MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'cardiology'. Sat, 03 Sep 2011 01:45:59 +0100 http://www.medworm.com/index.php?rid=5182000&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D342 The Zio™ Patch is an emerging FDA-approved device the size of a small calculator that can be worn under the patient’s clothes that records and stores ECG data for up to 30 days. After the ECG recordings are obtained, the device is then mailed to a national reading center to evaluate the data. There have been multiple studies that confirm the effectiveness of outpatient ECG monitoring. One study indicated that the sensitivity for diagnosing heart patients increased from 11.5% to 46.2% when they were monitored for over seven days. Another study suggested that using Holter technology to identify atrial fibrillation early could save healthcare $13,000 per year, per patient, making this technology all the more important. Dr. Carolyn M. Clancy, MD, director of the Agency for Healthcare R... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=5182000 Thu, 01 Sep 2011 13:36:19 +0100 5182000 http://www.medworm.com/index.php?rid=5181818&cid=t_90601_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FbxgjMCGhppA%2Fdisease-specific-social-network.html This study involving patients with spontaneous coronary artery dissection demonstrates the feasibility of and is a successful model for developing a “virtual” multicenter disease registry through disease-specific social media networks to better characterize an uncommon condition. This study is a prime example of patient-initiated research that could be used by other health care professionals and institutions. A cute factoid? The lead author of this social network-initiated study is actually called Dr. Tweet (as in a message on Twitter). References Electronic Communication and Medical Research: Beyond the Record Spontaneous Coronary Artery Dissection: A Disease-Specific, Social Networking Community–Initiated Study Posted at Clinical Cases and Images. Stay updated and subscribe,... Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=5181818 Wed, 31 Aug 2011 12:30:00 +0100 5181818 http://www.medworm.com/index.php?rid=5174619&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-news-stories-beware-of-insufficient-evidence%2F2011.08.28 After seeing the NBC Nightly News last night, a physician urged me to write about what he saw: a story about a “simple blood test that could save women’s lives.” Readers – and maybe especially TV viewers – beware whenever you hear a story about “a simple blood test.” And this is a good case in point. Brian Williams led into the story stating: “Two of three women who die suddenly of cardiac heart disease have no previous symptoms which is all the more reason women may want to ask their doctors about a blood test that can be a lifesaver.” Then NBC News chief medical editor Dr. Nancy Snyderman said: “It’s not a new test, it’s not an experimental test but nonetheless it’s a test not a lot of people know about and tha... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174619 Sun, 28 Aug 2011 14:00:15 +0100 5174619 http://www.medworm.com/index.php?rid=5169546&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fresearch-shows-decrease-in-time-from-hospital-arrival-to-heart-attack-treatment%2F2011.08.27 Heart attack patients are now being treated on average 32 minutes faster than they were five years ago, and medical societies are touting it as evidence of the success of national campaigns to treat heart attacks more quickly. The study, “Improvements in Door-to-Balloon Time in the United States: 2005-2010,” found that the average time from hospital arrival to treatment declined from 96 minutes in 2005 to just 64 minutes in 2010. In addition, more than 90% of heart attack patients who required emergency angioplasty in 2010 received treatment within the recommended 90 minutes, up from 44% in 2005. Also, the study reported that (more…) *This blog post was originally published at ACP Hospitalist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5169546 Sat, 27 Aug 2011 18:15:00 +0100 5169546 http://www.medworm.com/index.php?rid=5159261&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fwu4LhmCmmx0%2Fbarostim-neo-baroreflex-stimulator-receives-ce-approval-for-treatment-of-hypertension.html CVRx has received the European CE Mark of approval for its second-generation implantable anti-hypertensive barostimulation device, the Barostim neo. It is the successor of their RHEOS baroreflex stimulation device, which we have covered several times before. Compared to its predecessor, it features a new unilateral 1mm electrode and a smaller, more advanced stimulator. The stimulator is implanted underneath the pectoralis muscle, with a subfascial lead running to the carotid sinus. The system works by electrically activating the baroreceptors located on the carotid artery. This makes the body’s own blood pressure regulation mechanisms decrease blood pressure by reduction of the sympathetic tone, leading to a peripheral vasodilation, lower heart rate and increased fluid excretion by t... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5159261 Thu, 25 Aug 2011 17:11:02 +0100 5159261 http://www.medworm.com/index.php?rid=5159265&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fi5_13bnxbZQ%2Fheart-test-laboratories-myovista-system-to-present-results-of-clinical-trials-at-the-american-heart-association-scientific-sessions.html Heart Test Laboratories will be presenting clinical trial results of their Myovista cardiac screening system at the American Heart Association (AHA) Scientific Sessions in November 2011.  The proprietary patent-pending device is a portable diagnostic screening device that uses ECG technology to potentially detect coronary artery disease within minutes. The technology uses three-dimensional mapping and proprietary algorithms that continuously multiplex surface electrodes to provide information in regards to potential obstruction in the coronary arteries.  Heart Test Laboratories claim to have an impressive average 90% or greater correlation to an invasive angiogram with the MyoVista technology.  The device was awarded CE Marking in September 2010.  Look here on Medgadget for follow up f... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5159265 Wed, 24 Aug 2011 18:09:52 +0100 5159265 http://www.medworm.com/index.php?rid=5159270&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F3b-Ua7UgbLo%2Fmedgadget-interview-what-to-expect-and-how-to-make-informed-treatment-decisions-when-transcatheter-valve-therapy-comes-to-u-s.html The American College of Cardiology (ACC) and Society of Thoracic Surgeons (STS) recently published a consensus statement warning that transcatheter valve therapy (TVT) must be adopted carefully and selectively until these emergent technologies are tested more thoroughly. Also, according to the authors of the document, the procedures should only be performed at specialty centers with multidisciplinary teams of cardiologists and surgeons. To clarify for our readers the implications of the position statement, we asked cardiologist Robert Kipperman, M.D., the principal investigator for the Everest II MitraClip Trial and the CoreValve trial at the Advanced Therapy Unit at Gagnon Cardiovascular Institute at Morristown Medical Center in New Jersey, to answer the following questions: Medgadget: Wh... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5159270 Wed, 24 Aug 2011 16:16:58 +0100 5159270 http://www.medworm.com/index.php?rid=5159008&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FA_Uef_POJIA%2F "VT or not VT? That is the question..." you muse. Then your patient Bill says "A shock, a shock, my kingdom for a shock"... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5159008 Wed, 24 Aug 2011 00:00:08 +0100 5159008 http://www.medworm.com/index.php?rid=5139971&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D332 Balloon catheters have just recently entered the market as a therapeutic device for arrhythmias, but the current process of diagnosing and treating arrhythmias requires several catheters, which adds costs and time to the procedure. Considering over 220,000 catheter ablations are performed each year in the U.S., this adds significantly to the cost of healthcare. Scientists have developed new materials that allow for therapeutic arrays and sensors designed to measure electrical activity, temperature, blood flow, and pressure to flex with the opening and closing of a balloon. The balloon is inserted into the upper regions of the heart where it can be expanded. Once in place, the cardiologist can perform an EP study and ablate areas causing the arrhythmias. Along with lower costs, the technolo... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=5139971 Wed, 17 Aug 2011 14:09:45 +0100 5139971 http://www.medworm.com/index.php?rid=5125823&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FHryk4-WPp3g%2Fworldheart-corporation-ends-its-levacor-ventricular-assist-device-program-to-focus-on-next-generation-miflow-vads.html World Heart Corporation (WorldHeart) announced on July 29th, 2011 that it shall no longer pursue commercialization of their Levacor Ventricular Assist Device (VAD) technology and will focus on a smaller, new-generation MiFlow VAD.  WorldHeart’s investor page notes that with continued delay of their Bridge-To-Transplant Study and associated device refinements they no longer see Levacor as a commercially competitive product.  The Levacor VAD, a centrifugal pump that is completely magnetically levitated unlike other assist devices with mechanical or blood-lubricated bearings, is designed for adults with late-stage heart failure as a bridge to transplant. The company plans to focus on next generation technology such as the MiFlow VAD, a device designed to provide cardiac output flow up to ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5125823 Fri, 12 Aug 2011 15:43:40 +0100 5125823 http://www.medworm.com/index.php?rid=5119031&cid=t_90601_175_f&fid=39258&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FInsidePaTraining%2F%7E3%2Fu3sVNf3Jh0s%2Fphysician-assistant-specialty-cardiology Today, we examine a popular physician assistant specialty: cardiology. I called in a favor and interviewed my good friend, cardiology physician assistant, Liz Turok. Liz graduated just over a year ago from UC Davis School of Medicine’s PA Program, and works in Fremont, California as a cardiology PA.  She’s a very sharp but approachable lady [...] (Source: Inside PA Training) Inside PA Training blogs http://www.medworm.com/rss/comments.php?id=5119031 Thu, 11 Aug 2011 06:53:26 +0100 5119031 http://www.medworm.com/index.php?rid=5107525&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FyGCavJGs3jw%2F The LITFL team call upon the wider academic cardiological community to fund research into the under-diagnosed conditions of 'calligraphitis' or literary heart syndrome and the positive electropenogram (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5107525 Mon, 08 Aug 2011 07:42:56 +0100 5107525 http://www.medworm.com/index.php?rid=5107523&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-best-thing-a-patient-can-do-following-a-heart-attack%2F2011.08.07 I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good.  And the Italians are out to prove me right.  The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome. In a study of just under 1,300 patients,  Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients.   Researchers also found that resuming smoking increased  death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications.  And I’m sure these ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5107523 Sun, 07 Aug 2011 16:00:00 +0100 5107523 http://www.medworm.com/index.php?rid=5103394&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FQ9mRCjXmKms%2Fnovel-watch-based-device-detects-pulselessness-in-humans.html This study was designed to simulate cardiac arrest and assess the device’s ability to correctly identify pulse status.  24 hospitalized patients and 10 patients planned for implantable cardioverter defibrillator (ICD) testing were enrolled in the trial.  Pulselessness was simulated in the hospitalized patients via inflation of a blood pressure cuff on the same arm as the watch while they held still.  