Israel, Carsten W., additional, Kantharia, Bharat K., additional, Kaszala, Karoly, additional, Kay, G. Neal, additional, Khairy, Paul, additional, Kramer, Daniel B., additional, Kutalek, Steven P., additional, Lampert, Rachel, additional, Lau, Chu-Pak, additional, Lee, Kathy L., additional, Love, Charles J., additional, Maisel, William H., additional, Nazarian, Saman, additional, Niebauer, Mark J., additional, Perez, Marco V., additional, Pickett, Robert Andrew, additional, Pogwizd, Stephen M., additional, Prinzen, Frits W., additional, Regoli, François, additional, Reynolds, Dwight W., additional, Riley, Michael P., additional, Rorvick, Anthony, additional, Saarel, Elizabeth Vickers, additional, Saxon, Leslie A., additional, Schmidt, Craig L., additional, Serwer, Gerald A., additional, Sheldon, Robert S., additional, Shepard, Richard B., additional, Shetty, Ira, additional, Siu, Chung-Wah, additional, Skarstad, Paul M., additional, Smith, Warren M., additional, Stambler, Bruce S., additional, Strik, Marc, additional, Sweeney, Michael O., additional, Swerdlow, Charles D., additional, Talwar, Sandeep, additional, Tchou, Patrick J., additional, Tse, Hung-Fat, additional, Turakhia, Mintu P., additional, Untereker, Darrel F., additional, Varma, Niraj, additional, Walcott, Gregory P., additional, Wang, Paul J., additional, Wazni, Oussama, additional, Wilkoff, Bruce L., additional, Worley, Seth J., additional, and Zei, Paul C., additional

Published
2011
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19. Contributors

Author

Al-Ahmad, Amin, primary, Auricchio, Angelo, additional, Belott, Peter H., additional, Bernstein, Alan D., additional, Byrd, Charles L., additional, Chen, Henry, additional, Chung, Mina K., additional, Connolly, Stuart J., additional, Crespi, Ann M., additional, De Marco, Teresa, additional, Ellenbogen, Kenneth A., additional, Epstein, Andrew E., additional, Exner, Derek V., additional, Gillberg, Jeffrey M., additional, Gillis, Anne M., additional, Gula, Lorne J., additional, Healey, Jeff S., additional, Hersi, Ahmad, additional, Hsia, Henry H., additional, Ideker, Raymond E., additional, Kantharia, Bharat K., additional, Kay, G. Neal, additional, Klein, George J., additional, Krahn, Andrew D., additional, Kroll, Mark W., additional, Kutalek, Steven P., additional, Lakkireddy, Dhanunjaya R., additional, Lau, Chu-Pak, additional, LeRoy, Sarah S., additional, Levine, Paul A., additional, Love, Charles J., additional, Maquilan, J. March, additional, Marchlinksi, Francis E., additional, Morillo, Carlos A., additional, Okamura, Hideo, additional, Olson, Walter H., additional, Parsonnet, Victor, additional, Pinski, Sergio L., additional, Prinzen, Frits, additional, Rahimtoola, Shahbudin H., additional, Reynolds, Dwight W., additional, Rorvick, Anthony, additional, Russo, Andrea M., additional, Saarel, Elizabeth, additional, Saxon, Leslie A., additional, Schmidt, Craig L., additional, Serwer, Gerald A., additional, Sheldon, Robert S., additional, Shepard, Richard B., additional, Skanes, Allan C., additional, Skarstad, Paul M., additional, Spinelli, Julio C., additional, Stambler, Bruce S., additional, Sweeney, Michael O., additional, Swerdlow, Charles D., additional, Tchou, Patrick J., additional, Tse, Hung-Fat, additional, Untereker, Darrel F., additional, Walcott, Gregory P., additional, Wang, Paul J., additional, Worley, Seth, additional, and Yee, Raymond, additional

Published
2007
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26. Design of the Pacemaker REmote Follow-up Evaluation and Review (PREFER) trial to assess the clinical value of the remote pacemaker interrogation in the management of pacemaker patients

Author

Johnson W Ben, Crossley George H, Cohen Todd J, Choucair Wassim, Wilkoff Bruce L, Chen Jane, Mongeon Luc R, Serwer Gerald A, and Sherfesee Lou

