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Heart Rhythm Case Reports- August AHP article

  • 1.  Heart Rhythm Case Reports- August AHP article

    Posted 08-15-2022 15:36
    Colleagues,

    In the August issue of Heart Rhythm-Case Reports, we published a case of Twiddlers Syndrome with an S-ICD. Here is the link to the article for your reading interest.
    https://www.sciencedirect.com/science/article/pii/S2214027122001154

    Please consider a case or EP topic of interest you may want to publish in the Allied Health Professional (AHP) section of this great journal!!!
    There is no online access fee for our section. Instructions for submitting a manuscript to the AHP section are available on the journal's website.

    Best wishes for enjoying the remainder of the summer,
    Aileen Ferrick, PhD, RN, ACNP-BC, FHRS
    Nurse Practitioner and Asst. Director of Research EP Cardiology
    White Plains Hospital
    White Plains, NY



    ------------------------------
    Aileen Ferrick PhD, ACNP, RN, FHRS
    Nurse Practitioner/Clinical Researcher
    White Plains Hospital EP
    Valhalla NY
    914-261-8328
    ------------------------------


  • 2.  RE: Heart Rhythm Case Reports- August AHP article

    Posted 08-17-2022 05:53
    Dr. Ferrick,
    Congratulations on your case report! It was an excellent read. I've seen a few cases of S-ICD electrode dislodgment due to TS, and the ECGs looked almost identical to those in your case report. Fortunately, all were spared from traumatic inappropriate shocks (one never felt a shock because the electrode had retracted and coiled completely under the generator).

    When discussing TS cases with a vendor rep, I was told of a negative patient experience that he had years ago. He described trying to explain to a patient what was going on with her device and slipped in the term "twiddler" while speaking with her. She went home and did her research, and she called the clinic the next day in tears begging for the provider not to use the term twiddler in her chart. She explained that she was a foster parent, and she could not have anything in her medical history that could be misconstrued as a psychiatric diagnosis because it would jeopardize her privilege of fostering children. In her research, she discovered that TS is sometimes associated with anxiety disorders and obsessive-compulsive disorder. The rep told me that ever since that interaction, he refrained from using TS when talking with patients and instead refers to it as device manipulation and migration.

    In my own practice, I do see patients get defensive when there is a suggestion of device manipulation, even when it is explained that it can occur from subconscious actions. I'm interested to hear how others approach these discussions with patients when there is a high suspicion of manipulation by the patient vs other factors (e.g. too large of a pocket, body habitus, skin laxity, etc.). I usually start with a description of those events before ever approaching the idea of patient manipulation to avoid sounding as though I am laying blame on the patient. How do you approach this conversation with your patients?

    Thank you again for sharing an excellent case!

    Rebecca Yapejian, MSN, FNP-C, AACC



    Original Message


  • 3.  RE: Heart Rhythm Case Reports- August AHP article

    Posted 09-15-2022 17:56

    Hi everyone,

     

    Please continue to submit the work we do!  It really matters.  Much appreciate Dr. Ferrick's hard work and dedication to AHP communities and the work we do.  

     

     

    Regards,

     

    Martha G. Ferrara, DNP FNP CCDS FHRS

    Assistant Director EP Services

    White Plains Hospital

    HRS AP Council Chairwoman

    MFerrara3@wphospital.org

    @MGMayanrn

     




    Original Message


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