Ventricular fibrillation was induced in the 10 ICD patients as part of normal protocol to test the ICDs – essentially creating a pulseless, motionless state.  Of the 34 subjects, 5 had unusable signals, device ejection, or too much motion artifact.  Of the 29 remaining, the device correctly identified a pulse state in 3 of 4 patients and the time of pulselessness in 23 of 25 patie... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5103394 Fri, 05 Aug 2011 17:06:56 +0100 5103394 http://www.medworm.com/index.php?rid=5103395&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FEqP5_OEbbyw%2Fmedtronic%25e2%2580%2599s-second-mri-compatible-pacing-system-gets-fda-approval-for-a-us-clinical-trial.html The FDA approved Medtronic’s Investigational Device Exemption application and clinical trial protocol to assess the safety and effectiveness of the Advisa DR MRI Surescan pacing system in a clinical MRI setting.  The study will also provide data on how the MRI image quality is affected by the presence of an implanted pacemaker. The device, as reported prior on Medgadget, has already received European approval in the past. This will be the 2nd MRI compatible system potentially to be available in the US.  The first being Medtronic’s Revo MRI SureScan that received approval last February. From Medtronic: The Advisa MRI study is a prospective, randomized controlled, non-blinded, multi-center worldwide investigational study to confirm safety and effectiveness of the pacing system in the c... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5103395 Fri, 05 Aug 2011 16:30:03 +0100 5103395 http://www.medworm.com/index.php?rid=5096215&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FAGN1vEnQmY4%2F ECG pimping - the ECG rule of fours... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5096215 Fri, 05 Aug 2011 13:02:25 +0100 5096215 http://www.medworm.com/index.php?rid=5096200&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1701%2F0%2Fattila-cardiologist.mp3 Podcast: Note: DrRich has issued this warning more than once before. It has always gone unheeded. He will now try one more time, with this updated and hopefully more compelling version, not because he actually believes it will do any more good than similar warnings did those other times, but because he is a humanitarian and time is growing short. American physicians will continue to ignore this warning at their own peril. The history of Western civilization, from prehistoric times until relatively recently (so recently, in fact, that one cannot be absolutely certain the pattern has been broken), has been marked by successive waves of invasions by wild barbarians from the north. (This explains why DrRich will never completely trust the Canadians.) Every few hundred years, one group of prim... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=5096200 Tue, 02 Aug 2011 10:00:53 +0100 5096200 http://www.medworm.com/index.php?rid=5086304&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Feab8jdTrxfc%2Fa-new-chance-on-life%25e2%2580%25a6fda-advisory-panel-recommends-humanitarian-device-exemption-for-the-berlin-heart-excor-pediatric-ventricular-assist-device.html Another big endorsement by the FDA Circulatory System Devices Advisory Panel took place on July 21, 2011. The committee overwhelmingly agreed (16 to 0 vote) that the Berlin Heart Excor Pediatric Ventricular Assist Device (VAD) be granted a humanitarian device exemption (HDE).  The device, as reported prior on Medgadget, provides mechanical circulatory support as a bridge to heart transplantation in pediatric patients suffering from severe isolated left ventricular or biventricular dysfunction.  The sponsors of the VAD presented data from a recent prospective, non-randomized, multi-center, single arm study assessing the safety and probable benefit of the device.  48 children were enrolled in the trial and their outcomes were compared to those receiving ECMO (extracorporeal membrane oxyge... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5086304 Mon, 01 Aug 2011 18:17:08 +0100 5086304 http://www.medworm.com/index.php?rid=5086307&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FMvx06NzFUfM%2Fcool-it-no-really%25e2%2580%25a6it-may-make-a-difference-between-life-and-death.html Remember the Arctic Sun, a non-invasive system designed to rapidly manage the core temperature of critically ill patients? Further studies continue to demonstrate its positive role in treating out-of-hospital cardiac arrest (OHCA) patients via therapeutic hypothermia. In the July 12, 2011 issue of Circulation, Michael Mooney, et al. from  Minneapolis Heart Institute and Northwestern University in Chicago published data on 140 consecutive OHCA patients who were treated and transferred to a central therapeutic hypothermia-capable hospital. Patients were initially cooled in the ambulances or referring hospitals with ice packs and then transferred to the central hospital where they were further cooled and maintained at 33°C (92°F) for 24 hours with the Arctic Sun device (Medivance, Louisvil... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5086307 Mon, 01 Aug 2011 16:47:21 +0100 5086307 http://www.medworm.com/index.php?rid=5069594&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D310 Magnetocardiography’s (MCG) SQUID (Superconducting Quantum Interference Device) technology is designed to produce a map of the heart’s electrical activity, which allows for a quick noninvasive test for difficult to diagnose CAD (Coronary Artery Disease), a disease that more than half a million Americans die from each year. But, the most promising application of MCG technology is for a more accurate early diagnosis of adult and fetal arrhythmias.  Magnetic field imaging has been available for years to measure brain activity by measuring the body’s fluctuating magnetic field.  Advancements in extremely sensitive magnetic sensors (SQUIDs) have allowed for the measurement of small magnetic disturbances as a result of a patient’s heartbeat.  Because of this, MCG technology can produc... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=5069594 Tue, 26 Jul 2011 14:34:46 +0100 5069594 http://www.medworm.com/index.php?rid=5069479&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnsaids-might-be-risky-for-people-with-heart-problems%2F2011.07.26 As if people with the combination of high blood pressure and heart disease don’t already have enough to worry about, a new study suggests that common painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) pose special problems for them. Among participants of an international trial called INVEST, those who often used NSAIDs such as ibuprofen (Advil, Motrin and others), naproxen (Aleve, Naprosyn, and others), or celecoxib (Celebrex) were 47% more likely to have had a heart attack or stroke or to have died for any reason over three years of follow-up than those who used the drugs less, or not at all. The results were published in the July issue of the American Journal of Medicine. Millions of people take NSAIDs to relieve pain and inflammation. They are generally safe and effectiv... Better Health blogs http://www.medworm.com/rss/comments.php?id=5069479 Tue, 26 Jul 2011 14:00:35 +0100 5069479 http://www.medworm.com/index.php?rid=5062321&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FMNUhYSYSP4c%2Ftoyota-to-integrate-ecg-sensors-into-steering-wheels.html Toyota is working on a multitude of technologies that will make driving safer, and showed some of its up and coming safety innovations in a demonstration to reporters last Thursday at its facility in Japan. Among the exhibits were a pre-collision system with a steering-control feature, a pop-up hood and blocking of high-beam headlights, but also an ECG detecting driving wheel. Whereas Ford is opting for a contactless ECG-sensing driving seat, Toyota is going the more obvious way, by direct contact sensors in the steering wheel. Of course this depends on the driver keeping hands on the steering wheel long enough to detect any abnormal heart rhythm, which might not be the case in more acute conditions such as VF. An optical sensor mounted in the steering wheel picks up a single-lead ECG sign... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5062321 Mon, 25 Jul 2011 14:38:53 +0100 5062321 http://www.medworm.com/index.php?rid=5062245&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-blood-thinner-shifts-responsibility-to-patients%2F2011.07.24 I recently came across a very important blog post on the use of the novel new blood-thinner, dabigatran (Pradaxa). Fellow Kentucky cardiologist, and frequent TheHeart.org contributor, Dr. Melissa Walton-Shirley wrote this very detailed case presentation involving a cantankerous non-compliant rural patient with AF (atrial fibrillation) that sustained a stroke while “taking” dabigatran. Dr. Walton-Shirley details the very commonly done procedure of cardioversion (shock) for AF. As she clearly points out, the most important safety feature of shocking AF back to regular rhythm entails adequate blood thinning before and after the procedure. Thin blood prevents the possibility of clots dislodging after restoring normal contraction to the top chambers of the heart (atria). Herein lies the rub... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062245 Sun, 24 Jul 2011 18:00:37 +0100 5062245 http://www.medworm.com/index.php?rid=5057794&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FBDvwYc3vTEA%2Fspacelabs-healthcare-xprezzon-patient-monitor-from-the-future-also-viewable-on-ipad.html Spacelabs Healthcare (named so because it originally developed telemetry devices to monitor the vital signs of orbiting astronauts) has recently launched XPREZZON, a patient monitor that pretty much fullfills all the wishes we ever had for a monitor and that also makes some clever use of existing remote desktop technology. It has a sleek, frameless, iPad-like high resolution touchscreen display. It can display custom trends which can be accessed with a single touch, or they can be displayed continuously and arranged to the user’s liking. It has bright LED alarm lights both on the front and the back. For those accustomed to dual-screen desktop set-ups, a second display can be attached to the monitor, acting as a secondary screen for charting and other clinical applications. Under the ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5057794 Fri, 22 Jul 2011 15:08:50 +0100 5057794 http://www.medworm.com/index.php?rid=5050577&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fresearch-investigates-a-percutaneous-option-for-aortic-valve-replacement%2F2011.07.21 To ensure rational and responsible dissemination of this new technology (transcatheter aortic valve replacement [TAVR]), government, industry and medicine will need to work in harmony.” - David R. Holmes, Jr., MD, FACC President, American College of Cardiology Today, Edwards Lifesciences’ will request pre-market approval of its SAPIEN Transcatheter Heart Valve from the FDA’s Circulatory Systems Devices Panel of the Medical Devices Advisory Committee. And for the first time, the groundwork for our complicated new era of health care rationing will be exposed. To win an expensive technology on behalf of patients these days, there will have to be “harmony” between doctors and their professional organizations and government regulators. If not, patients lose. At issue is a... Better Health blogs http://www.medworm.com/rss/comments.php?id=5050577 Thu, 21 Jul 2011 18:00:00 +0100 5050577 http://www.medworm.com/index.php?rid=5050580&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Frecognizing-different-arrhythmias-theres-an-app-for-that%2F2011.07.21 The recognition and management of cardiac arrhythmias is a must-have clinical skill for residents and physicians, and one that is often not well-taught at some institutions. For example, deciding whether a patient is in a shockable rhythm, realizing what medications should or should not be given in a particular situation, or assessing the degree of atrioventricular block, can all be important considerations in patient care. The Arrhythmias app, designed by Abe Balsamo, recently cracked the Top 10 list of most-downloaded medical apps in the app store.  This app represents Mr. Balsamo’s first foray into the app world, though he has several other apps in development, according to his website AppsByAbe.com.  