catlabrn

If I can go, I'll let you know.

I'm trying to get to NASPE, but my manager is being a pain. It's nice to see other EP types out there, especially lurking on an anesthesia forum. I,too, am considering anesthesia school.

Hello all-- I'm an EP nurse who does ICD implants and followup. This topic has been near and dear to my heart this week after we had a bovie-related "near-miss" in our EP lab. I just wanted to say that you really need to think twice before putting a magnet on any ICD. You can make the magnet response whatever you want it to be on implant in most devices. In some Guidant devices, a magnet will leave detection off until it's turned back on by a programmer. It's a better idea to just have a rep or one of your EP nurses turn detection off until after the procedure. We've been doing this in our facility, and it's been quite successful. And, yes, there are anti-atrial tachy pacers/ICD's out there and their success has been mixed at best. Medtronic offers one with a little remote control that will even let the "highly motivated" patient cardiovert himself with the help of a little keychain wand which looks like a car alarm keychain. To my knowledge, they haven't been tremendously popular. Thanks.

Try cutting back on caffeine. If the palpitations really interfere with your life, call a cardiologist. You may wind up with an implanted loop recorder to watch things for an extended period of time. They're easy to place and easy to remove.

Our docs usually have them stay flat 4-6 hours, depending on the particular physician (most use 6Fr. sheaths). With Angioseal and Perclose, most will allow them up after 1 hour. Many won't use closure devices, primarily because of a really baaaad experience we had with a closure device last year which resulted in a fatality.

You asked about pacing being a good area for nurses. Answer: ABSOLUTELY!! I work in a cath/EP lab where we do angiography, interventions, and all electrical procedures. All of us are trained to assist in the procedures, and three of us (I am one of them) have been trained to do the stimulation during electrophysiology studies and ablations. We also do the programming for new pacemakers and defibrillators, as well as the follow-up and troubleshooting while the patient is in the hospital. I like the challenge. It's also another skill to add to the old resume. Many EP nurses become pacemaker company representatives, although I'm not interested in that right now.