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Heart Rhythm Society Meeting Tseng Article on Taser Research Bias 2011

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3ession V

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,,,'ng ODOV (OR: 15.23); increasing OLRDSLTV (OR:
I -Ole PPHB occurring earlier aller procedure would be

POS-174

'i~
'ficulty recovered.
liusions: The outcome of PPHB after transcatheter closure

FUNDING SOURCE AND AUTHOR AFFILIATION SEVERELY
BIASES TASER RESEARCH

Ii', SDs was good because most of the PPHB could revere
Iral sinus rhythm. DLROSLTV,OAVD and ODOV were the
:'1 =- criterion to predict the occurrence of newly-developed
':~- transcatheter closure of PMVSOs.

Peyman Azadani, MD, Zian H. Tseng, MD, Gregory Marcus, MD
and Byron K. Lee, MD. University of Calilornia San Francisco,
San Francisco, CA

I

r~73

~ LEAD EXTRACTION IN CONGENITAL HEART
~SE

.,,. C. McCan/a, MD, Michael P. Carboni, MD. Melissa H.
\ ", '0, Ruth Ann Greenfield, MD, Patrick M. Hr'anitzky, MD
-r3id J.

~

Kanter, MD. Duke University, Durham, NC

'otion: Laser lead extraction (LLE) in congenital heart
:: \CHD) is a promising modality for patients (pts) requiring
I; device therapy. To date there is little experience 'with
I""s population.
'os: This is a retrospective, case-controlled (gender- &
!,'-ate age-matched, without CHD) analysis of all CHD
r 2002-2010 at a single institution who undelWent LLE
;: sxtraction modality. Characteristics of interest included
I=~s, durations of lead in situ, anatomic lead locations,
• ".chanisms & lead types. The primary oufcome
::0 success rate. Secondary outcomes included death,
ci.i:ons & factors related to LLE failure.
22 pts undelWent 24 procedures 10 extract 36 leads.
gnoses included: atrial switch for d-transposition
.:,=11); repaired double outlet right venfricle (2); repaired
;c:al defect (2); unrepaired I-TGA (2); and repaired
~' 01 Fallot, AV septal defect, d-TGAiventricular septal
'SO), I-TGAiVSD, and subaortle stenosis (1 each)

I"

t30hics and Results

CHD (n=24 LLE) C;O~:rOIS (n=24
LLE
~; ~

at extraction
,,,srs)
Sl.elght at
,C .,anoe, ko)
'"arcn in situ
. SO, months)
:-:: fasered

~;e

leads (%)

:;.tation leads (%»
: ·,iy using LLE

p
value

35 (12-62)

29 (10-57)

78 (54-121)

73 (47-138)

0.62

94 ±54

79 ±52

0.24

\36 I~~ A, 20 V,
1 CS
4 (11%)

37 ~~A, 24 V,
1 CS
t4 (38%)

<0.01

3(8%)

10 (27%)

0.13

26 (72%)

36 (97%)

!,,0.01

0.47

:S=coronary sinus, V=ventricular
D pfs, LLE failure was not associated with lead
\.. situ; prior atrial switch; or lead location, type, or
lechanism. 7 of the 10 leads for which LLE was
i,'ul were successfully extracted using other methods
:"anical-rotational device, 2 by surgical extraction).
:ations were observed in the CHD group whereas 1
"'1onary embolism) was observed in the control group.
ons: (1) Pis with CHD are less likely to have
LLE than controls. (2) LLE appears to be safe in CHD
13ults from LLE after atrial switch operation are similar
'-:0 pts having 2 ventricles.

I....

Introduction: Controversy exists regarding the safety of
electrical stun guns (TASERs). We sought to determine if funding
source or author affiliation biases research on TASERs.
Methods: Medtine was searched for TASER or electrical
stun-gun studies. All human and animal studies published
up to September 01, 2010 were included. Reviews, editorial
letters, and case reports were excluded from Ihe analysis.
Two independent reviewers evaluated each study for funding
source(s), author affiliations, and conclusions with regard to
TASER safety. Study conclusions were classified as harmfUl,
probably harmful, unlikeiy harmful and not harmful.
Results: Filly two studies were reviewed: 34 (65%) were human
studies and 18 (35%) were animal studies. Forty·six percent
(n=24) of the studies were lunded by TASER International or
were written by an author affiliated with the company. Of these
24, 23 (96%) concluded that TASERs are unlikely harmful (29%)
or not harmful (67%). In contrast, of the studies not affiliated with
TASER International, only 15 (54%) concluded that TASERs
are unlikely harmful (29%) or not harmful (25%). A study with
any affiliation with TASER International was approximately 20
times more likely to conclude that the TASER is likely safe when
compared to studies without such affiliation (odds ratio 19.9,
95% confidence interval 2.4-168.6, p = 0.001).
Conclusions: Studies funded by TASER International andl
or written by an author affiliated with the company are
apprOXimately 20 times more likely to conclude that T':'.S"f's :;:'9
safe. This finding suggests that TASER Interna~iooa 5_:::~:;::
research may be severely biased and its leg!t'T:ac;.' S;";::';"': .'.~
questioned.

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0 ~ 01)

POS-17S
LEFT CARDIAC SYMPATHETIC DENERVATION
IN A PEDIATRIC PATIENT WITH HYPERTROPHIC
CARDIOMYOPATHY

Jonathan N. Johnson, MD, Katy M.. Harris, MS. RN, J. Martijn.
Bas, MD, PhD, Christopher Molr, MD, Yung R. Lau, MD and
Michael J. Ackerman, MD, PhD. Mayo School of Graduate
Medical Education, Rochesler, MN, University 01 Alabama at
Birmingham, Birmingham, AL
Introduction: Lell cardiac sympathetic denervation (LCSD),
initially performed for angina in the early 1900's, has been
used successfully in patients with Long QT Syndrome and
Catecholaminergic Poiymorphic Ventricular Tachycardia.
Here, we describe a patient with hypertrophic cardiomyopathy
(HCM) who undelWenl LCSD for his malignant, ventricular
fibrillation-prone HCM substrate in hopes of delaying cardiac
transplantation.
Methods: A 5-year-old male with severe HCM was referred.
After presenting with an out-of hospital cardiac arrest for which
he was successfully defibrillated, he was diagnosed with HCM
and an implantable cardioverter-deflbrillator (ICO) was placed
at the age of 3. He was symptom free for 8 months, however,
he subsequently had 5 appropriate ventricular fibrillation (VF)terminating shocks over the next 4 months. At that time, he
was referred to our institution for a second opinion regarding
denervation therapy for refractory arrhythmias in lieu oi cardiac
transplantation.
Results: The patient undelWent LCSO utilizing video-assisted