The app’s growing popularity has been driven by its point-of-care abilities that... Better Health blogs http://www.medworm.com/rss/comments.php?id=5050580 Thu, 21 Jul 2011 12:00:55 +0100 5050580 http://www.medworm.com/index.php?rid=5050850&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D304 Implantable cardiac generator technology has moved rapidly over the years, offering patients a wide range of therapies.  But, one of the limitations falls within the lead technology.  Leadless technology will allow the technology to be smaller and longer lasting while taking away one of the main components associated with the device’s failure and complication rate.  Studies have shown that lead failure is also associated with 16% of major adverse clinical events with the devices.   The average battery life of a pulse generator is over eight years, and in this time period, 40% of the leads will fail before the generator needs replacing. I spoke to Dr. Mark J. Smith, MD, PhD, of the biostimulation unit at the National Institutes of Health in Bethesda, MD, about the effects of leads wi... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=5050850 Tue, 19 Jul 2011 15:46:34 +0100 5050850 http://www.medworm.com/index.php?rid=5036306&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FzaJez4PwN0k%2Fst-jude-medical-receives-european-ce-mark-approval-for-its-ilumien-system.html St. Jude Medical has received European CE Mark approval for its ILUMIEN system, the first integrated diagnostic technology that combines optical coherence tomography (OCT) and fractional flow reserve (FFR) technologies on one platform for cardiac catheterizations. FFR is an index determining the functional severity of narrowings in the coronary arteries by measuring pressure differences across stenoses. OCT utilizes near-infrared light to create images that help visualize and measure important vessel characteristics and stent positions. The combined system offers physicians advanced physiological and anatomical insight to improve the diagnosis and treatment of coronary artery disease. The ILUMIEN system features the St. Jude Medical PressureWire(TM) Aeris, a wireless interventional tool t... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5036306 Fri, 15 Jul 2011 17:34:10 +0100 5036306 http://www.medworm.com/index.php?rid=5028530&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fs-4xj09jBs4%2Fnew-technology-paves-way-for-low-energy-cardiac-defibrillation.html One of the most dramatic scenes in medicine is reviving a patient in ventricular fibrillation using a defibrillator.  An international team of scientists however has developed a new low-energy method that may take a lot of the drama out of the procedure. Their technique, called LEAP (Low-Energy Anti-fibrillation Pacing), reduces the energy required for defibrillation by 84%. LEAP, tested in dogs, works by applying a series of five small shocks, instead of one large one. It takes advantage of the shape of the heart’s vasculature, which affects spatial patterns of electric currents, creating ‘virtual electrodes’ that essentially amplify the voltage applied to the tissue. The technique was first developed and tested in isolated pieces of dog atria and ventricles, and then l... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5028530 Thu, 14 Jul 2011 15:04:43 +0100 5028530 http://www.medworm.com/index.php?rid=5028033&cid=t_90601_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F07%2Fradiation-exposure-heart-tests-increasing-future-cancer-risks-worrisome%2F Dr. Jersey Chen of Yale University and his colleagues have published a study in the Journal of the American College of Cardiology documenting the signficant increase in the number of ionizing radiation tests being administered each year and the unknown risk of possible increased cancer rates because of it. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=5028033 Sun, 10 Jul 2011 08:29:22 +0100 5028033 http://www.medworm.com/index.php?rid=5008193&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-blood-pressure-monitor-for-iphone-costs-4-times-more-than-off-the-shelf-version%2F2011.07.08 One of the most interesting things I saw at this year’s Doctors 2.0 and You event was Withins’ Blood pressure monitor. This iPhone-connected blood pressure monitor made its first appearance at CES, but you’ll finally be able to order one of your own today. Compatible with iPhone, iPad, and iPod touch, the $129 accessory costs three to four times as much as off-the-shelf blood pressure monitors, but integrates well if you’re looking to pair it with your Withings scale for a complete vitals management solution. *This blog post was originally published at ScienceRoll* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5008193 Fri, 08 Jul 2011 14:00:08 +0100 5008193 http://www.medworm.com/index.php?rid=5008359&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FvcRAbjBQ0IA%2Fintelesens-aingeal-vital-signs-monitor-gets-u-s-clearance.html Intelesens, “the Belfast wireless health monitoring company,” received FDA regulatory clearance for its Aingeal wireless Holter monitor. The device measures ECG, heart and respiratory rate, temperature and body motion and relays it to a central server for clinician analysis. The device underwent clinical testing at the Massachusetts General Hospital last year and has already received European marketing approval. Real time monitoring and analysis of respiration and ECG signals (modified Lead II) Skin temperature and activity (3-axis accelerometer) Up to 48 hours of use Recognition and notification of specific cardiac events (configurable by clinician) Pre and post event data recording (configurable by clinician) Out of range detection and alert to patient Min... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5008359 Wed, 06 Jul 2011 19:36:59 +0100 5008359 http://www.medworm.com/index.php?rid=4997525&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fomega-3-fatty-acids-the-science-behind-their-potential-heart-health-benefits%2F2011.07.03 The Biology of Omega-3 fatty acids: (Just a little science:) When fish, flax-seeds or Brussels sprouts pass through the intestine, pancreatic enzymes transform the fat to free fatty acids. These acids are quickly taken up by the cells. Once in the cell, these fatty acids enter the mitochondria, endoplasmic reticulum and cytosol–places that you might recall because your mom helped you make a Cell sponge cake in 7th grade Biology. In the cells, the Omega-3 fatty acids (ALA, DHA and EPA) exert their healthy influence in three major ways: in the control of chemical messengers; in the flux of ions—cell electricity; in the smoothness and health of the cell membrane. That’s enough about cells. How do these (good) fats help our bodies? Omega-3 fatty acids reduce Inflammation: –Omega-3s ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4997525 Sun, 03 Jul 2011 16:00:49 +0100 4997525 http://www.medworm.com/index.php?rid=4984522&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FIQOxEaVSx3g%2Fvasomedical%25e2%2580%2599s-new-biox-2302-ecg-holterbp-monitor-and-model-1804-monitor-get-510k-clearance.html Vasomedical has announced FDA 510(k) clearance of its BIOX 2302 combination ECG Holter/ambulatory blood pressure monitor and Model 1804 ambulatory blood pressure monitor. The BIOX 2302 expands on the 2301, which we covered last year, with a 12-lead ECG, while the Model 1804 provides stand-alone blood pressure monitoring. The BIOX 2301 and 2302 are the only FDA cleared devices which provide ECG Holter and BP monitoring in a singe unit. More details from the press release: With the new clearance by the U.S. FDA, Vasomedical now offers both 3-channel (Model 2301) and 12-channel (Model 2302) Combined Holter ECG/ABP Monitors. While they can also be configured by the user to record ECG or blood pressure data only, the newly cleared Model 1804 and the previously cleared Model 1305 provide economi... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4984522 Thu, 30 Jun 2011 16:29:54 +0100 4984522 http://www.medworm.com/index.php?rid=4975976&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FRIzJ6zN-M9c%2Fmedtronics-carelink-now-on-iphones-ipads.html Medtronic has released an iOS app that allows physicians to access the firm’s CareLink Network from just about anywhere. CareLink relays important data from Medtronic’s implantable cardiac devices, including patient physiologic data and device diagnostics. Thanks to CareLink Mobile, cardiologists will now be able to tap through their patient updates in seconds and make decisions without having to be in front of an old school computer. This new application allows clinicians to review Medtronic CareAlert® transmissions and a patient’s last transmission anytime, anywhere. Clinicians can then triage clinical events and take action as needed. The CareLink Network provides similar in-depth device information as an office visit for Pacemakers, Implantable Cardioverter-Defibrillator... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4975976 Tue, 28 Jun 2011 16:37:01 +0100 4975976 http://www.medworm.com/index.php?rid=4975980&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FIF0pD2p46TA%2Fbiotroniks-new-single-chamber-icd-detects-atrial-arrhythmias.html BIOTRONIK has launched a new single-chamber implantable cardiac defibrillator and lead system. The Lumax 540 VR-T DX is capable of detecting atrial fibrillation in addition to traditional ventricular rhythm monitoring that other single-chamber ICD’s perform.  This is done thanks to the new Linoxsmart S DX ICD leads that feature a floating atrial dipole (side image) that can sense electrical activity in the atrium.  Like other BIOTRONIK implants, the new device is supported by the company’s HOME MONITORING system that will communicate any adverse events or detected conditions (like AF) straight to the physician. More details about the new system from the press release: Signals coming from the atrial chambers of a patient’s heart can now be sensed by the floating atrial dipol... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4975980 Mon, 27 Jun 2011 18:10:24 +0100 4975980 http://www.medworm.com/index.php?rid=4968627&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FlQoftuok6og%2Fst-jude%25e2%2580%2599s-unify-crt-d-and-fortify-st-icd-make-their-way-to-japan.html St. Jude Medical’s Unify cardiac resynchronization therapy defibrillator (CRT-D) and Fortify ST implantable cardioverter defibrillator (ICD), which were FDA approved and CE Marked last year, have now been cleared for distribution in Japan. The Unify and Fortify are the smallest CRT-D and ICD on the market, which allows surgeons to use smaller incisions during implantation. The devices can also deliver more energy than existing options, and use SJM’s proprietary algorithms to monitor patients and reduce the likelihood of unnecessary shocks. From the announcement: The Unify CRT-D and Fortify ST ICD feature advanced battery technology and circuitry that allow for a smaller device, with more energy capacity and rapid charge times, all while increasing device longevity. The energy capabilit... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4968627 Thu, 23 Jun 2011 15:37:04 +0100 4968627 http://www.medworm.com/index.php?rid=4997536&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fi5up-SjFC0Q%2F This one's for our medical student friends... and anyone else fighting the axis of evil! Understanding axis is one of the keys to understanding ECGs. Super Axis Man (SAM) is here to help! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4997536 Thu, 23 Jun 2011 09:29:03 +0100 4997536 http://www.medworm.com/index.php?rid=4952846&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-new-world-view-of-coronary-artery-disease%2F2011.06.20 In 2007, when the results were published from the COURAGE trial, all the experts agreed that this study would fundamentally change the way cardiologists managed patients with stable coronary artery disease (CAD).