October, 2022

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Roundup: VUNO's at-home ECG device cleared in South Korea and more briefs

Mobi Health News - ECG

Also, Max Life in India has developed an analytics solution that detects inaccurate medical reports in real time.

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I'm so sorry when medics get abused for activating the cath lab

Dr. Smith's ECG Blog

Cortland Ashbrook from Spokane County, Washington, sent this message: Hey doctor Smith, I wondered if you’d give me your opinion on these ECG tracings I took as a paramedic in the field? Case: The call was an elderly gentleman who was at home when he experienced a sudden onset of vague chest discomfort along with nausea, and left arm aching. It started while walking, and began to decrease at rest but never fully resolved.

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What’s New in Ultrasound Tech – 2023 Edition

Cassling

While you weren’t looking, a lot has been happening in the field of ultrasound! New technologies, new workflows, new best practices. Over just a few short years, the potential uses of ultrasound have grown exponentially, and that means exciting things for you and your imaging team. Join us as we take a look at the latest developments in ultrasound you may have missed, even if you’re working on equipment that’s just a couple years old.

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Bioresorbable vascular scaffolds versus conventional drug-eluting stents across time: a meta-analysis of randomised controlled trials

Open Heart

Background Bioresorbable vascular scaffolds (BVS) were designed to reduce the rate of late adverse events observed in conventional drug-eluting stents (DES) by dissolving once they have restored lasting patency. Objectives Compare the safety and efficacy of BVS versus DES in patients receiving percutaneous coronary intervention for coronary artery disease across a complete range of randomised controlled trial (RCT) follow-up intervals.

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COVID19 vaccination

Dr. Malcolm Kendrick

25th October 2022 I have been somewhat quiet recently. I have started about ten blogs, then got bogged down …. possibly blogged down? Then stopped, and started again, then tore it all up – metaphorically. The problem is that I have been looking at COVID19 vaccination. There is much to say, maybe too much. However, one treads a very fine line here.

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Ep 175 Emergency Orthopedics Differential: SCARED OF Mnemonic – When X-rays Lie

ECG Cases

In this main episode podcast, Dr. Arun Sayal creator of the CASTED course and Dr. Yatin Chadha a radiologist with a fellowship in MSK radiology, join Anton for Part 1 of 2 podcasts on Emergency Orthopedic Injuries. This episode focuses on a differential diagnosis of MSK injuries that are occult to X-ray with the help of the SCARED OF mnemonic. It ensures we pick up all the “can’t miss” diagnoses that can be easily overlooked when we do not integrate a pointed history and physical exam with the X

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Roundup: Dozee to launch AI-powered ECG patch and more briefs

Mobi Health News - ECG

Also, Royal Philips has expanded the roll-out of its AR surgical navigation solution to Japan.

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Disrupting the Status Quo in Remote Patient Monitoring

Vector Remote

Introduction Medical technology has made remarkable advances in the last 50 years and continues to grow despite disruptions caused by the pandemic. The need to adapt to virtual healthcare solutions due to challenges from the coronavirus pandemic has spurred a trend in the growth of remote healthcare to benefit both patients and clinicians. Remote patient monitoring (RPM) is one area where The post Disrupting the Status Quo in Remote Patient Monitoring appeared first on Vector Remote Care.

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User experience and image quality influence on performance of automated real-time quantification of left ventricular function by handheld ultrasound devices: a diagnostic accuracy study with data from general practitioners, nurses and cardiologists

Open Heart

Background and objectives Echocardiography is the cornerstone of heart failure (HF) diagnosis, but expertise is limited. Non-experts using handheld ultrasound devices (HUDs) challenge the clinical yield. Left ventricular (LV) ejection fraction (EF) is used for assessment and grading of HF. Mitral annular plane systolic excursion (MAPSE) reflects LV long-axis shortening.

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The backlog of heart care in the UK – how AI algorithms can reduce queues for cardiologists?

