Gaps

Alert Triage Workflow for CIED Remote Monitoring Clinics

A standardized, evidence-based framework for managing CIED remote monitoring alerts in outpatient device clinics. Includes a color-coded triage algorithm (RED/YELLOW/GREEN), complete SOP, staff training materials, and interactive metrics dashboard that…

A Systems-Based Quality Improvement Protocol: Preventing Lost-to-Follow-Up in Cardiac Device Patients

There is a need to establish a standardized process for identifying, contacting, and re-engaging cardiac device patients who have become inactive in remote monitoring or clinic follow-up, in order to…

Reducing Missed Remote Device Monitoring Alerts: A Quality Improvement Playbook

Missed remote monitoring alerts and unclear escalation pathways represent common, preventable system failures in cardiac device programs, particularly in community and hybrid care settings. These gaps can delay clinical response,…

Index of Device Markers

Quick Reference List of all cardiac devices markers and their meaning.

Arrhythmias in Pregnancy

Journal Articles: Increasing maternal mortality and incidence of arrhythmias in pregnancy have been noted over the past 2 decades in the United States. Pregnancy is associated with a greater risk of arrhythmias, and patients with a history of arrhythmias are at significant risk of arrhythmia recurrence during pregnancy. The incidence of atrial fibrillation in pregnancy is rising. This review discusses the management of tachyarrhythmias and bradyarrhythmias in pregnancy, including management of cardiac arrest. Management of fetal arrhythmias are also reviewed. For patients without structural heart disease, bblocker therapy, especially propranolol and metoprolol, and antiarrhythmic drugs, such as flecainide and sotalol, can be safely used to treat tachyarrhythmias. As a last resort, catheter ablation with minimal fluoroscopy can be performed. Device implantation can be safely performed with minimal fluoroscopy and under echocardiographic or ultrasound guidance in patients with clear indications for devices during pregnancy. Because of rising maternal mortality in the United States, which is partly driven by increasing maternal age and comorbidities, a multidisciplinary and/or integrative approach to arrhythmia management from the prepartum to the postpartum period is needed. (J Am Coll Cardiol EP 2022;8:120–135) © 2022 by the American College of Cardiology Foundation.

AFC Scale and Growth

Presentations and Graphics: Infographic depicting considerations, challenges, and questions to address when managing AFib clinic growth.

EP News – QI and Outcomes – APR 2021 AF Quality Indicators (Sandhu)

Journal Articles: Understanding the quality of atrial fibrillation (AF) care delivery is critically important for identifying care gaps, targeting improvement efforts, and guiding resource allocation. In this effort, several professional societies have defined a series of AF quality indicators (QIs) that can be used to monitor adherence to evidence-based processes and AF-related outcomes. In Canada, this effort has been led by the Canadian Cardiovascular Society (CCS). On behalf of the CCS AF QI Working Group, in this issue of Heart Rhythm Journal, we summarize our process for defining and measuring AF QIs, present 2 recent publications reporting national data on key AF Qis, and discuss challenges encountered and future directions.