* ____ *”Stable” CAD simply means that a patient with CAD is not suffering from one of the acute coronary syndromes – ACS, an acute heart attack or unstable angina. At any given time, the large majority of patients with CAD are in a stable condition. ____ But a new study tells us that hasn’t happened. The COURAGE trial has barely budged the way cardiologists treat patients with stable CAD. Lots of people want to know why. As usual, DrRich is here to help. The COURAGE trial compared the use of stents vs. drug therapy in patients with stable CAD. Over twenty-two hundred patie... Better Health blogs http://www.medworm.com/rss/comments.php?id=4952846 Mon, 20 Jun 2011 18:00:25 +0100 4952846 http://www.medworm.com/index.php?rid=4952839&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1623%2F0%2Fnot-follow-guidelines.mp3 Podcast: In an article appearing last week in the American Heart Journal, investigators concluded that if American doctors would prescribe for their patients with heart failure each of the six therapies which are most strongly recommended in current heart failure guidelines, 68,000 lives per year could be saved. The following (for the interest of the reader, and for the convenience of any attorneys who may follow DrRich’s offerings), is an ordered list of these six proven, life-saving heart failure therapies, along with the number of American lives that could be saved each year if only American doctors would stop grossly under-utilizing them in violation of published guidelines: aldosterone antagonist therapy – 21,407 lives beta blockers – 12,922 lives implantable de... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4952839 Mon, 20 Jun 2011 11:21:47 +0100 4952839 http://www.medworm.com/index.php?rid=4934484&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D282 A blood coagulation test (prothrombin time test) that’s as easy to use as a home glucose meter and cheaper?  Wow!  Over 10% of all adverse drug events ending in a hospital stay are associated with blood thinners.  Because of this, regular monitoring is recommended to ensure the desired effect.  Unfortunately, the current technology is either costly or must be performed by qualified technicians. Currently, there are several point-of-care tests on the market, but the cost of the consumable test strips make it more expensive than laboratory testing.  However, the SmartStrip mimics “lab on a chip” technology but instead of fluidics, it’s based on microelectromechanical systems (MEMS) placed on a disposable test strip.  The result is a low-cost test that can be performed in minute... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4934484 Tue, 14 Jun 2011 13:39:53 +0100 4934484 http://www.medworm.com/index.php?rid=4934156&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1615%2F0%2Fcourage.mp3 Podcast: In 2007, when the results were published from the COURAGE trial, all the experts agreed that this study would fundamentally change the way cardiologists managed patients with stable coronary artery disease (CAD).* ____ *”Stable” CAD simply means that a patient with CAD is not suffering from one of the acute coronary syndromes – ACS, an acute heart attack or unstable angina. At any given time, the large majority of patients with CAD are in a stable condition. ____ But a new study tells us that hasn’t happened. The COURAGE trial has barely budged the way cardiologists treat patients with stable CAD. Lots of people want to know why. As usual, DrRich is here to help. The COURAGE trial compared the use of stents vs. drug therapy in patients with stable CAD. Ove... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4934156 Mon, 13 Jun 2011 11:21:25 +0100 4934156 http://www.medworm.com/index.php?rid=4921541&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FouUj8NV4eoY%2Fsmartheart-lightweight-personal-12-lead-ecg-announced.html SHL Telemedicine recently announced the Smartheart, a lightweight personal ECG. The device, about the size of the average smartphone, is strapped around the chest and records a full 12-lead ECG. The strap seems to include many of the ecg electrodes that are normally attached separately to the chest. One separate lead is still needed that connects to the lower left part of the belly. The device is to be used in conjunction with a mobile app, available on iPhone, Android, and BlackBerry, which connects to the ECG wirelessly and captures the ECG within about 30 seconds. The results can be emailed to the cardiologist or hospital, and the device will sport some form of automatic assessment. A few questions about the device still remain unanswered. While we can see how this device will be able t... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4921541 Fri, 10 Jun 2011 17:17:05 +0100 4921541 http://www.medworm.com/index.php?rid=4911479&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstatins-reduce-heart-disease-risk-but-probably-not-because-they-lower-cholesterol%2F2011.06.08 When cyclists find out that I am a heart doctor, they most frequently ask about cholesterol numbers. “…My cholesterol is this…What do you think?” “…My doctor wants me to take a statin…But I read that these drugs might lower my functional threshold power 2.014 watts/40km.” All this focus on numbers saddens me. Remember, I am a forest guy, not a tree guy. What’s more, as a doctor that revels in the adrenaline rush of ablating rogue circuits with technology that would impress even a twenty-something, I find questions about biochemistry dreary–like eating quinoa. I wish folks would ask me about how to terminate AF with a catheter, or how an (evidenced-based) ICD saved a mom’s life, or perhaps even this: “Do you do heart surgery?” But more often than not people want t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911479 Wed, 08 Jun 2011 21:00:58 +0100 4911479 http://www.medworm.com/index.php?rid=4911602&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FI9LJFq3KeO4%2Fst-judes-portico-transcatheter-aortic-valve-implanted-in-human-exclusive-pics.html St. Jude Medical has just announced the first successful human implantation of the company’s Portico transcatheter aortic heart valve in a patient with aortic stenosis. The procedure was performed by Dr. John Webb, director of cardiac catheterization and interventional cardiology at St. Paul’s Hospital in Vancouver, British Columbia. We hear that St.Jude is working hard to make sure the device is safe and secure, so things like perivalvular leaks and valve displacements do not happen during or after implantation. Furthermore, the company is looking into ways to develop both transapical and transfemoral deliveries for the valve. And, in addition, the device, when it is finally approved, might feature the company’s proprietary Linx anticalcification technology that might ac... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4911602 Wed, 08 Jun 2011 20:11:14 +0100 4911602 http://www.medworm.com/index.php?rid=4911604&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FqPD5_5WX2V0%2Fact%25e2%2580%2599s-tempasure-for-atrial-arrhythmias-wins-european-approval.html Advanced Cardiac Therapeutics, Inc. has received the European CE Mark for its TEMPASURE cardiac ablation catheter.  The device is capable of measuring local temperature of the treatment area, helping prevent overheating, while delivering saline irrigation. The TEMPASURE system is designed to result in better outcomes for patients by reducing overall procedure time and increasing therapeutic effectiveness, while avoiding rare but serious adverse events that can occur with current technologies. The system’s novel passive sensing microwave radiometry technology allows the electrophysiologist to measure the temperature of cardiac tissue during the ablation procedure, providing real-time information that enables proper energy delivery and lesion control. This technology ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4911604 Wed, 08 Jun 2011 17:06:38 +0100 4911604 http://www.medworm.com/index.php?rid=4902424&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fan-interview-with-a-cardiac-cath-lab-nurse%2F2011.06.05 Ready to learn more about nurses who work beyond the bedside?  Nurses who work in the Cardiac Catheterization Lab (CCL) play an important role in cardiac care.  Amy Sellers, RN BSN CCRN CSC CMC blogs at Nursing Influence and graciously agreed to give us a peek at what a nurse is responsible for doing in the CCL. Amy has worked in the Cath Lab for about 6 months now.  She previously worked in CVICU for almost 5 years before deciding that she needed a new challenge.  She is paid hourly and works three 12 hour shifts per week (all daytime Mon-Fri) with lots of opportunities for overtime and call shifts. A cath lab is an area of the hospital that uses fluoroscopy and contrast dye to check for narrowing/blockages in arteries or veins in the body. Using special equipment, they are able to pe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4902424 Sun, 05 Jun 2011 15:30:43 +0100 4902424 http://www.medworm.com/index.php?rid=4893598&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fz6rwckEHX_4%2Fbiotroniks-orsiro-hybrid-des-performs-well-in-human-trial.html The objective of the study was to assess the safety and clinical performance of the Orsiro Hybrid DES as measured by freedom from major adverse cardiac events (MACE) and in-stent late lumen loss at 9 months, evaluated by quantitative coronary angiography (QCA). At 9 months, the results for the primary endpoint in-stent late lumen loss were 0.05 ±0.22 mm. Two patients were symptomatic at 9 months, resulting in two cases of clinically driven target vessel revascularization (TVR) (6.7%). Clinical follow-up will continue annually out to at least 3 years. Orsiro demonstrated sustained safety out to 9 months, as indicated by absence of death, stent thrombosis and myocardial infarction (MI). Press release: Industry’s First Hybrid Drug-Eluting Stent from BIOTRONIK demonstrates Safety and Effic... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4893598 Thu, 02 Jun 2011 19:16:36 +0100 4893598 http://www.medworm.com/index.php?rid=4893600&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FgdHcvTW7qjo%2Fscottcare-oneview-crm-for-cardiac-device-management.html ScottCare of Cleveland, Ohio has released the OneView CRM, a software package that can manage data from various implantable cardiac devices, including those from St. Jude Medical, Boston Scientific, Biotronik and Medtronic. “OneView provides allied professionals and physicians with the ability to monitor and manage patients with implantable cardiac devices, regardless of the manufacturer. We are able to consolidate discrete data and PDFs from St. Jude Medical, Boston Scientific, Biotronik and Medtronic – from the programmer at implant or in-clinic interrogation, and from manufacturer web portals for remote device interrogations,” said Brad Freeman, National Sales Director for ScottCare. OneView™ is a web-accessible application and can be accessed from any computer, iPad, or sma... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4893600 Thu, 02 Jun 2011 16:55:09 +0100 4893600 http://www.medworm.com/index.php?rid=4883700&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FoD3PYK2R5VQ%2Fford-unveils-contactless-ecg-sensing-driver-seat.html Just a week ago, Ford announced partnerships for its in-car health management system, and now it is unveiling another, this time self-developed, auto part: a contactless ECG sensing driver’s seat. The seat has six built-in sensors that together produce a signal very similar to a single lead ECG. The sensors, developed by Aachen University in Germany, consist of capacitative electrodes that can detect electrical activity contact-free at a short distance.  Through thin layers of clothing an accurate ECG can be produced, while thicker layers increase interference.  But even with clothes thickness of 2.5 mm, at least the QRS-complex can be clearly identified. Several filtering techniques are employed to reduce artifacts caused by body movements. According to Ford, the seat produces acc... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4883700 Tue, 31 May 2011 05:26:27 +0100 4883700 http://www.medworm.com/index.php?rid=4883574&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1586%2F0%2Fexperts-on-cholesterol.mp3 This study was designed to show that increasing HDL levels with niacin would improve outcomes.)  The study was stopped 18 months ahead of schedule not only because it was determined to be extremely unlikely that the increase in HDL produced by niacin would improve outcomes, but also because of an unexpected increase in strokes among the patients receiving niacin. 