August, 2022

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South Korea clears VUNO's personal ECG device

Mobi Health News - ECG

The clearance signals the company's move to offer medical AI devices to consumers.

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Lethal Blockade

EMS 12-Lead

Acute LAD occlusion in the setting of Right Bundle Branch Block and Left Anterior Fascicular Block. Case Review: [link] Key features of Right Bundle Branch Block: In general, there is no ST elevation throughout the 12 Lead ECG. RBBB has expected slight ST depression, with T wave inversion, in V1-V3 when discordant to a positive R' wave. A possible normal variant is lateral ST elevation (i.e., I/aVL/V5/V6) with bulky T waves when subsequent to a large, slurred S wave.

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WHAT EXACTLY IS AN ARRHYTHMIA?

Dr. Sanjay Gupta

The word arrhythmia comes from two Greek words. The first is ‘a-’ which means absence or loss and the second is ‘rhythmos’ which means rhythm. So arrhythmia literally means absence or loss of rhythm. A cardiac arrhythmia therefore means loss of cardiac rhythm. It is however used in medical practice as a description for disturbance rather than absence of heart rhythm.

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Ep 173 Febrile Infant – Risk Stratification and Workup

ECG Cases

In this main episode podcast on ED risk stratification and workup of the febrile infant, recorded at the CAEP 2022 Conference in Quebec City with Dr. Brett Burstein and Dr. Gary Joubert, we answer such questions as: Which febrile infants require lumbar puncture? How accurate is procalcitonin in identifying low risk febrile infants? What is the difference between serious bacterial infection (SBI) and invasive bacterial infection (IBI) and why is this important in the work up of the febrile infant

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Arrest after Cardiac Surgery: Is Your Team Ready?

Society of Thoracic Surgeons - Allied Health

Webinar Arrest after Cardiac Surgery: Is Your Team Ready? kchalko Wed, 08/24/2022 - 08:44 August 18, 2022 During this installment of the STS Webinar Series, an expert panel highlights a team-based approach to managing cardiac surgery patients who suffer sudden postoperative cardiac arrest. The panel also discusses the implementation of Cardiac Surgery Advanced Life Support protocols and their utility in failure-to-rescue algorithms.

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Cardiotoxicity of adjuvant chemotherapy with trastuzumab: a Japanese claim-based data analysis

Open Heart

Objective Adjuvant chemotherapy with trastuzumab improves the postoperative life expectancy of women with early-stage breast cancer. Although trastuzumab is reportedly cardiotoxic, quantification based on real-world evidence is lacking. Therefore, in this study, we aimed to analyse trastuzumab cardiotoxicity using a nationwide claim-based database. Methods In this retrospective study, we used data from a nationwide claims database (Japan Medical Data Center, Tokyo, Japan) under the universal hea

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Does this ST Depression Maximal in V3 Represent Posterior OMI?

Dr. Smith's ECG Blog

I saw this EKG when reading through the system: What do you think? This is what I wrote: ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE RIGHT AXIS DEVIATION [QRS AXIS > 100] RIGHT BUNDLE BRANCH BLOCK MARKED ST DEPRESSION, CONSIDER SUBENDOCARDIAL INJURY "Severe ischemia (STE in I and aVL with reciprocal STD in inferior leads; precordial STD precordial maximal in V3): subendocardial ischemia vs. acute coronary occlusion.

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A Paradigm Shift in Electrophysiology Reimbursement

Vector Remote

What Clinics Can Do to Protect the Diagnosis and Treatment of Cardiac Arrhythmias Scope of Reimbursement Cuts The release of the annual Proposed Medicare Physician Fee Schedule is an event that business leaders and caregivers in healthcare anxiously anticipate. Operations and hiring plans are built and broken at the hands of the Schedule creators. Reimbursement directly translates The post A Paradigm Shift in Electrophysiology Reimbursement appeared first on Vector Remote Care.

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ECG Cases 34 – ECG Interpretation in Aortic Dissection

ECG Cases

Which patients with ECG evidence of coronary occlusion require a CT scan to rule out aortic dissection? What are the range of ECG findings in acute aortic dissection and how do they change management? Dr. Jesse McLaren guides us through 9 cases to answer these and other questions on ECG interpretation in aortic dissection. The post ECG Cases 34 – ECG Interpretation in Aortic Dissection appeared first on Emergency Medicine Cases.

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Artificial intelligence and cardiology

Cardiomatics

Technology provides us with more and more possibilities in many areas of life, including medicine. One of the largest areas of development in the IT industry is artificial intelligence. What is its application in health care? It is no longer just a future dream, but a new reality for clinicians and patients who can already benefit from new technologies.

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Inter-arm blood pressure difference as a tool for predicting coronary artery disease severity

Open Heart

Background Patients with severe atherosclerosis have been found to exhibit considerable changes in blood pressure (BP) between arms. The objective of our study was to investigate the predictive value of interarm blood pressure difference (IABPD) for coronary artery disease (CAD) severity. Methods It was a cross-sectional study conducted in the Department of Cardiology, Chittagong Medical College Hospital, Chattogram from May 2020 to November 2020.