Cardiomatics

Modern cardiology is currently facing many challenges. According to WHO , cardiovascular diseases are the leading cause of death worldwide. Therefore, it is crucial to provide better diagnostics and treatment to cardiac patients. One country that is currently struggling to reduce the number of patients with heart diseases is the United Kingdom. What are the obstacles causing this, and how can they be overcome?

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ECG Cases 36 – PACER Mnemonic for Approach to Pacemaker Patients

ECG Cases

In this month's ECG Cases blog Dr. McLaren explains the PACER mnemonic approach to patients with pacemakers: Pacemaker spike: is it appropriately presence/absent, is there pacemaker-mediated tachycardia (apply magnet) or is there failure to pace (apply magnet to stop sensing, cardio consult)? Aware (sensing): is it normal, is there oversensing (underpacing: apply magnet) or undersensing (treat reversible causes, cardio consult).

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Patient Centered Care and Communication Defined: How They Lead to Better Health Outcomes

Cassling

For many patients, hospital visits bring a lot of fear and uncertainty. Patients are thrown into an unfamiliar environment with minimal knowledge and lack the confidence to ask the questions they want to, leaving them feeling overwhelmed and lost. When providers don’t take the time to center the care and communication around their patient, it can lead to poor health outcomes.

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What is this rhythm? Back to basics.

Dr. Smith's ECG Blog

Submitted by Dr. Arjun J V in India, An elderly patient presented to the ED with multiple complaints. An ECG was recorded in triage: What do you think? Classic for those who have seen it before. The ECG shows a regular narrow complex rhythm which is difficult to see amongst the very severe high voltage artifact which is occurring with a frequency of approximately 300 cycles per minute.

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Remote Patient Cardiac Monitoring Cost – from Expense to Investment

Vector Remote

Remote cardiac monitoring collects information from patients’ implantable rhythm management devices and directly transmits data to a physician’s office, saving both the patient and clinic time and cost. This allows the medical team to review the results promptly and eliminates the need for a patient to be physically present. The benefits of remote patient monitoring are vital to the success of a cardiac clinic, The post Remote Patient Cardiac Monitoring Cost – from Expense to Investment appeared

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Percutaneous left atrial appendage occlusion discrepancy between randomised trials and clinical practice

Open Heart

In patients with atrial fibrillation and previous episodes of bleeding on oral anticoagulant treatment, left atrial appendage occlusion (LAAO) has emerged as an alternative way to decrease the risk of stroke. The use of the procedure has been on the rise, and the news coverage has been dominated by an uncritical acceptance of the benefit of this procedure, which probably have contributed to the increasing number of procedures.

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A behind-the-scenes look at the mSToPs clinical trial with Dr. Steinhubl.

iRythm Technologies

Interview with mSToPS clinical trial senior author Dr. Steven R. Steinhubl, Scripps Research, about monitoring and screening for undiagnosed atrial fibrillation.

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EM Quick Hits 43 Pediatric Cannabis Poisoning, Esophageal Perforation, Brugada, Career Transitions in EM

ECG Cases

On this month's EM Quick Hits podcast: Best of University of Toronto EM with Yaron Finkelstein on pediatric cannabis poisoning pitfalls, Brit Long on recognition and management of esophageal perforation, Jesse McLaren on 3 questions to diagnose Brugada Syndrome, Tahara Bhate on QI Corner, Constance Leblanc on maintaining wellness in career transitions from CAEP 2022.

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How the world now works – or doesn’t

Dr. Malcolm Kendrick

30th October 2022 [How fewer doctors means more doctors – it’s official] This blog has nothing to do with heart disease, or vaccines, or anything directly about medical practice at all. However, it does have a great deal to do with data manipulation, which is something very close to my heart. It also illustrates how a ‘fact’ can be anything but. I am also hoping to help highlight an increasingly worrying trend that now scours the planet.

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Emergency (ED placement) Transvenous Pacer appears to be working perfectly. What might go wrong?

Dr. Smith's ECG Blog

Thanks to our Electrophysiologists Omar Iqbal and Rehan Karim for the below strips and the explanations I will be giving on this post. A patient had 3rd degree AV block in the ED. A transvenous pacer was placed in the Emergency Department by the emergency physicians. Capture was obtained and a 12-lead ECG was recorded: What do you see here and what complication can occur?