5) Numerous trials using statin drugs have demonstrated that these drugs can reduce cardiovascular events and improve cardiovascular mortality – without an increase in non-cardiovascular mortality – in patients who have known heart disease or who are at increased risk for heart disease. However, the mechanism by which statins provide these benefits may have little or nothing to do with their chol... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4883574 Mon, 30 May 2011 11:24:50 +0100 4883574 http://www.medworm.com/index.php?rid=4872192&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F08lCqLEyfis%2Fcordis-receives-fda-approval-for-exoseal-vascular-closure-device.html Cordis has received FDA approval for its Exoseal vascular closure device. The tool, used to close the femoral artery puncture site during diagnostic angiographies and interventional procedures, employs an absorbable plug to close the vessel wall. In a clinical trial comparing the Exoseal to the traditional alternative, prolonged manual compression or compression with a clamp or bag, the Exoseal resulted in shorter time to cessation of bleeding and an almost two-third reduction in time to ambulation. The device has been available in Europe, Asia and Latin America since June 2010. Some more information on the workings of the device from the press release: The EXOSEAL™ Vascular Closure Device makes use of key technological developments to support the clinical safety of the closure procedure... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4872192 Fri, 27 May 2011 19:40:38 +0100 4872192 http://www.medworm.com/index.php?rid=4872195&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FPviCqFKQjvY%2Fabbott-unveils-new-smaller-diameter-xience-v-drug-eluting-cardiac-stent.html The FDA has approved Abbott’s new 2.25mm diameter XIENCE V stent, which the company has dubbed XIENCE nano. Abbott claims that the XIENCE platform is ideal for small vessel angioplasties, which experience restenosis more often than larger vessels. From the press release: FDA approval of XIENCE nano was supported by results from the SPIRIT Small Vessel clinical trial, which showed very low late loss (a measure of vessel re-narrowing) of 0.20 mm and a target lesion failure (TLF) rate of 8.1 percent, which is comparable to results observed in the SPIRIT clinical trials with XIENCE V. TLF is defined as a composite measure of important efficacy and safety outcomes for patients and includes cardiac death, heart attack attributed to the target vessel (target vessel myocardial infarction), and i... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4872195 Thu, 26 May 2011 18:22:32 +0100 4872195 http://www.medworm.com/index.php?rid=4872196&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F5GNTZ7xFSno%2Faera-ct-continuous-wireless-cardiac-monitor.html TZ Medical and Cinterion have unveiled a new wireless heart monitor that can continuously record and transmit cardiac data without any interaction by the user. The Aera CT can detect atrial fibrillation, bradycardia, tachycardia, and pauses, and will transmit physician defined events back to the clinic along with relevant recorded data.  The device is capable of continuous operation for up to 28 days, and can also work as a communication device using the built-in speakerphone.  Emergency personnel can be quickly dispatched if the clinic is seeing the patient’s heart having a life threatening arrhythmias.  It is expected the Aera CT will be going to market in North America in the third quarter of this year. Features from the product brochure: Combines the internet, wireless communi... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4872196 Thu, 26 May 2011 18:20:13 +0100 4872196 http://www.medworm.com/index.php?rid=4852863&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprediction-physicians-will-retire-earlier-and-earlier-because-medicine-is-no-longer-fun%2F2011.05.21 I wonder if we’re in danger of stifling fun in medicine. Certainly there are still fun things to do in medicine (ablating a pesky accessory pathway safely, for instance). But as I watch the newly-minted medical school graduates emerge from their long, sheltered educational cocoon, I wonder what their attrition rate will be from medicine once they see our new more-robotic form of health care community. There is a social camaraderie in medicine when you train. Maybe it’s the “misery loves company” syndrome. In medical school you stick together through thick and thin because few others understand what you’re going through. You strive for the day when, collectively, you earn the designation of “doctor of medicine.” There’s a strength in numbers. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4852863 Sat, 21 May 2011 16:00:00 +0100 4852863 http://www.medworm.com/index.php?rid=4848016&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F7b_1t-bRq5U%2Fnano-patching-a-broken-heart.html How can you mend a broken heart? Cardiologists (and the Bee Gees) have been wrestling with this question for years. The difficulty is that when one suffers a myocardial infarction (heart attack), the lack of blood supply to certain parts of the heart can eventually cause myocardial scarring. Myocardial scarring can lead to potentially life-threatening arrhythmias and increase the risk of a ventricular aneurism. Moreover, the loss of this healthy heart tissue is essentially permanent. Part of the heart literally dies. However, advances in nanotechnology have allowed researchers at Brown University to investigate the use of carbon nanotubes to regenerate cardiomyocytes and neurons. Using carbon nanotubes and a polymer as a kind of scaffold, they seeded it with cardiomyocytes. Why use carbon ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4848016 Fri, 20 May 2011 18:12:55 +0100 4848016 http://www.medworm.com/index.php?rid=4848019&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F8UVttgaOvhE%2Fsubclavian-approach-proves-successful-in-implanting-medtronic%25e2%2580%2599s-corevalve-system.html We’ve reported on Medtronic’s alternative subclavian approach for installing its CoreValve System in the past, and now the company has announced a new study which further demonstrates the procedure’s safety and efficacy. The CoreValve system allows for replacement of a stenosed aortic valve via a catheter, without the need for open heart surgery. The procedure was CE marked last December, making CoreValve the only transcatheter aortic valve implantation system approved for use via subclavian approach. From the press release: The multi-center study evaluated 132 consecutive subclavian patients in Italy and found positive patient outcomes, despite patients in the subclavian group being sicker than patients in the femoral access group (based on EuroSCORE and rates of peripheral arte... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4848019 Fri, 20 May 2011 15:59:46 +0100 4848019 http://www.medworm.com/index.php?rid=4841686&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D267 What a revolutionary concept: reshaping the heart to treat coronary artery disease (CAD) and mitral regurgitation.  Each year an estimated 95,000 surgical procedures are performed to treat the 500,000 Americans that are diagnosed with heart valve disease.  Although mitral valve surgery has improved over the years, the procedure it is not without risks.  Damage to the heart muscle as a result of the surgery has mortality ranges from 2% to 7%, depending on the condition of the patient. The promise of preventing heart valve leakage without the need for surgical replacement or cardio-pulmonary bypass technology has several companies developing devices.  Designs are based on a combination of biocompatible mesh wraps and strips that are implanted around the heart.  These can be adjusted to ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4841686 Thu, 19 May 2011 17:41:38 +0100 4841686 http://www.medworm.com/index.php?rid=4841646&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FUoqGhikLSo8%2Ftryton-side-branch-coronary-stent-now-in-larger-sizes-in-eu.html Tryton Medical has received CE Mark approval for the company’s larger sized side stents for treatment of coronary artery disease.  The Tryton Side Branch System is now available in 3.0 to 3.5mm and 3.5 to 4.0mm sizes. From the product page: The Tryton Side Branch Stent System is designed to treat a wide spectrum of bifurcated lesions. The system’s highly deliverable stent is deployed in the side branch artery using a standard single-wire balloon-expandable stent delivery system. A conventional drug eluting stent is then placed in the main vessel. The Side Branch Stent features a low-profile cobalt chromium design compatible with 5F guide catheters. The stent’s unique three-zone design provides superior scaffolding within the side branch, radial strength in the transition zone, a... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4841646 Thu, 19 May 2011 17:16:37 +0100 4841646 http://www.medworm.com/index.php?rid=4841649&cid=t_90601_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Ftqzx-reSE0I%2Fwatching-the-watchman-again.html We last reported on the Watchman left atrial appendage device back  in 2009.  Since then, Minnesota based AtriTech has been acquired by Boston Scientific, and there is new data about its use as an alternative to warfarin. To review,  the Watchman is a device that is placed in the left atrium to exclude the left atrial appendage, where a thrombus is likely to form in a patient with atrial fibrillation, thus reducing the potential for a stroke.  The device is implanted in the cath lab with conscious sedation (see animation). Previous studies have confirmed the non-inferiority of this device to warfrain, and the latest data shows its utility in patients who have contraindications to warfarin.  Twenty-four of these patients were implanted with the Watchman device and received aspirin a... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4841649 Wed, 18 May 2011 19:26:37 +0100 4841649 http://www.medworm.com/index.php?rid=4828889&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FSS9WGdbMWKw%2F The generic standard of mediocrity underpinning the Emergency Musical Interlude series has just taken a giant step forward with "Not Enough Perfusion" b y Manik, M.D.M.C. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4828889 Tue, 17 May 2011 09:27:42 +0100 4828889 http://www.medworm.com/index.php?rid=4820857&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-industry-largesse-is-a-necessary-part-of-good-healthcare%2F2011.05.12 Largesse: (Form thefreedictionary.com): 1. a. Liberality in bestowing gifts, especially in a lofty or condescending manner. b. Money or gifts bestowed. 