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Objective The aim of this systematic review is to evaluate the various modalities available for extended ECG monitoring in the detection of atrial fibrillation (AF) following a cryptogenic stroke. Methods MEDLINE (Ovid), EMBASE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 2011 to November 2021. All randomised controlled trials and prospective cohort studies including the use of extended ECG monitoring >24 hours with a minimum duration of AF of 3
Emergency Medicine has undergone many changes over the last couple of decades and especially during the COVID pandemic. Most of these changes have been very positive, but increasing volumes, staff shortages, aging populations, increasing breadth of responsibilities and better access to more imaging have made some of us question how we should define the scope of our practices.
Written by Matthew Beadman Patients experiencing ectopic heartbeats are sometimes referred to a clinical psychologist. Patients often wonder what this means about their symptoms; could the cardiologist believe my ectopic beats are purely psychological or ‘all in my head?’ This brief article aims to address this common misconception and explains how cardiac specialist clinical psychologists aim to help people who are living with ectopic heartbeats.
Today’s post on the latest COVID vaccine myocarditis paper gets a big assist from the wicked smart data visualization expert Josh Stevenson ( subscribe to his substack !) In August 2021, the CDC began a study to follow-up cases of myocarditis in the age group at highest risk for myocarditis after mRNA COVID-19 vaccination. The survey based study is deserving of a deeper dive, but the date of the publication of these studies is particularly galling because it means the CDC had this data whe
Speaker: Simran Kaur, Co-founder & CEO at Tattva Health Inc.
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
National Pharm Tech Day is October 18 and it’s a perfect day to recognize a nd honor the hard work each pharmacy technician provides. But we know technicians work hard every day, so why not celebrate their dedication year - round? With so many new responsibilities and higher demand across the profession, it’s more important than ever to recognize your technicians.
A 40-something woman with diabetes and peripheral vascular disease who frequently needs the ED for chronic pain called 911 for sudden severe chest pain. The patient was very agitated and could not hold still. I greeted medics at the door to view the prehospital ECG. Here it is: It is not normal, but there is no specific evidence of Occlusion MI (OMI) There are some Q-waves in inferior and lateral leads (of uncertain age) and there is some "terminal QRS distortion" in inferior leads and V4-V6, bu
Objectives Examine the association between arrhythmias and adverse maternal outcomes in women with structurally normal hearts. Methods This was a case–control study of women admitted in labour to one of eight hospitals of Northwell Health from January 2015 to June 2021. After excluding women with structurally abnormal hearts, we identified women with an arrhythmic event and randomly subsampled the rest of the cohort to create a control group of 1025 patients.
Objectives Examine the association between arrhythmias and adverse maternal outcomes in women with structurally normal hearts. Methods This was a case–control study of women admitted in labour to one of eight hospitals of Northwell Health from January 2015 to June 2021. After excluding women with structurally abnormal hearts, we identified women with an arrhythmic event and randomly subsampled the rest of the cohort to create a control group of 1025 patients.
It may come as no surprise that the practice of medicine often goes beyond prescriptions and test results, often integrating diet and lifestyle patterns as effective mechanisms to promote heart health. The overwhelming prevailing opinion among Cardiologists (including from our own Heartbeat Cardiology team w/hundreds of combined years of experience treating cardiovascular disease) is that people can benefit from adopting a Mediterranean diet, so let’s dive in and understand what that really mean
We live and work in the communities we serve, which makes a profound difference when it comes to the level of service we provide at Cassling. When you know it’s you or a loved one who could be reliant on the lifesaving equipment we work on every day, you’re going to do everything you can to ensure it’s operating at peak efficiency. That is why, when you hear this about Field Service Engineer Terry Hingtgen from longtime Cassling Field Service Engineer Jason Schmitt, you know how important the st
14th September 2022 Some of you may remember COVID19. We had an epidemic, or a pandemic, or … choose whatever word you like best. The legacy of it still hangs about in many strange, disconnected actions. My last flight in late August, on Lufthansa, required me to wear a mask. The connecting flight with Swissair, did not. No mask was required whilst waiting at Munich airport or being transported to and from the planes in a crowded bus.