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2023 STS Coronary Conference

Society of Thoracic Surgeons - Allied Health

Event 2023 STS Coronary Conference kchalko Tue, 10/25/2022 - 08:37 Event dates Jun 3–4, 2023 Loews Miami Beach Hotel Location Miami, Florida Thank you to all attendees, speakers, exhibitors, and supporters who made the 2023 STS Coronary Conference a success! Interested in attending next year? Fill out the interest list form to be notified when details are available.

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Artificial intelligence-enabled phenotyping of patients with severe aortic stenosis: on the recovery of extra-aortic valve cardiac damage after transcatheter aortic valve replacement

Open Heart

Objective A novel artificial intelligence-based phenotyping approach to stratify patients with severe aortic stenosis (AS) prior to transcatheter aortic valve replacement (TAVR) has been proposed, based on echocardiographic and haemodynamic data. This study aimed to analyse the recovery of extra-aortic valve cardiac damage in accordance with this novel stratification system following TAVR.

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Annals Celebrates “Peer Review Week”: Research Integrity and Priorities

Society of Thoracic Surgeons - Research

Webinar Annals Celebrates “Peer Review Week”: Research Integrity and Priorities kchalko Tue, 10/04/2022 - 08:43 September 22, 2022 In this STS webinar—scheduled during Peer Review Week (Sept 19-23)—"The Annals of Thoracic Surgery" Editor-in-Chief Joanna Chikwe, MD, FRCS, is joined by a panel of editors, editorial board members, and experts to highlight touchstones of publication ethics, how research drives quality and affects patient safety, and a focused discussion on research priorities for ou

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The Florida Study and the public health hypocrites

Dr. Anish Koka

On October 7th, 6 pm, the Florida Department of Health sent out a bulletin announcing new guidance from Florida Surgeon General Dr. Joseph Ladapo that recommended against males aged 18-39 years of age from receiving mRNA COVID-19 vaccines. This was based on a study commissioned by Florida that found an 84% increase in the relative incidence of cardiac-related death within 28 days after mRNA vaccination.

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Lipoprotein(a) levels in a global population with established atherosclerotic cardiovascular disease

Open Heart

Objective Lipoprotein(a) (Lp(a)) is an important genetically determined risk factor for atherosclerotic vascular disease (ASCVD). With the development of Lp(a)-lowering therapies, this study sought to characterise patterns of Lp(a) levels in a global ASCVD population and identify racial, ethnic, regional and gender differences. Methods A multicentre cross-sectional epidemiological study to estimate the prevalence of elevated Lp(a) in patients with a history of myocardial infarction, ischaemic st

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Benefits of support groups for patients living with implantable cardioverter defibrillators: a mixed-methods systematic review and meta-analysis

Open Heart

Background Patients with implantable cardioverter defibrillators (ICD) experience anxiety, depression and reduced quality of life (QoL). Objectives This mixed-methods systematic review evaluates whether ICD support groups have a beneficial effect on mental well-being. Methods Literature searches were carried out in MEDLINE, Embase, CINAHL, PsycINFO and Web of Science.

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Cardiac care of children with dystrophinopathy and females carrying DMD-gene variations

Open Heart

Objective We provide succinct, evidence-based and/or consensus-based best practice guidance for the cardiac care of children living with Duchenne muscular dystrophy (DMD) as well as recommendations for screening and management of female carriers of mutations in the DMD -gene. Methods Initiated by an expert working group of UK-based cardiologists, neuromuscular clinicians and DMD-patient representatives, draft guidelines were created based on published evidence, current practice and expert opinio

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Is there Terminal QRS Distortion?

Dr. Smith's ECG Blog

This ECG has ST Elevation in multiple leads. Is it normal STE? Or is it ischemic STE? What do you think? This ECG is interesting because it mimics TQRSD. There are no S-waves in V2 and V3. BUT look at the very prominent J-waves (J point notching)!! It is several mm high! This is a normal ECG. This patient had CO poisoning but did not have myocardial injury or OMI.