2. Generosity of spirit or attitude. Two days into last week’s Heart Rhythm Society meeting, Propublica, an independent online investigative journalism-in-the-public-interest endeavor published a series of high profile articles as part of their Dollars for Docs series. Their marquee piece, published prominently in the USA Today, chronicled the strong financial ties (the ‘largesse’) that bind medical societies to industry. Reporters Charlie Ornstein and Tracy Weber highlighted the meeting’s ‘mansion’-sized exhibits, intense advertising, and the fact that most of the opinion leaders, officers of medical societies and guideline wri... Better Health blogs http://www.medworm.com/rss/comments.php?id=4820857 Thu, 12 May 2011 15:30:02 +0100 4820857 http://www.medworm.com/index.php?rid=4813287&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcould-a-low-salt-diet-be-bad-for-your-heart%2F2011.05.11 In this study of 3,681 men and women from Belgium, Bulgaria, Italy, Poland, Romania and Russia whose health was followed for eight years, participants with the lowest sodium excretion (which is a good measure of sodium intake) were 56% more likely to have died from cardiovascular disease than those with the highest sodium excretion. Among the nearly 2,100 participants with normal blood pressure at the study’s start, sodium excretion (sodium intake) had no effect on the development of high blood pressure. These are startling findings. If true, they would undercut major programs by the U.S. government to reduce Americans’ intake of salt—the main source of sodium—from prepared and processed foods and at home. (more…) *This blog post was originally published at Harvard ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4813287 Wed, 11 May 2011 16:00:07 +0100 4813287 http://www.medworm.com/index.php?rid=4803132&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fplavix-and-the-purple-pill-are-they-really-a-dangerous-combination%2F2011.05.10 When the medical press seizes a story, it can become an obsession. Any physician who is reading any journal is aware of the reported interaction between clopidrogel (Plavix) and proton pump inhibitor (PPI) drugs, including Prilosec and her cousins. PPI medicines are not exotic elixirs known only to medical professionals. They are known to any person with a working TV set or who still reads a newspaper, since ads for these drugs are omnipresent. Just google ‘purple pill’ and begin your entrance into the PPI Chamber of Advertising. PPI medicines are highly effective for peptic ulcers and gastroesophageal reflux, although I suspect that most patients on these medications do not have any true indication for them. (Disclosure: I’ve pulled the PPI trigger too quickly on many patients who d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803132 Tue, 10 May 2011 14:05:51 +0100 4803132 http://www.medworm.com/index.php?rid=4803135&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcalcium-supplements-good-for-your-bones-but-bad-for-your-heart%2F2011.05.10 Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as an important measure in preserving bone density and reducing the risk of fractures. For those who don’t like dairy products, even products like orange juice and Vitamin Water are fortified with calcium. The general perception seemed to be that calcium consumption was a good thing – the more, the better. Until recently. In a pattern similar to that I described with folic acid, there’s new safety signals from trials with calciu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803135 Tue, 10 May 2011 13:00:59 +0100 4803135 http://www.medworm.com/index.php?rid=4803140&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fgender-disparities-in-heart-attack-treatment-women-more-likely-to-die%2F2011.05.09 One-third (33.5%) of female heart attack patients receive surgery or angioplasty compared to nearly half (45.6%) of men, and among heart attack patients receiving an intervention such as coronary bypass surgery or angioplasty, women had a 30% higher death rate compared to men, reports HealthGrades. The findings are based on an analysis of more than 5 million Medicare patient records from 2007 to 2009 and focused on 16 of the most common procedures and diagnoses among women. The most noticeable disparities were in cardiovascular care. Heart disease is the #1 killer of women in America, surpassing all forms of cancer combined, the company said in a press release. (more…) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4803140 Mon, 09 May 2011 16:00:00 +0100 4803140 http://www.medworm.com/index.php?rid=4797773&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-education-at-its-best-an-example-from-griffin-hospital%2F2011.05.07 A vital aspect of participatory medicine is helping patients learn how to participate. This week I saw a great example of someone who’s doing it right. Here’s the story, including the patient aid for download. We hear a lot about “patient-centered”: patient-centered care, patient-centered thinking, everything. Frankly, a lot of it strikes me as patient-centered paternalism: people mean well, but patients sense that the thinking didn’t happen while standing in patients’ shoes, because the advice, policies, and publications just don’t hit home. It’s like somebody guessed what you want, instead of knowing (because they’re like you). A couple of years ago I learned about Planetree, a terrific, small organization in Connecticut that’s been thinking from the patient’s point... Better Health blogs http://www.medworm.com/rss/comments.php?id=4797773 Sat, 07 May 2011 20:00:15 +0100 4797773 http://www.medworm.com/index.php?rid=4789244&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-competitive-cyclists-undergo-cardiac-ablation-for-atrial-fibrillation%2F2011.05.06 The number of emails that come from fellow cyclists (and endurance athletes) with heart rhythm issues amazes me. I am more convinced than ever that our “hobby” predisposes us to electrical issues like atrial fibrillation (AF)—that the science is right. Obviously, my pedaling “habit” creates an exposure bias. I hear from many of you because we cyclists understand each other. Like you, I consider not competing a lousy treatment option. As a bike racer, I know things: that prancing on an elliptical trainer at a health club doesn’t cut it, and, that spin classes may look hard, but do not come close to simulating real competition. I know the extent of the inflammation required to close that gap, to avoid getting dropped when one of the local Cancellara-types have you in the gutter i... Better Health blogs http://www.medworm.com/rss/comments.php?id=4789244 Fri, 06 May 2011 08:38:25 +0100 4789244 http://www.medworm.com/index.php?rid=4789414&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D255 We have great news for cardiology service lines: the 2011 payment level for outpatient cardiac rehabilitation will see an increase from $38 to $69 (APC 0095).  This may not seem like it will make a significant impact, but considering that CMS covers up to 36 one-hour sessions per patient, this translates to over $1,100 in additional revenue (per patient) for hospitals and $200 for physicians.  Rehab programs are intended to limit patients’ chances of a new heart attack and to help them return to society as quickly as possible.  Clinical trials show that attending all 36 sessions reimbursed by Medicare lowers the risk of death (47%) and heart attack (32%) when compared to attending fewer sessions or no rehab at all.  Each year, approximately 4.7 million patients with congestive heart ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4789414 Thu, 05 May 2011 13:54:13 +0100 4789414 http://www.medworm.com/index.php?rid=4780373&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D252 The 2011 payment level for monitoring implantable loop recordings (ILR) jumped from $38 to $166.  What a boost!  That’s over a 330% increase.  Someone at CMS must be pretty excited about what the technology has to offer patients. Prior to 2011, CPT 93299 (implantable loop recorder monitoring system data management) was assigned to APC 0689 (electronic analysis of cardioverter-defibrillators).  The code is intended to reimburse the hospital for the receiver station, the remote storing, and review of the data by a technician.  The increase in payment is a result of CMS assigning the CPT code 93299 to APC 0691 (electronic analysis of programmable shunts/pumps).  Why such a significant increase?  When CMS makes a big change like this, it is to help encourage the use of a technology, a... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4780373 Tue, 03 May 2011 13:49:03 +0100 4780373 http://www.medworm.com/index.php?rid=4775390&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbig-brother-taken-to-another-level-physician-movements-tracked-with-rfid-tags-at-medical-conferences%2F2011.05.02 Not everything that counts can be measured. Not everything that can be measured counts. -Albert Einstein Recently, a disturbing trend of monitoring physician quality and accountability has taken another ominous turn: tracking physician’s movements at scientific conferences (so called “tag and release”) using RFID tags imbedded in attendees name badges at national scientific sessions. Having had personal experience with the recent American College of Cardiology meeting, this technology will also be imbedded in the name badges for attendees at the upcoming Heart Rhythm Society meeting to be held in San Francisco in May. On first blush, it shouldn’t be such a big deal, right? It was all just a great way for companies to obtain, for a fee, the names and institutions of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775390 Mon, 02 May 2011 16:00:00 +0100 4775390 http://www.medworm.com/index.php?rid=4775392&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiologists-not-needed-a-nurse-and-a-computer-will-do%2F2011.05.02 Wait… Before reading any further, I would like to issue a warning. If your ideas about healthcare delivery are of an older ilk; if you cling white-knuckled to past dogma, please stop reading now. What follows may cause your atria to fibrillate. Last month I wrote that the best tool for treating atrial fibrillation (AF) was to give patients information—to teach them about their AF, its complications, role of lifestyle factors and the many treatment options. I didn’t say this was easy. In fact, thoroughly explaining AF takes nearly the same time it takes me to isolate the pulmonary veins–a lot longer than the 10 minutes allotted for a typical office visit. (Remember: of a 30 minute office visit, I have to review your chart, listen attentively to your story, examine you, and complete ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775392 Mon, 02 May 2011 12:00:46 +0100 4775392 http://www.medworm.com/index.php?rid=4767994&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbeer-bellies-anyone-waist-measurement-can-determine-risk-for-heart-disease%2F2011.04.30 Extra fat that accumulates around the abdomen goes by many names: beer belly, spare tire, love handles, apple shape, middle-age spread, and the more technical “abdominal obesity.” No matter what the name, it is the shape of risk. Abdominal obesity increases the risk of heart attack, stroke, diabetes, erectile dysfunction, and other woes. The danger zone is a waist size above 40 inches for men and 35 inches for women. As I describe in the April 2011 issue of the Harvard Men’s Health Watch, beer is not specifically responsible for a beer belly. What, then, is to blame? Calories. Take in more calories with food and drink than you burn up with exercise, and you’ll store the excess energy in fat cells. Many studies indicate that people who store their extra fat around the midsection (ap... Better Health blogs http://www.medworm.com/rss/comments.php?id=4767994 Sat, 30 Apr 2011 12:00:10 +0100 4767994 http://www.medworm.com/index.php?rid=4753696&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstatin-use-is-increasing-dramatically-are-americans-healthier-for-it%2F2011.04.25 Baseball fans have the Baseball Prospectus annual. Political junkies can get their fix from Nate Silver’s 538 blog. For those of us with geeky interest in health and medicine statistics, graphs, and charts, the Health, United States, 2010 report from the National Center for Health Statistics is that kind of treat. The 41 charts and graphs and 148 trend tables in the 2010 report (it’s dated 2010 but was released earlier this year) could keep me happily occupied for hours. One graph that really caught my eye shows the percentage of Americans that take a statin. Statins are prescribed mainly to lower “bad” LDL cholesterol, but they may have other benefits, too. The statins include atorvastatin (sold as Lipitor), rosuvastatin (sold as Crestor), and simvastatin (sold as Zocor but also a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4753696 Mon, 25 Apr 2011 18:00:48 +0100 4753696 http://www.medworm.com/index.php?rid=4734101&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Famazing-leaps-in-medical-knowledge-heart-physiology-then-and-now%2F2011.04.20 These last several weeks I have been absolutely overwhelmed with science, meetings, writing, and reviews. I might complain, but I should also be flattered that I am as busy as I am. Mama is in demand, little muffin. Still, things are beginning to slow down to a tolerable level on my end, which means I will be back to blogging. Today I was working on some writing when I had cause to review some historical texts. It gives me pause to stop and consider things that we take for granted. For example, think about how blood flows through the heart and lungs… Figure 1: Blood flows from right to left, across the lungs. I can’t tell you how many times a day I look at a heart and  take for granted that blood should flow from the venous circulation, into the right side of the heart, acros... Better Health blogs