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What happens if you don't recognize Hyperacute T-waves?

Dr. Smith's ECG Blog

The origin of these ECGs cannot be revealed. Time 0: Sinus rhythm with an intraventricular conduction delay (QRS is about 120 ms) Hyperacute T-waves in V2-V5, Diagnostic of Proximal LAD occlusion, but without ANY ST Elevation except for less than 1 mm in aVL, and 0.25 mm in lead I. There is also minimal STE in aVL with reciprocal STD in II, III, aVF.

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In Review: LBBB and Sgarbossa Criteria

EMS 12-Lead

It's back to the basics! Take a seat and relax as the maestro, Tom Bouthillet, guides us through a stepwise approach to assessing Left Bundle Branch Block-- especially in the nefarious context of Occlusive Myocardial Infarction.

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21st-Century Learning | 3 Ways Advance Medical Assistant Training | NHA

Learning + Leading

Today’s medical assistant (CCMA) is challenged with an onslaught of information and more regularly challenged to solve increasingly complex issues than ever before.

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EM Quick Hits 41 – IO Limitations, Missed Ectopic Pregnancy, Bronchiolitis O2 Monitoring, DRE in Cauda Equina Syndrome, Withdrawal of Life Sustaining Care

ECG Cases

In this EM Quick Hits podcast: Anand Swaminathan on limitations and practical tips on intraosseus access,Tahara Bhate QI corner on missed ectopic pregnancy, Sarah Reid from EM Cases Summit on oxygen saturation monitoring in bronchiolitis and management of infant gastro-esophageal reflux, Brit Long on the value of rectal exam in diagnosis of cauda equina syndrome, Hans Rosenberg & Ariel Hendin on withdrawal of life-sustaining care in the ED.

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A potentially transformative treatment for POTS/Long COVID.

Dr. Sanjay Gupta

What is POTS? POTS stands for postural orthostatic tachycardia syndrome. In this condition, patients complain when they stand up for a prolonged period of time, they feel very uncomfortable with dizziness, palpitations and tremulousness and therefore they either have to sit or lie down or they risk collapsing. When you examine them, the heart rate can be found to be excessively fast.

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Individualised left anterior oblique projection for lead implantation into interventricular septum

Open Heart

Objective We sought to investigate whether it is possible to obtain individualised left anterior oblique (LAO) by preprocedural electrocardiographic parameters and, if so, whether these parameters can help to improve the success rate of right ventricular (RV) lead implantation into the interventricular septum. Methods In this observational study, we assessed the relationship between preoperative electrocardiographic parameters and the angle of the interventricular septum obtained using thoracic

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A new paper by me – please share widely

Dr. Malcolm Kendrick

26th August 2022 And so, after a great deal of faffing about, my article on cardiovascular disease ‘Assessing cardiovascular disease: looking beyond cholesterol’ has been made free to view. Writing an article for a medical journal is not that difficult. Trying to submit it through Kafkaesque editorial systems, now, that is tricky. They seem incapable of understanding that I am not funded by anyone.

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What Lies Beneath

EMS 12-Lead

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary and peer review by Dr. Jesse McLaren @ECGcases [link] [link] This case was kindly submitted by Dr. Paco Dardon (@PacoDardon), and it’s a privilege to present it as a formal review due to the many pathophysiological, and electrophysiological, phenomenon at play.

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Most women OK with wearing ECG monitor in pregnancy

Medical Xpress - ECG

A survey of 507 U.S. women found that most were amenable to using wearable electrocardiogram (ECG) technology throughout their pregnancy to monitor maternal and fetal health, according to a UW Medicine-led study published recently in the Archives of Gynecology and Obstetrics.

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Ep 172 Syncope Simplified with David Carr

ECG Cases

In this main episode podcast, Dr. David Carr joins Anton to give us his simplified approach to syncope based solely on history, physical and ECG to help guide disposition decisions. We answer questions such as: What features have the best likelihood ratios to help distinguish syncope from seizure? What key clinical features on history and physical exam can help us distinguish orthostatic and reflex syncope from the more sinister cardiac syncope?

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WELCOME TO THE PRIMARY BANK OF ASPIRIN

Dr. Sanjay Gupta

My name is Sanjay Gupta and in my last video, I decried the over-zealous prescription of medications which may have no or limited benefit for the patient. In this video, I wanted to explore this further with respect to Aspirin which is commonly prescribed for prevention or treatment of heart disease. This video is enigmatically entitled ‘Welcome to the primary Bank of Aspirin’.

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Bioprosthesis in aortic valve replacement: long-term inflammatory response and functionality

Open Heart

Background The evaluation of long-term inflammatory response and function in postoperative patients with aortic valve replacement (AVR) deserves special analysis because it is important to try to prevent reoperation and improve durability and functionality of the prostheses. It is our objective Methods In this study, we included a cohort of patients with aortic valve damage treated by AVR with mechanical prosthesis, bio prosthesis and we included a control group.

