Single chamber or dual chamber pacemaker? Cardiology Basics
The decision between single chamber and dual chamber pacemaker though important based on cost, device longevity and complication wise, is not that easy to make. I am trying to summarize based on the 2018 American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines on this aspect [1]. In underprivileged regions, given an option, there is always a potential bias towards single chamber devices as they are cheaper, tend to have more battery life, easier to implant and likely to have lesser procedure and lead related issues.
In symptomatic sinus node dysfunction, with correlation between symptoms a...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
A man in his 30s with cardiac arrest and STE on the post-ROSC ECG
Conclusions: outpatients with witnessed cardiac arrest and primary PEA carry a high probability of Massive Pulmonary Embolism________________Case Continued:" Initial ROSC EKG showed what appeared to be in atrial fibrillation with inferior ST elevations, depressions in aVL, concerning for STEMI. "He had multiple cardiac arrests with ROSC regained each time. " Endotracheal tube re-intubation was confirmed multiple times, bilateral breath sounds, yet O2 saturation remained in the 50s and 60s. I was able to visualize the ETT on initial intubation pass through the cords however given his continued hypoxemia, I felt it...
Source: Dr. Smith's ECG Blog - October 10, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
How is thyroid linked to heart disease? Cardiology Basics
Disorders of thyroid gland can cause heart disease in multiple ways. Heart disease can occur with both hypothyroidism and hyperthyroidism. In hyperthyroidism, heart rate increases and there is a hyperdynamic circulatory state which can lead to high output cardiac failure. Unlike in the usual congestive heart failure in which the extremities are cold due to vasoconstriction, in heart failure due to hyperthyroidism, the extremities are warm. Instead of a low volume pulse in usual heart failure, thyrotoxic heart failure has a high volume pulse.
Another important cardiac problem in hyperthyroidism is atrial fibrillation with ...
Source: Cardiophile MD - October 5, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Pulsed field ablation of cardiac arrhythmia
Commonest form of ablation of cardiac arrhythmias uses radiofrequency current delivered through a catheter to produce localised tissue heating and damage of the arrhythmic circuit. Pulsed-field ablation is a novel modality which employs a train of microsecond duration high amplitude electrical pulses that ablate myocardium by electroporation of the sarcolemmal membrane without measurable tissue heating. The ablation pulse waveform has multiple variable components that affect ablation efficacy and is different for different equipment [1].
Success of pulse field ablation depends on the proximity of the electrode to the targ...
Source: Cardiophile MD - October 2, 2022 Category: Cardiology Authors: Johnson Francis Tags: ECG / Electrophysiology Source Type: blogs
Coffee good for heart health – Large study
Coffee good for heart health – Large study
Usually physicians, including me, ask patients with cardiovascular disease to avoid coffee, especially for those with cardiac arrhythmia [1]. Now, here is a study which says that taking 2-3 cups of decaffeinated, ground or instant coffee a day is associated with significant reductions in incident cardiovascular disease and mortality. Even more, ground and instant coffee, but not decaffeinated coffee was associated with reduced arrhythmia [2].
In fact, coffee consumption at 3-4 cups per day has been described as probably not harmful and perhaps even moderately beneficial in t...
Source: Cardiophile MD - September 30, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Atrial functional mitral regurgitation
Atrial functional mitral regurgitation occurs secondary to left atrial disease, without left ventricular dilatation and intrinsic mitral valve disease. Atrial functional MR typically occurs in the setting of long-standing atrial fibrillation. It is associated with increased mortality risk and hospitalization for heart failure [1]. Reported prevalence of atrial functional MR in patients with AF vary between 3 to 15%. These patients have worse clinical outcome [2].
Dilatation of the mitral annulus, atriogenic tethering of mitral leaflets and insufficient mitral leaflet remodeling are thought to be important pathogenic mecha...
Source: Cardiophile MD - September 28, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Contrasting results of REDUCE-IT and STRENGTH trials of Omega 3
Contrasting results of REDUCE-IT [1] and STRENGTH [2] trials of Omega 3 fatty acid preparations have caught the attention of scientific community. Icosapent ethyl, a highly purified eicosapentaenoic acid ethyl ester was evaluated in REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention Trial). In STRENGTH trial carboxylic acid formulation of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were used.
REDUCE-IT was a multicenter, randomized, double blind, placebo controlled trial. Patients enrolled had established cardiovascular disease or diabetes with other risk factors. They were rece...
Source: Cardiophile MD - September 27, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Finerenone, a non-steroidal MRA
Finerenone is a nonsteroidal, selective mineralocorticoid receptor antagonist. Finerenone is thought to have lower risk of hyperkalemia and renal issues compared to other MRAs. It has been shown to reduce albuminuria in patients with chronic kidney disease and type 2 diabetes mellitus. FInerenone in reducing kiDnEy faiLure and dIsease prOgression in Diabetic Kidney Disease (FIDELIO-DKD) study evaluated the renal and cardiovascular outcomes in patients with CKD and type 2 diabetes mellitus. 5734 patients with CKD and type 2 diabetes were randomized to finerenone or placebo. All patients were on renin-angiotensin system blo...
