Dr Ian Weisberg

  Dr. Ian Weisberg Abstract Objective: Limited published data show outcomes in patients with cardiovascular implantable electronic device (CIED) reimplantation on the same day that a CIED is removed due to isolated pocket infection. Methods: A retrospective, cohort study was performed in consecutive patients undergoing CIED extraction for infection from 1999–2008. We analyzed the cohort for patient and infection characteristics as well as for procedure indications, details, and outcomes. Results: Forty-nine patients [mean age 70.6 years; 44 (88%) male] of 138 (36%) infection extractions underwent same-day CIED reimplantation following successful complete extraction for an isolated pocket infection. These patients had pocket swelling, fistula, and/or erosion; blood cultures grew no organisms and no vegetations were seen with TEE. Thirty-six patients (76%) were pacemaker-dependent and 7 (14%) had CRT devices. The mean time from the most recent CIED procedure to infection was 13.8 m...

  Dr. Ian Weisberg Matthew P Smelley 1 , Dipak P Shah , Ian Weisberg , Susan S Kim , Albert C Lin , John F Beshai , Martin C Burke , Bradley P Knight Abstract Introduction: The purpose of this study was to determine the safety and efficacy of using a novel radiofrequency (RF) powered transseptal needle to perform transseptal puncture (TSP). Methods: TSP was performed in 35 consecutive patients undergoing left-sided catheter ablation (mean age = 51 years; male = 71%) using a RF powered transseptal needle (NRG, Adult Large and Standard Curve C1, 71 cm, Baylis Medical Company, Inc.). Prior TSP had been performed in 34% of patients. The transseptal apparatus was positioned with the tip of the dilator engaged in the fossa ovalis. RF energy was delivered to the tip of the transseptal needle using a proprietary RF generator at 10 W for 2 seconds as gentle pressure was applied to the needle. Results: In 5 of the 41 TSPs, the needle crossed into the left atrium before RF energy was deliver...

  Dr. Ian Weisberg Dr. Ian Weisberg , Shrojal M. Desai PhD, Paul O. Davison MS, Dipak P. Shah MD, Jose Baez-Escudero MD, John F. Beshai MD, Martin C. Burke DO and Bradley P. Knight MD. University of Chicago Medical Center, Chicago IL, Boston Scientific CRM, St. Paul MN, Peak Surgical Incorporation, Palo Alto CA Abstract Introduction: Standard electrocautery can cause thermal injury to the insulation of transvenous pacing and defibrillation leads. There is a novel surgical cutting blade that uses pulsed radiofrequency (RF) to generate a plasma-mediated discharge along the exposed rim of an insulated blade, creating an effective cutting edge while minimizing collateral thermal damage. The purpose of this study was to determine the effects of electrocautery using the pulsed RF blade on transvenous lead insulation materials. Methods : A preparation of chicken breasts at 37°C was used with transvenous leads tunneled superficially. Energy was delivered using a standard cautery blade and ...

  Dr. Ian Weisberg - Medtronic Sprint Fidelis lead recall: determining the initial 5-year management cost to Medicare Abstract Background: The Medtronic Sprint Fidelis defibrillator lead has a high failure rate and was recalled in October 2007. Objective: The purpose of this study was to determine the incremental cost of the management of this lead to Medicare. Methods: Real hospital cost data in U.S. dollars were collected on 32 patients with a Medtronic Sprint Fidelis lead who underwent lead revision. Of these patients, 15 were excluded because they had insurance coverage other than that provided by the Centers for Medicare & Medicaid Services. Seventeen patients with Medicare or Medicaid coverage underwent lead revision either electively (n = 6) or after being hospitalized for multiple shocks caused by a lead fracture (n = 11). Eighty-eight percent of the patients underwent extraction of the Fidelis lead at the time of lead revision. A decision model was made that outl...

  Dr. Ian Weisberg - Late Potential at the High Ventricular Septal Level in a patient with Brugada: Possible mechanisms and Clinical implications Case report A 34-year-old Mexican immigrant was referred for symptomatic paroxysmal atrial fibrillation. A baseline electrocardiogram (ECG) in sinus rhythm showed type 1 Brugada pattern with right bundle branch block and negative T waves as well as ST-segment elevation in V1-V3. The patient had no prior history of ventricular arrhythmia, syncope, or cardiac arrest. However, a positive family history of sudden cardiac death (brother died at age 20) prompted referral to our service for further risk Discussion Ventricular late potentials and wide and fractionated electrograms, which reflect delayed and fragmented ventricular conduction, have been reported in both the epicardium 1and endocardium 2of patients with Brugada syndrome (BS). Marked regional endocardial conduction delay and heterogeneities in repolarization exist in these pati...