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THE REASON WHY

Dr. Malcolm Kendrick

24th August 2022 As a change in direction, I thought I would share a short story I wrote. This was an entry to the New England Journal of Medicine competition. This one under the theme “A patient who presented too late”. It did not win, but I thought some of the readers of this blog may like it. THE REASON WHY The ewe was suffering, lying on its side, its bleat reduced to a painful gasp.

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Something Winter This Way Comes

EMS 12-Lead

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic @DidlakeDW A 50 y/o Male was taking his dog for a leisurely stroll through the park when he suddenly experienced new onset chest discomfort. He waited for it to subside, but after 30 minutes of persistence he called 911. EMS personnel found him seated on a bench, uncomfortable, but without gross distress.

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Disrupting circ-GNB4 mitigates high glucose-induced human mesangial cells injury by regulating the proliferation, ECM accumulation, inflammation and oxidative stress through circ-GNB4/miR-23c/EGR1 pathway [RETRACTED]

Journal of Cardiovascular Pharmacology

Diabetic nephropathy (DN) is the most common complication of diabetes mellitus. Although G protein subunit beta 4 (GNB4)-derived circular RNA (circ-GNB4; hsa_circ_0068087) is a promising candidate biomarker in diabetes mellitus, whether circ-GNB4 participates in DN occurrence and development remains unknown. Herein, we focused on DN-associated human renal mesangial cells (HRMCs) injury, and HRMCs were exposed in high glucose (HG) condition.

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Myectomy: Still the Gold Standard for HOCM

HCM Beat

An expert panel comprised of many of the world's top HCM experts recently published a retrospective analysis which looked at septal myectomy over the last 60 years of practice. It concludes that myectomy remains the best treatment for patients with obstructive hypertrophic cardiomyopathy.

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ACO REACH: A New Evolution in At-Risk Primary Care

The Beat Blog

The History The first recorded mention of the term “Accountable Care Organization” was by Dr. Elliott Fisher during a 2006 public meeting with the Medicare Payment Advisory Committee (MedPAC). Then, six years later in 2012, The Patient Protection and Affordable Care Act (ACA) authorized the use of Accountable Care Organizations (ACOs) to improve the safety and quality of care and reduce health care costs in Medicare.

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Comparison of telecardiac rehabilitation with centre-based cardiac rehabilitation and usual care: a protocol for systematic review including a meta-analysis

Open Heart

Introduction Cardiac diseases are the leading causes of morbidity and mortality. Cardiac rehabilitation is proven to be beneficial in reducing morbidity, mortality and rehospitalisation rates. Recently, more emphasis is given to home-based telemonitored cardiac rehabilitation due to the recent pandemic of SARS-CoV-2. We plan to perform this systematic review and meta-analysis to compare the differences in functional capacity (FC) (measured in peak oxygen uptake (PVO 2 )) and health-related quali

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Vaccines – how did they come about?

Dr. Malcolm Kendrick

6th August 2022 I find vaccines quite fascinating. To be more accurate, I find the thinking and emotion around vaccines endlessly fascinating… and often quite disturbing. They have become, what we in the UK call ‘national treasures.’ A national treasure is someone, such as Dame Judi Dench, or Sir David Attenborough. We laugh at their little jokes, we forgive them any possible weakness, we treat their statements as carrying a great and solemn weight.

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Real-world bleeding in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) and prescribed different combinations of dual antiplatelet therapy (DAPT) in England: a population-based cohort study emulating a 'target trial

Open Heart

Objective To estimate the incidence and HRs for bleeding for different dual antiplatelet therapies (DAPT) in a real-world population with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) in England. Design A retrospective, population-based cohort study emulating a target randomised controlled trial (tRCT). Data sources Linked Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES).

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Disrupting circ-GNB4 mitigates high glucose-induced human mesangial cells injury by regulating the proliferation, ECM accumulation, inflammation and oxidative stress through circ-GNB4/miR-23c/EGR1 pathway

Journal of Cardiovascular Pharmacology

No abstract available

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Individual-level income and out-of-hospital cardiac arrest survival in men and women

Open Heart

Objective Area-level socioeconomic factors are known to associate with chances to survive out-of-hospital cardiac arrest (OHCA survival). However, the relationship between individual-level socioeconomic factors and OHCA survival in men and women is less established. This study investigated the association between individual-level income and OHCA survival in men and women, as well as its contribution to outcome variability and mediation by resuscitation characteristics.

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Association of body mass index with outcomes in patients with newly diagnosed atrial fibrillation: GARFIELD-AF

Open Heart

Objective While greater body mass index (BMI) is associated with increased risk of developing atrial fibrillation (AF), the impact of BMI on outcomes in newly diagnosed AF is unclear. We examine the influence of BMI on outcomes and whether this is modified by sex and evaluate the effect of non-vitamin K oral anticoagulants (NOACs) in patients with high BMI.