I read with great interest the editorial by Fuster [(1)][1], detailing both expanded recommendations to address the global burden of cardiovascular disease and the necessity for evaluating implemented recommendations by measuring outcomes. These are important steps to address a crisis unappreciated

Cardiac catheterization from radial artery access is observed to cause increased heart rate via oversensing in ipsilateral rate adaptive pacemaker. The mechanism of this phenomenon is discussed. This interaction was not observed in the setting of an implanted cardiac defibrillator.

Several high profile cases have called into question whether interventionalists are performing percutaneous coronary interventions (PCI) on lesions that are not flow limiting. We hypothesized that in northern New England there is agreement among interventionalists on what vessel segments have flow

Distal embolization during saphenous vein graft angioplasty may result in myocardial infarction. The use of dual nonocclusive filter wire during angioplasty in a bifurcating saphenous vein graft is described.

Environmental interference with implanted rhythm management devices may result in inappropriate pacemaker inhibition and bradycardia or inappropriate stimulation and tachycardia. In permanent rate adaptive pacemakers with motion-based activity sensors or unipolar electrodes, this interference may be particularly problematic. We report the first case of repeated, prolonged exposure of a unipolar, motion-based rate adaptive pacemaker system in a pacemaker-dependent patient without sequelae.