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Although pacemakers are primarily used for the treatment of bradycardia, diagnostic data available in current pacemakers allow them to be also used as sophisticated, continuous monitoring devices. Easy access to these stored data may assist clinicians in making diagnostic and therapeutic decisions sooner, thus avoiding potential long-term sequelae due to untreated clinical disorders. Internet-based remote device interrogation systems provide clinicians with frequent and complete access to stored data in pacemakers. In addition to monitoring device function, remote monitors may be a helpful tool in assisting physicians in the management of common arrhythmia disorders. Methods The Pacemaker REmote Follow-up Evaluation and Review (PREFER) trial is a prospective, randomized, parallel, unblinded, multicenter, open label clinical trial to determine the utility of remote pacemaker interrogation in the earlier diagnosis of clinically actionable events compared to the existing practice of transtelephonic monitoring. There have been 980 patients enrolled and randomized to receive pacemaker follow up with either remote interrogation using the Medtronic CareLink® Network (CareLink) versus the conventional method of transtelephonic monitoring (TTM) in addition to periodic in-person interrogation and programming evaluations. The purpose of this manuscript is to describe the design of the PREFER trial. The results, to be presented separately, will characterize the number of clinically actionable events as a result of pacemaker follow-up using remote interrogation instead of TTM. Trial registration ClinicalTrials.gov: NCT00294645.

Published
2008
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27. Usefulness of the bidirectional Glenn procedure as staged reconstruction for the functional single ventricle

Author

Pridjian, Ara K., Mendelsohn, Alan M., Lupinetti, Flavian M., Beekman, Robert H., III, Dick, Macdonald, II, Serwer, Gerald, and Bove, Edward L.

Subjects
Congenital heart disease, Heart ventricles, Health
Abstract

The bidirectional Glenn operation may be particularly useful as an intermediate procedure before Fontana correction in high-risk patients. From October 1989 through February 1992, 50 patients 1 to 60 months old (median 12) have undergone a bidirectional Glenn operation. Diagnoses included hypoplastic left heart syndrome in 21 patients, pulmonary atresia with intact ventricular septum in 10, tricuspid valve atresia in 9, other complex univentricular heart defects in 9, and Ebstein's anomaly in 1. Mean pulmonary vascular resistance was 2.2 [+ or -] 0.2 Wood U (range 0.5 to 7.3) and mean pulmonary artery area Nakata index was 318 [+ or -] [mm.sup.2/m.sup.2] (range 80 to 821). Additional procedures were performed in 17 patients, including pulmonary artery reconstruction in 15 (29%) and bilateral caval anastomoses in 5 (10%). There were 4 hospital deaths (8%). Two deaths resulted from myocardial infarction in patients with pulmonary atresia with intact ventricular septum and sinusoids and 1 from severe pulmonary vascular disease in a patient with hypoplastic left heart syndrome. There was 1 late death from pneumonia. Actuarial survival is 92 [+ or -] 4% at 1 month and beyond, with a mean follow-up of 13.4 [+ or -] 1 months. Risk factor analysis showed that pulmonary vascular resistance >3 Wood U and pulmonary artery distortion were associated with increased mortality. Twelve patients have undergone a Fontan procedure at a mean duration after bidirectional Glenn of 18 months with 1 death (8%). The bidirectional Glenn procedure provides excellent palliation in high-risk patients and appears useful as a staging procedure before Fontan correction.

Published
1993

32. 2017 AHA/ACC Key Data Elements and Definitions for Ambulatory Electronic Health Records in Pediatric and Congenital Cardiology: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards

Author

Boris, Jeffrey R., primary, Béland, Marie J., additional, Bergensen, Lisa J., additional, Colan, Steven D., additional, Dangel, Joanna, additional, Daniels, Curtis J., additional, Davis, Christopher, additional, Everett, Allen D., additional, Franklin, Rodney, additional, Gaynor, J. William, additional, Gray, Darryl T., additional, Hirsch-Romano, Jennifer C., additional, Jacobs, Jeffrey P., additional, Jacobs, Marshall, additional, Jeffries, Howard, additional, Krogmann, Otto Nils, additional, Lomotan, Edwin A., additional, Lopez, Leo, additional, Marelli, Ariane, additional, Martin, Gerard R., additional, Matherne, G. Paul, additional, Mavroudis, Constantine, additional, McCardle, Ken, additional, Pearson, Gail D., additional, Rosenthal, Geoffrey, additional, Scott, John S., additional, Serwer, Gerald A., additional, Seslar, Stephen S., additional, Shaddy, Robert, additional, Slesnick, Timothy, additional, Vener, David F., additional, Walters, Henry L., additional, and Weinberg, Paul M., additional

Published
2017
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33. 2017 AHA/ACC Key Data Elements and Definitions for Ambulatory Electronic Health Records in Pediatric and Congenital Cardiology