Takotsubo Syndrome is usually triggered by an emotional or physical stress leading to acute catecholaminergic myocardial stunning. The initial ST elevation phase of Takotsubo Syndrome mimics Occlusion MI, can not be distinguished by patient factors or POCUS findings, and requires immediate angiogram. The subsequent phase of Takotsubo Syndrome has T wave inversion in an apical distribution, which can mimic reperfusion, but often has very deep T wave inversions and a very long QT interval.
Coronary thrombosis is a dynamic process of platelet aggregation and subsequent coagulation. During spontaneous reperfusion -- whether via thrombolysis, or recruitment of collateral circulation -- there exists characteristic ST/T changes on the ECG.
Objectives To investigate the association of the heart rate-corrected QT interval (QTc) with the risk of atrial fibrillation (AF) and ischaemic stroke. Methods We estimated the risk of AF and ischaemic stroke associated with QTc duration (ms) by Cox regression in study participants from the cohort of 60-year-old men and women from Stockholm (60YO) (n=4232).
This cohort study examines registry data for patients with type A aortic dissection to assess mortality rates in the first 48 hours after hospital arrival and reflect any updates due to the advances in diagnostic testing and treatment of the contemporary era.
Webinar The Changing Face of Pretreatment Nodal Staging for Patients with Lung Cancer kchalko Fri, 09/23/2022 - 12:27 October 6, 2022 Procedures to evaluate lymph nodes before lung cancer therapy, including endobronchial guided nodal aspiration and mediastinoscopy, can help diagnose and stage the patient effectively. Research findings demonstrate, however, that these procedures are underutilized overall or employed in a highly variable fashion.
21st September 2022 Once again, saturated fat is found not guilty [yes, once again] I suppose that what I am about to tell you is pretty much old hat. Many people, including me, have been saying – for many years – that saturated fat has no impact on cardiovascular disease. Never has, never will. The scientific support for it has always been non-existent, and the hypothesis has always been complete fact-free, evidence-free, thought-free, nonsense.
In this EM Quick Hits podcast: Salim Rezaie on venous thromboembolism recurrence in subsegmental pulmonary embolism, Andrew Petrosoniak on pain management in the polytrauma, Nour Khatib on a rural EM case on management of near-drowning patient, Sara Reid delivers a polio primer, Anand Swaminathan on head-up CPR. The post EM Quick Hits 42 – Subsegmental PE, Trauma Analgesia, Drowning, Polio, Head-up CPR appeared first on Emergency Medicine Cases.
Accurate lead placement is invaluable, and makes a significant impact on appropriate care trajectory, or misdiagnosis with unnecessary utilization of resources. A common finding associated with V1 / V2 malposition is P wave inversion, and rSr’ QRS with T wave inversion -- potentially leading clinicians to suspect Brugada pattern, for example, when no such entity exists.
Objective The usefulness of screening for atrial fibrillation (AF) using several home blood pressure (BP) monitors has been reported. We evaluated the accuracy of a high-resolution system (HiRS) for AF prediction and its usefulness when installed in home BP monitors. Methods In patients with paroxysmal, persistent or permanent AF, ECG recording and BP measurements were performed simultaneously.
This retrospective cohort study attempts to derive and validate a simple transthyretin amyloid cardiomyopathy score to predict increased risk of transthyretin amyloid cardiomyopathy in patients with heart failure and preserved ejection fraction.
There appears to be some confusion about ultrasounds and fetal heart beats. Stacy Abrams, a Georgia Democrat politician kicked off the recent festivities by stating : There is no such thing as a heartbeat at six weeks. It is a manufactured sound designed to convince people that men have the right to take control of a woman's body Conservatives “pounced” on the statement, spurring an editor of the Washington Post, (and resident fact checker!