Source: Cardiophile MD - September 24, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Implantable cardioverter defibrillator (ICD)
Implantable cardioverter defibrillator, known in short as ICD, is a device which monitors the heart rhythm continuously and treats it electrically when needed. As it functions automatically without the need for a bystander intervention as in automated external defibrillator or AED, it is also known as automatic implantable cardioverter defibrillator or AICD. When Michel Mirowski reported on a standby automatic defibrillator in 1970, it was met with a lot of skepticism [1]. But now ICD is a time tested life-saving equipment.
The most commonly implanted ICD is also called transvenous ICD because the leads are introduced thr...
Source: Cardiophile MD - September 19, 2022 Category: Cardiology Authors: Johnson Francis Tags: ECG / Electrophysiology Source Type: blogs
Assessment of right ventricular diastolic function
Assessment of right ventricular diastolic function is often done by echocardiography, though not as commonly as for the left ventricle. An RV focussed apical four chamber view is used for the assessment of right ventricle. In RV focussed view, transducer is adjusted from the standard apical four chamber view to have right ventricle in the centre of the image than the usual image centered on the left ventricle. The left ventricular outflow tract should not come into the view and left ventricular apex should remain at the top of the image sector. In this adjusted view, the entire right ventricular free wall should be visibl...
Source: Cardiophile MD - September 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: Echocardiography Source Type: blogs
Vitamin K antagonist superior to DOAC in RHD with AF – INVICTUS study
Vitamin K antagonist superior to DOAC in RHD with AF – INVICTUS study
The INVICTUS program (INVestIgation of rheumatiC AF Treatment Using VKA) was designed as an open label parallel group trial comparing treatment with vitamin K antagonists or rivaroxaban, in rheumatic heart disease with atrial fibrillation [1]. It was an international multicentre randomized study. A registry of 17,000 patients was also planned to document the contemporary clinical course of patients with RHD, including a focused sub-study on pregnant women with RHD within the registry. RHD is considered as a neglected disease affecting 33 million pe...
Source: Cardiophile MD - September 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Weekly Overseas Health IT Links –10th September, 2022.
This article is adapted fromVoices in the Code: A Story About People, Their Values, and the Algorithm They Made,out Sept. 8 from Russell Sage Foundation Press.In May 2021, I got a call I never expected. I was working on abook about A.I. ethics, focused on the algorithm that gives out kidneys to transplant patients in the United States. Darren Stewart —a data scientist from UNOS, the nonprofit that runs the kidney allocation process—was calling to get my take: How many decimal places should they include when calculating each patient’s allocation score? The score is an incredibly important number, given it determines w...
Source: Australian Health Information Technology - September 10, 2022 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
Bonus Features – August 28, 2022 – Epic data shows only 5% of OD patients get tested for fentanyl, 40% of clinicians plan to add AI to their day-to-day work, and more
This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job.
News and Studies
A report from Epic Research and the University of Maryland’s Center for Substance Abuse Research (CESAR) found that just 5% of overdose patients are tested for fentanyl in the ED, compared to an opiate t...
Source: EMR and HIPAA - August 28, 2022 Category: Information Technology Authors: Brian Eastwood Tags: AI/Machine Learning Analytics/Big Data C-Suite Leadership EMR-EHR Health IT Company Healthcare IT Hospital - Health System Bamboo Health BronxCare Health System Cadence CalOptima Health CESAR Clarify Health CloudDx Conduit Heal Source Type: blogs
Biofourmis Raises Additional Funding from Intel Capital in Series D Extension and Names Top Healthcare Leaders to its Board
Additional funding brings Series D round to $320M total
Trevor Fetter, MBA, senior lecturer on the faculty of Harvard Business School and former longtime Tenet Healthcare chairman and CEO, named to Board
Sachin H. Jain, physician executive with government, pharmaceutical, payer and provider experience, joins Board
Biofourmis, a Boston-based global leader in virtual care and digital medicine, today announced that Intel Capital, the strategic investment arm of chipmaker Intel Corporation, has joined its Series D financing in an extension that brings the total funding raised in the round to $320M. The initial Series D funding...
Source: EMR and HIPAA - August 25, 2022 Category: Information Technology Authors: Healthcare IT News Tags: Health IT Company Healthcare IT Biofourmis Health IT Funding Health IT Fundings Health IT Investment Home-Based Care Intel Capital Kuldeep Singh Rajput Mark Rostick NYSE:CVS Sachin H. Jain Trevor Fetter Source Type: blogs
Why “ Isolation of pulmonary veins ” and “ Arrest of AF ” may turn out to be two different events !
AF is not only the most common cardiac arrhythmia,it is also an extensively researched entity in cardiology literature. We are trying to rein in, this arrhythmia for the past three decades with multiple strategies. Drugs, pacemakers, ICDs devices, surgical cuts, RF catheters, and the latest technique is trying to frostbite the atrial electrical circuits with ICE. ( Karl-Heinz Kuck,N Engl J Med 2016 )
It is believed that up 60% of AF originate from pulmonary veins. What does it mean? So, when we blindly suggest PV Isolation routinely for all PAF, there is 40% futility straightaway! Apart from the hugely variable anatom...
Source: Dr.S.Venkatesan MD - August 19, 2022 Category: Cardiology Authors: dr s venkatesan Tags: Atrial fibrillation Uncategorized affirm trial CABANA trial fire and ice study atrial fibrillation pulmonary vein isolation race trial rate vs rhythm control in af RF ablation for af right atrial focus in atrial fibrillation svc focus Source Type: blogs