Author

Boris, Jeffrey R., primary, Béland, Marie J., additional, Bergensen, Lisa J., additional, Colan, Steven D., additional, Dangel, Joanna, additional, Daniels, Curtis J., additional, Davis, Christopher, additional, Everett, Allen D., additional, Franklin, Rodney, additional, Gaynor, J. William, additional, Gray, Darryl T., additional, Hirsch-Romano, Jennifer C., additional, Jacobs, Jeffrey P., additional, Jacobs, Marshall, additional, Jeffries, Howard, additional, Krogmann, Otto Nils, additional, Lomotan, Edwin A., additional, Lopez, Leo, additional, Marelli, Ariane, additional, Martin, Gerard R., additional, Matherne, G. Paul, additional, Mavroudis, Constantine, additional, McCardle, Ken, additional, Pearson, Gail D., additional, Rosenthal, Geoffrey, additional, Scott, John S., additional, Serwer, Gerald A., additional, Seslar, Stephen S., additional, Shaddy, Robert, additional, Slesnick, Timothy, additional, Vener, David F., additional, Walters, Henry L., additional, and Weinberg, Paul M., additional

Published
2017
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35. Development of Quality Metrics in Ambulatory Pediatric Cardiology

Author

Chowdhury, Devyani, primary, Gurvitz, Michelle, additional, Marelli, Ariane, additional, Anderson, Jeffrey, additional, Baker-Smith, Carissa, additional, Diab, Karim A., additional, Edwards, Thomas C., additional, Hougen, Tom, additional, Jedeikin, Roy, additional, Johnson, Jonathan N., additional, Karpawich, Peter, additional, Lai, Wyman, additional, Lu, Jimmy C., additional, Mitchell, Stephanie, additional, Newburger, Jane W., additional, Penny, Daniel J., additional, Portman, Michael A., additional, Satou, Gary, additional, Teitel, David, additional, Villafane, Juan, additional, Williams, Roberta, additional, Jenkins, Kathy, additional, Campbell, Robert, additional, Chowdhury, Devyani, additional, Behera, Sarina, additional, Hokanson, John, additional, Lu, Jimmy, additional, Kakavand, Bahram, additional, Boris, Jeff, additional, Cardis, Brian, additional, Bansal, Manish, additional, Schultz, Amy, additional, O'Connor, Matthew, additional, Vinocur, Jeffrey M., additional, Halnon, Nancy, additional, Johnson, Jonathan, additional, Barrett, Cindy, additional, Graham, Eric, additional, Krawczeski, Catherine, additional, Franklin, Wayne, additional, McGovern, James, additional, Hattendorf, Brandy, additional, Cotts, Timothy, additional, Davidson, Alex, additional, Harahsheh, Ashraf, additional, Johnson, Walter, additional, Jone, Pei-Ni, additional, Sutton, Nicole, additional, Tani, Lloyd, additional, Dahdah, Nagib, additional, Portman, Michael, additional, Mensch, Deborah, additional, Newburger, Jane, additional, Hougen, Thomas, additional, Cross, Russell, additional, Diab, Karim, additional, Peuster, Matthias, additional, Schiff, Russell, additional, Saarel, Elizabeth, additional, Serwer, Gerald, additional, Edwards, Tom, additional, Penny, Daniel, additional, Carlson, Karina, additional, Jayakumar, K. Anitha, additional, Park, Matthew, additional, Tede, Nikola, additional, Uzark, Karen, additional, Baker Smith, Carissa, additional, Fleishman, Craig, additional, Connuck, David, additional, Ettedgui, Jose, additional, Likes, Maggie, additional, and Tsuda, Takeshi, additional

Published
2017
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37. 2016 ACC/ASE/ASNC/HRS/SCAI Health Policy Statement on Integrating the Healthcare Enterprise

Author

Windle, John R., primary, Katz, Alan S., additional, Dow, J. Paul, additional, Fry, Edward T.A., additional, Keller, Andrew M., additional, Lamp, Terran, additional, Lippitt, Alexander, additional, Paruche, Marianne P., additional, Resnic, Frederic S., additional, Serwer, Gerald A., additional, Slotwiner, David J., additional, Tcheng, James E., additional, Tilkemeier, Peter L., additional, Weiner, Bonnie H., additional, and Weintraub, William S., additional

Published
2016
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47. Implantable Cardioverter Defibrillator Therapy for Life-Threatening Arrhythmias in Young Patients

Author

University of Michigan Congenital Heart Center, Women's Hospital, UMHS, L1242, Box 0204, Ann Arbor, MI, 48109-0204, Ann Arbor, Stefanelli, Christopher B., Bradley, David J., Leroy, Sarah, Dick, Macdonald II, Serwer, Gerald A., Fischbach, Peter S., University of Michigan Congenital Heart Center, Women's Hospital, UMHS, L1242, Box 0204, Ann Arbor, MI, 48109-0204, Ann Arbor, Stefanelli, Christopher B., Bradley, David J., Leroy, Sarah, Dick, Macdonald II, Serwer, Gerald A., and Fischbach, Peter S.