Objective Atrial fibrillation (AF) remains a highly prevalent arrhythmia with significant burden on morbidity and mortality. The impact of AF in the revascularised population remains incompletely described. Given the high prevalence of AF in the revascularised population, we sought to evaluate the incidence and prognosis in patients with pre-existing and new-onset AF following revascularisation.
Background The burden of valvular heart disease (VHD) has increased significantly among ageing populations, yet remains poorly understood in the present-day context of percutaneous and surgical interventions. Objective To define the incidence, clinical correlates and associated mortality of VHD in the UK Biobank cohort. Methods We interrogated data collected in the UK Biobank between 1 January 2000 and 30 June 2020.
Introduction This prospective pharmacodynamic nutraceutical study assessed the effect of a 1-week trial of 30 g/day of 65% cocoa (dark chocolate) ( Theobroma cacao L.) consumption intervention on platelet reactivity. Methods Patients with stable coronary artery disease (CAD) (n=20) who were on maintenance dual antiplatelet therapy of aspirin (ASA) 81 mg/day and clopidogrel 75 mg/day were recruited.
Objective Postoperative atrial fibrillation (POAF) is a common complication affecting approximately one-third of patients after cardiac surgery and valvular interventions. This umbrella review systematically appraises the epidemiological credibility of published meta-analyses of both observational and randomised controlled trials (RCT) to assess the risk and protective factors of POAF.
Identifying patients with high-risk heart failure (HF) who would benefit from an implantable cardioverter-defibrillator (ICD) remains controversial. A potential marker for arrhythmic sudden death is fragmented QRS (fQRS). fQRS is the notching and slurring of the QRS complex in a 12-lead ECG and it indicates abnormal ventricular depolarisation and myocardial scarring and fibrosis.
Introduction Mineralocorticoid receptor antagonists (MRAs) reduce mortality and morbidity in patients with heart failure and reduced ejection fraction (HFrEF), but are largely underused. We evaluated the frequency, motives, predictors and outcomes of MRA discontinuation in a real-world heart failure population. Methods and results This was a single-centre, retrospective cohort study where medical record-based data were collected on patients with HFrEF between 2010 and 2018.
This Patient Page describes what it means to have coronary heart calcium, why a clinician may recommend testing for it, and the benefits and risks of knowing your coronary heart calcium score.
Aims To describe the use of warfarin and direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) and chronic kidney disease (CKD), to evaluate changes in renal function over time and predictors of rapid decline, and to describe time in therapeutic range (TTR) and predictors of poor TTR among patients on warfarin. Methods and results Using data from AuriculA, the Swedish oral anticoagulation registry, patients with AF on warfarin or DOAC were identified between 2013 and 2018
Objective To examine risk factors for cardiac-related postacute sequelae of SARS-CoV-2 infection (PASC) in community-dwelling adults after acute COVID-19 infection. Methods We performed a cross-sectional analysis among adults who tested positive for COVID-19. Outcomes were self-reported cardiac-related PASC. We conducted stepwise multivariable logistic regression to assess association between the risk factors (existing cardiovascular disease (CVD), pre-existing conditions, days since positive te
Objective To examine sex differences in prevalence, volume and distribution of vascular brain lesions on MRI among patients with atrial fibrillation (AF). Methods In this cross-sectional analysis, we included 1743 patients with AF (27% women) from the multicentre Swiss Atrial Fibrillation study (SWISS-AF) with available baseline brain MRI. We compared presence and total volume of large non-cortical or cortical infarcts (LNCCIs), small non-cortical infarcts, microbleeds (MB) and white matter hype
Objectives Shift work is associated with myocardial infarction and stroke. We studied if shift work is also associated with incident atrial fibrillation (AF) and if this association differs, depending on sex and age. Methods We studied 22 339 participants (age 37.0±9.8 years, 49% women) with paid work from the third (1986–1987), fourth (1994–1995), fifth (2001) and sixth (2007–2008) surveys of the population-based Tromsø Study, Norway.
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