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Precordial Swirl -- 20 cases of Swirl or Look-Alikes

Dr. Smith's ECG Blog

Pendell (Pendell Meyers, of course), with a little help from Smith, coined a new LAD Occlusion pattern "Precordial Swirl," in which there is rightward STE vector, with STE in V1 and aVR, with reciprocal STD in V5 and V6. It is due to transmural ischemia not only of the anterior wall and apex, but due to transmural ischemia of the septum, usually due to occlusion proximal to the first septal perforator.

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Chest pain and anterior ST depression. What’s the cause(s)?

Dr. Smith's ECG Blog

Written by Jesse McLaren, with edits from Smith and Grauer A 60 year old with no past medical history presented with two hours of chest pain radiating to the left arm, with normal vitals. What do you think? I sent this to Dr. Meyers without any other information, and he responded, “do you have a prior to make sure that it is all just because of the delta wave?

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Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention

Open Heart

Background Renal impairment post-percutaneous coronary intervention (post-PCI) is a well-described adverse effect following the administration of contrast media. Within a large cohort of registry patients, we aimed to explore the incidence, predictors and clinical outcomes of renal impairment post-PCI. Methods The Victorian Cardiac Outcomes Registry is an Australian state-based clinical quality registry focusing on collecting data from all PCI capable centres.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

Written by Pendell Meyers and Peter Brooks MD A man in his 30s with no known past medical history was reported to suddenly experience chest pain and shortness of breath at home in front of his family. He reportedly told his family "I think I'm having a heart attack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive.

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Association between operator volume and mortality in primary percutaneous coronary intervention

Open Heart

Background There is a paucity of real-world data assessing the association of operator volumes and mortality specific to primary percutaneous coronary intervention (PPCI). Methods Demographic, clinical and outcome data for all patients undergoing PPCI in Leeds General Infirmary, UK, between 1 January 2009 and 31 December 2011, and 1 January 2013 and 31 December 2013, were obtained prospectively.

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30 yo woman with trapezius pain. HEART Pathway = 0. Computer "Normal" ECG. Reality: ECG is Diagnostic of LAD Occlusion.

Dr. Smith's ECG Blog

This is a repost of this amazing case: Echocardiography, even (or especially) with Speckle Tracking, can get you in trouble. The ECG told the story. A completely healthy 30-something year old woman with no cardiac risk factors had sudden onset of bilateral trapezius pain that radiated around to her throat. It resolved after about 5 minutes, but then recurred and was sustained for over an hour.

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Coronary perforation incidence, outcomes and temporal trends (COPIT): a systematic review and meta-analysis

Open Heart

Coronary perforation is a potentially life-threatening complication of percutaneous coronary intervention (PCI). We studied incidence, outcomes and temporal trends following PCI-related coronary artery perforation (CAP). Methods Prospective systematic review and meta-analysis including meta-regression using MEDLINE and EMBASE to November 2020. We included ‘all-comer’ PCI cohorts including large PCI registries and randomised controlled trials and excluding registries or trials limited

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Novel scoring system based on clinical examination for prediction of in-hospital mortality in acute coronary syndrome patients: a retrospective cohort study

Open Heart

Background This study aims to develop PADjadjaran Mortality in Acute coronary syndrome (PADMA) Score to predict in-hospital mortality in acute coronary syndrome (ACS) patients based on clinical examination only. Additionally, we also compared the predictive value of the PADMA Score with the Global Registry of Acute Coronary Events (GRACE), Canada Acute Coronary Syndrome (C-ACS), and The Portuguese Registry of Acute Coronary Syndromes (ProACS) risk scores.

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The college football fans that beat COVID and the experts that couldn’t

Dr. Anish Koka

The COVID pandemic was supposed to herald the end of the idea that a smaller government is a better government. The experts who desperately seek to be in charge of a sprawling bureaucratic state told us that it was only a powerful central authority that could do what was needed to safeguard individual liberties at a time when a highly contagious respiratory virus was spreading across the globe.