Abstract

Objectives: This study examined the indications, efficacy and outcomes of implantable cardioverter defibrillator (ICD) use in the pediatric population.

Published
2006

48. Electrogram Patterns Associated with Successful Radiofrequency Ablation of Accessory Pathways in Children

Author

Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI 48109-0204, USA, US, Ann Arbor, Serwer, Gerald A., Leroy, Sarah, Schwartz, S.M., Dick, Macdonald II, Dorostkar, Parvin C., Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI 48109-0204, USA, US, Ann Arbor, Serwer, Gerald A., Leroy, Sarah, Schwartz, S.M., Dick, Macdonald II, and Dorostkar, Parvin C.

Abstract

Electrograms observed prior to successful and unsuccessful ablation trials in 33 patients (362 attempts) with manifest pathways and 18 patients (194 attempts) with concealed pathways were compared to identify the electrogram patterns that are associated with successful radiofrequency ablation of accessory atrioventricular connections in young patients (mean age 12.7 years; range 4???22 years). Success was defined as permanent or transient interruption of conduction in the accessory connection. Predictors of success in patients with manifest pathways were local ventricular preexcitation (p = 0.0001), left-sidedness (43 or 174) of the accessory connection compared (p = 0.04) to right-sidedness (27 of 172), a probable Kent bundle potential (29 of 84 versus 39 of 256; p = 0.0001), and short antegrade atrioventricular conduction intervals (53.1?? 31.9 ms versus 64.6?? 32.0 ms; p = 0.02). Predictors of success in patients with concealed pathways were short ventriculoatrial conduction times (103.3?? 35.8 ms versus 117.9?? 34.8 ms; p = 0.01), and left-sided (42 of 125) pathways (p = 0.03; versus right-sided, 11 of 60). The presence of a Kent bundle potential was not significant. We conclude that specific electrogram patterns can predict successful ablation of either manifest or concealed accessory pathways. Use of these criteria may reduce the delivery of unnecessary energy to young myocardium.

Published
2006

49. Two-dimensional and Doppler echocardiographic evaluation after arterial switch repair in infancy for complete transposition of the great arteries

Author

From the Departments of Pediatrics and Surgery, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, Michigan, U.S.A., Martin, Monica M., Snider, A. Rebecca, Bove, Edward L., Serwer, Gerald A., Rosenthal, Amnon, Peters, Jane, Pollock, Patricia, From the Departments of Pediatrics and Surgery, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor, Michigan, U.S.A., Martin, Monica M., Snider, A. Rebecca, Bove, Edward L., Serwer, Gerald A., Rosenthal, Amnon, Peters, Jane, and Pollock, Patricia

Abstract

The most recent postoperative echocardiographic examinations of all children who underwent arterial switch repair of transposition of the great arteries from August 1985 to December 1987 were reviewed. The patients included 35 children whose age at operation was 12 +/- 16 days and whose weight was 3.6 +/- 0.4 kg. Thirty-three patients are alive and well; 1 died intraoperatively and 1 died immediately postoperatively. The time of the follow-up echocardiographic examination ranged from 1 day to 2.5 years (mean 9.2 months) with 11 patients examined>1 year after surgery. Complete examination of the repair site was possible in all patients. Echocardiographic visualization of distortion of the great arteries at the suture lines was seen in all patients; however, Doppler evidence of hemodynamically significant obstruction at the repair site was uncommon. On Doppler examination in the surviving 33 patients, 16 had no supravalvular pulmonary stenosis and 14 had mild to moderate supravalvular pulmonary stenosis with peak systolic pressure gradients ranging from 16 to 56 mm Hg (mean 31). Three patients had severe supravalvular pulmonary stenosis and peak systolic pressure gradients of 66, 74 and 77 mm Hg (2 have had reoperation, 1 is awaiting surgery). On Doppler examination, 4 patients had mild supravalvular aortic stenosis with peak systolic gradients ranging from 10 to 29 mm Hg. Doppler gradients were confirmed in 10 patients who had catheterization 12 +/- 3 months after surgery. Three patients had mild pulmonary regurgitation by Doppler examination, 5 had mild aortic regurgitation, 4 had mild tricuspid regurgitation and 2 had mild mitral regurgitation. In all 33 patients, ventricular dimensions, left ventricular shortening fraction (42 +/- 6%) and rate-corrected mean velocity of circumferential fiber shortening (1.25 +/- 0.24 circumference/s) were normal.

Published
2006

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