http://www.medworm.com/rss/comments.php?id=4734101 Wed, 20 Apr 2011 19:00:08 +0100 4734101 http://www.medworm.com/index.php?rid=4734102&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-hug-that-may-have-saved-a-life%2F2011.04.20 Every once in a while we physicians make an astute (or perhaps lucky) observation that becomes a turning point in a patient’s life. I’ll never forget the time that I placed a hand on an elderly woman’s belly after she said that she felt a little bit dizzy – the pulsatile abdominal mass that I discovered set in motion a cascade of events that resulted in life-saving surgery for an disecting abdominal  aortic aneurysm (AAA). It was incredibly gratifying to be involved in saving her life – and now anyone who so much as swoons in my vicinity gets a tummy rub! (Yes, Dr. Groopman I know that’s not necessarily a rational response to one lucky “exam finding.”) Last week I made a fortunate “catch” on the order of the AAA discovery from ye... Better Health blogs http://www.medworm.com/rss/comments.php?id=4734102 Wed, 20 Apr 2011 16:00:32 +0100 4734102 http://www.medworm.com/index.php?rid=4723801&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Funcover-your-heart-disease-risk-with-a-wrist-band-device%2F2011.04.18 A study published in journal Chest has shown that novel intra-sleep pulse oxymetry can be an effective modality in identifying cardiovascular disease risk in patients. In the study, a modified version of Weinmann‘s SOMNOcheck micro oximeter was used to observe pulse wave attenuation, heart rate acceleration, pulse propagation times, as well as respiration-related pulse oscillations and oxygen desaturation episodes. All the collected data was analyzed by an algorithm, and the prognostic results were checked against European Society of Hypertension/European Society of Cardiology (ESH/ESC) risk factor matrix. Some details from the study abstract: (more…) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4723801 Mon, 18 Apr 2011 15:00:51 +0100 4723801 http://www.medworm.com/index.php?rid=4724005&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D238 MR is a complicated degenerative heart disease that requires surgical intervention to either repair or replace the valve.  Because of this, patients face a two to three hour surgery and at least a week in the hospital.  Although surgical intervention has a high success rate for younger, healthy patients, surgery may not be an option for those in a compromised state.  As a result, multiple systems are being developed that will assist physicians delivering the therapy percutaneously and on a beating heart.  Similar to a lot of emerging technologies, the first-generation systems will focus on end-stage heart patients.  But, as percutaneous technologies evolve, cath labs will play a larger part in heart surgeries traditionally seen in the operating room. Percutaneous mitral valve repair i... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4724005 Mon, 18 Apr 2011 13:35:02 +0100 4724005 http://www.medworm.com/index.php?rid=4714740&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-doing-fine-is-relative%2F2011.04.14 It was 11:00 pm when the pager vibrated, then beeped: it was the ER, Hospital #3. “This is Dr. Fisher returning your page?” “Thank you Dr. Fisher, just a moment for Dr. Frigamafratz.” A brief pause, then: “Wes, I think we’ll need your services. Old guy, found down at the nursing home, brought in unconscious, pulse 25 – hooked him up to an external pacer, he’s back with us now.” “I’m on my way.” When I arrived, there was the usual cacophony of activity in the Emergency Room. Someone screaming in one corner. Intercom sounding. Ambulance en route to our location. Breathing treatments underway in Bay 5. Room 10 headed to the CT scanner. Has room 12 got a bed? By comparison my patient was easy: his disposition in the eyes o... Better Health blogs http://www.medworm.com/rss/comments.php?id=4714740 Thu, 14 Apr 2011 23:00:00 +0100 4714740 http://www.medworm.com/index.php?rid=4714741&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-a-patient-who-asks-for-salt-for-his-eggs-could-cost-a-hospital-2-5-million%2F2011.04.14 This was a classic moment of comical clarity that only comes along once a week.  As you may or may not know, starting in 2013, The Medicare National Bank has promised to take back 1% of all  of a hospital’s total Medicare revenue (to increase in future years) if the hospital has a higher 30 day readmission rate for  congestive heart failure, acute myocardial infarction or pneumonia than an as yet undefined acceptable 30 day rate of readmission. What does this mean?  It means if the government decides that 20% is an acceptable rate for congestive heart failure 30 day readmission, and the hospital has a readmission rate of 25%, the hospital will be told to return 1% of all Medicare revenue for the year, not just their heart failure revenue. Let’s use some hypothetical numbers... Better Health blogs http://www.medworm.com/rss/comments.php?id=4714741 Thu, 14 Apr 2011 21:00:00 +0100 4714741 http://www.medworm.com/index.php?rid=4714750&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FQiqApWaeJFc%2F It's April 2011 and time for @EBMedicineʼs Emergency Medicine Practice. This month the focus on the hottest of hot topics, therapeutic hypothermia. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4714750 Thu, 14 Apr 2011 15:07:15 +0100 4714750 http://www.medworm.com/index.php?rid=4709209&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FfxqSH9JDGF4%2F Is it safe to give a patient frusemide if he has an allergy to sulfa drugs? Are you feeling slightly immunologically discombobulated? The answer's here. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4709209 Wed, 13 Apr 2011 07:38:13 +0100 4709209 http://www.medworm.com/index.php?rid=4696619&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-childs-impression-of-an-operating-room%2F2011.04.10 He must have been about eight at the time. I had made the mistake of watching doctor shows on TV with him and he had probably heard my wife and I describe the challenges of my doctor lifestyle at times over dinner. For the most part, he seemed oblivious and liked the things that most young boys at that age do: sports, jungle gyms, mud, and bicycles, but he had never seen his Dad at work. So the day came when my wife was doing errands and stopped by the hospital with the kids to drop off my pager which I had inadvertently left at home. As timing would have it, I had just scrubbed in a case, so she was kind enough to bring the pager to the electrophysiology lab control room where the technicians could retrieve it for me. My son, realizing how close he was to my workplace asked within earshot... Better Health blogs http://www.medworm.com/rss/comments.php?id=4696619 Sun, 10 Apr 2011 20:00:00 +0100 4696619 http://www.medworm.com/index.php?rid=4693368&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D232 Remote real-time monitoring of heart patients will see a 7% boost in payment for 2011 but could have seen over a 75% reduction (CPT 93229) if the 2010 CMS assessment was allowed to stand.  Telemonitoring is the next generation of Holter technology and is set to impact a market already worth an estimated $140 million for 2010.  The reimbursement is good news, but new technology needs to improve outcomes as well as have a physician following.  I spoke with Ron Merrill, MD, chairman of the Department of Surgery at Virginia Commonwealth University in Richmond, VA, and one of the early supporters of telemedicine.  He explained, “Telemonitoring allows us to bring more information about a patient’s condition to the physician in real time no matter where they are.  This is especially impo... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4693368 Fri, 08 Apr 2011 14:06:53 +0100 4693368 http://www.medworm.com/index.php?rid=4676916&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D227 A few months ago, I read in the Federal Registry that Cardiac PET studies will see a 23% cut in reimbursement for 2011.  This looks pretty dramatic but one thing to consider is that in 2010, Cardiac PET studies saw a 20% increase.  It is this kind of unpredictability the makes it hard for a CFO to project a budget.  Is it just a readjustment by CMS or is there another reason for the change?  I did some checking, and other than labor, there are two primary costs associated with Cardiac PET studies: capital costs and the Rubidium-82 radioisotopes.  According to the MD Buyline database, capital costs for PET and radioisotope generating technology have been fairly stable over the last few years. The consumable portion of the radioisotope generator costs between $29,000 and $32,000, depend... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4676916 Mon, 04 Apr 2011 14:17:19 +0100 4676916 http://www.medworm.com/index.php?rid=4670108&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysicians-pressured-not-to-order-tests-then-sued-if-they-dont%2F2011.04.02 Cardiologists in Connecticut are standing up to the lack of liability protection in the state’s new low-income health plan called SustiNet: The SustiNet program would create large pools of people, including those who can’t currently afford health insurance, that would theoretically drive down premium costs by competing with the plans of private insurers. Among other cost savings, it would designate a single doctor or practice for each patient, to reduce emergency care use, and create new “best-use” procedures for a variety of ailments to reduce the number of tests doctors order. But a key provision of the plan was that doctors, in return for following the new procedures and ordering fewer tests, would be protected from malpractice suits if the outcome of a case was ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4670108 Sat, 02 Apr 2011 21:00:00 +0100 4670108 http://www.medworm.com/index.php?rid=4670112&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysical-activity-versus-physical-fitness-it-could-mean-the-difference-between-life-and-death%2F2011.04.01 My neighbor Ed was a thin man all his life. He maintained an ideal body weight by combining regular physical activity with a modest intake of calories. He was a “young” seventy year-old who looked the picture of heart health. Ed regularly read the newspaper while walking on his treadmill, he hit a golf ball straighter and longer than his peers, and he wore the same size jeans now than he did in college 50 years ago. What’s more, he bragged about his low blood pressure, normal cholesterol level and perfect blood chemistries. He took no pills. I think he went to his primary care doctor each year just to show off his health. The morning he woke with crushing chest pressure and shortness of air stunned him. “This couldn’t be a heart attack?” he thought. An hour later, minutes after... Better Health blogs http://www.medworm.com/rss/comments.php?id=4670112 Fri, 01 Apr 2011 20:00:20 +0100 4670112 http://www.medworm.com/index.php?rid=4664177&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmitral-valve-regurgitation-caused-elizabeth-taylors-death-could-it-affect-you%2F2011.03.31 I am saddened that Elizabeth Taylor died recently of heart failure. In his appreciation of her, film critic Roger Ebert said in the Chicago Sun-Times, “Of few deaths can it be said that they end an era, but hers does.” She is a star that many of us felt we knew. She was a great actress and a woman of great beauty who was a hard working champion of people with AIDS and always seemed to be a determined person who knew herself. Yet she always had a vulnerable side. So many marriages, so many illnesses, so many, many surgeries, over 40, I’ve read. And then her heart problem developed. Which leads me to talk a little about that problem, mitral valve leakage. The heart’s mitral valve The heart has four chambers and four valves that open to let blood through to the next chamber of th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4664177 Thu, 31 Mar 2011 23:00:00 +0100 4664177 http://www.medworm.com/index.php?rid=4653602&cid=t_90601_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FdtWgguerbvk%2F Yet another study has found a conflict of interest among doctors. This time, conflicts were reported by 56 percent of 498 docs who helped write 17 guidelines for the American Heart Association and American College of Cardiology between 2003 through 2008, according to the study published today in the Archives of Internal Medicine (see the abstract). And this finding matters because these panels typically wield considerable influence. “Panels are the select groups of experts who are assigned to evaluate science independently and issue their advice to other doctors on what to do in clinical practice,” the researchers write. Guidelines “play an important role in synthesizing information for clinicians, as well as increasing uniform practice to certain standards and avoiding t... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4653602 Tue, 29 Mar 2011 20:15:11 +0100 4653602 http://www.medworm.com/index.php?rid=4642592&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-government-is-not-keeping-up-with-medical-guidelines%2F2011.03.28 In case people are wondering if our governmental overlords really care about the latest and greatest treatment guidelines published by our professional health care organizations, take note. CMS (Center for Medicare and Medicaid Services) is still using guidelines for defibrillator implantation from 2005 to justify payment for services in their national coverage decision, whereas the latest guidelines published by the Heart Rhythm Society published in 2008 carry signficiant differences in their recommendations for appropriate patients for this technology. So which set of guidelines should doctors use? The answer is obvious: if you use the latest data to decide who should receive a defibrillator, you might be subject to a Department of Justice investigation. So much for using updated guideli... Better Health blogs http://www.medworm.com/rss/comments.php?id=4642592 Mon, 28 Mar 2011 14:00:00 +0100 4642592 http://www.medworm.com/index.php?rid=4642593&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Felizabeth-taylor-and-understanding-heart-failure%2F2011.03.28 The condition that took Elizabeth Taylor’s life affects millions of Americans. Reports of Elizabeth Taylor’s death focused, as they should, on her life, not on her death from heart failure. But given how common this condition is—the American Heart Association says nearly 6 million Americans are living with heart failure and it kills about 300,000 each year—a little attention to it might be a good idea. What is heart failure? The term “heart failure” is a scary one, conjuring up images of a heart that is suddenly unable to work. In truth, it represents a gradual decline in the heart’s ability to pump enough blood to meet the body’s needs. As the heart weakens, all parts of the body suffer the consequences. (more…) *This blog post was originally published at H... Better Health blogs http://www.medworm.com/rss/comments.php?id=4642593 Mon, 28 Mar 2011 12:00:26 +0100 4642593 http://www.medworm.com/index.php?rid=4626835&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FL1d65XzpRt4%2F Musings on the point of equipoise for investigating and discharging chest pain patients in light of a new paper in the Lancet describing a rapid rule-out protocol for acute coronary syndromes (the ASPECT trial). (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4626835 Wed, 23 Mar 2011 08:55:13 +0100 4626835 http://www.medworm.com/index.php?rid=4622251&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F5tJjFa-c_Ag%2F Bedside echocardiodiography is taking over the resuscitation world. Learn how to 'own the echo' when it comes to the critically ill or shocked patient! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4622251 Wed, 23 Mar 2011 04:30:36 +0100 4622251 http://www.medworm.com/index.php?rid=4615110&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FgbEuKJm-LT8%2F Brilliant images illustrating the art of myocardial infarct localisation by ECG interpretation. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4615110 Mon, 21 Mar 2011 11:52:44 +0100 4615110 http://www.medworm.com/index.php?rid=4600536&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fobesity-beats-adiposity-for-cardiovascular-risk%2F2011.03.16 Obesity contributes to cardiovascular risk no matter where a person carries the weight, concluded researchers after looking at outcomes for nearly a quarter-million people worldwide. Body mass index, (BMI) waist circumference, and waist-to-hip ratio do not predict cardiovascular disease risk any better when physicians recorded systolic blood pressure, history of diabetes and cholesterol levels, researchers reported in The Lancet. The research group used individual records from 58 prospective studies with at least one year of follow up. In each study, participants were not selected on the basis of having previous vascular disease. Each study provided baseline for weight, height, and waist and hip circumference. Cause-specific mortality or vascular morbidity were recorded according to well d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4600536 Wed, 16 Mar 2011 17:00:00 +0100 4600536 http://www.medworm.com/index.php?rid=4592399&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoes-i-know-cpr-mean-you-can-do-cpr%2F2011.03.14 While I was browsing the produce section of my grocery store the other day, the sound of a panicked voice coming over the store’s loudspeaker made me jump. “Does anyone in the store know CPR? Anyone? CPR? We need you in baked goods!” I froze. In theory, I know how to perform CPR — cardiopulmonary resuscitation. I took a two-hour course on it nearly 25 years ago. But I hadn’t given it much thought since then and I certainly hadn’t practiced what I learned. My mind started whirling as I tried to remember the sequence of steps. They’d changed the rules a few years back — I knew that much — so I wouldn’t have to do mouth-to-mouth resuscitation. But where exactly on the chest was I supposed to push? Should I form a fist and push down with my knuckles, or use the ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4592399 Mon, 14 Mar 2011 17:00:53 +0100 4592399 http://www.medworm.com/index.php?rid=4570543&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1453%2F0%2Fscreening-athletes.mp3 According to this study, the national mandatory cardiac screening program for athletes, instituted in Israel in 1997, seems not to have reduced the incidence of sudden death in young athletes at all. The incidence of sudden death was 2.6 per 100,000 athlete-years both before and after the mandatory screening was instituted. Does this mean that screening does not save any lives? No. It is certain that some individuals are spared sudden death thanks to this aggressive type of screening program – just not enough to affect the overall statistics. This result illustrates that when you are dealing with an event that has such a low incidence of occurrence, it is extraordinarily difficult to prove that your intervention is producing a statistically significant reduction in that incidence. Fu... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4570543 Thu, 10 Mar 2011 19:41:06 +0100 4570543 http://www.medworm.com/index.php?rid=4570547&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbehavior-vs-disease-a-new-way-to-look-at-health%2F2011.03.10 What is the leading cause of death in the United States? Heart disease? Cancer? No, it’s smoking. Smoking? Yes, depending on how you ask the question. In the early 90s, McGinnis and Foege turned the age-old question of what people die of on its head by asking not what diseases people die of but rather what the causes of these are. Instead of chalking up the death of an older man to say lung cancer, they sought to understand the proximate cause of death, which in the case of lung cancer is largely smoking. Using published data, the researchers performed a simple but profound calculation — they multiplied the mortality rates of leading diseases by the cause-attributable fraction, that proportion of a disease that can be attributed to a particular cause (for example, in lung can... Better Health blogs http://www.medworm.com/rss/comments.php?id=4570547 Thu, 10 Mar 2011 16:00:06 +0100 4570547 http://www.medworm.com/index.php?rid=4570551&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FgnrI48aoH-o%2F Two quick ECG problems for you this week. See if you can spot the common thread. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4570551 Thu, 10 Mar 2011 10:30:06 +0100 4570551 http://www.medworm.com/index.php?rid=4565905&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Findependent-peer-reviewed-scientific-journals-just-how-independent-are-they%2F2011.03.09 On September 27, 2010, the peer-reviewed scientific journal Europace published online-before-print a case report entitled “Spontaneous explosion of implantable cardioverter-defibrillator” by Martin Hudec and Gabriela Kaliska. In the pdf of that case report a figure containing a color photo of the affected patient’s chest, chest X-ray, and two pictures of the extracted device (one seen here) were included. The pictures and case presentation were dramatic and the case very rare. Both were perfect reasons to report such an important case to the medical literature. And so these doctors sent the case to Europace on June 29, 2010, and the article was accepted after revision on August 16, 2010, with the article appearing online September 27, 2010. The authors must have felt v... Better Health blogs http://www.medworm.com/rss/comments.php?id=4565905 Wed, 09 Mar 2011 16:00:00 +0100 4565905 http://www.medworm.com/index.php?rid=4552056&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdont-treat-the-number-treat-the-patient%2F2011.03.05 In medicine we’re often reminded not to base our therapy solely on lab test results. Although it’s tempting to reduce patient care to a checklist of “normal” bloodwork targets, we all know that this is only a fraction of the total health picture. Today I made a mistake that brought this truism home: “Don’t treat the number, treat the patient.” I’m turning 40 this year and decided to make an ambitious fitness goal for myself — to be in better shape at 40 than I was at 30. No small feat for a person who used to be in good form a decade ago (not so much now, ahem). So, I joined a gym owned by an affable triathlete and invited her to make me her project. Let’s just say that Meredith believes that one piece of sprouted grain bread is t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4552056 Sat, 05 Mar 2011 20:06:03 +0100 4552056 http://www.medworm.com/index.php?rid=4552058&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fis-turbulence-good-for-the-heart%2F2011.03.05 It’s hard to believe that turbulence could be a good thing for the heart. Consider how the word turbulent is defined: “Characterized by conflict, disorder, or confusion; not controlled or calm.” Those traits don’t sound very heart-healthy. But when it comes to heart rhythm, it turns out that a turbulent response — to a premature beat — is better than a blunted one. The more turbulent the better. No, you haven’t missed anything, and turbulence isn’t another of my typos. Until [recently], heart rate turbulence was an obscure phenomenon buried in the bowels of heart rhythm journals. What Is Heart Rate Turbulence (HRT)? When you listen to the heart of a young physically-fit patient, you are struck not just by the slowness of the heartbeat, but also by the variability... Better Health blogs http://www.medworm.com/rss/comments.php?id=4552058 Sat, 05 Mar 2011 15:00:27 +0100 4552058 http://www.medworm.com/index.php?rid=4549753&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpulmonary-embolism-if-it-can-strike-serena-williams-it-can-ace-anyone%2F2011.03.04 News that tennis star Serena Williams was treated for a blood clot in her lungs is shining the spotlight on a frightfully overlooked condition that can affect anyone — even a trained athlete who stays fit for a living. Williams had a pulmonary embolism. That’s doctor speak for a blood clot that originally formed in the legs or elsewhere in the body but that eventually broke away, traveled through the bloodstream, and got stuck in a major artery feeding the lungs. (To read more about pulmonary embolism, check out this article from the Harvard Heart Letter.) Pulmonary embolism is serious trouble because it can prevent the lungs from oxygenating blood — about one in 12 people who have one die from it. “No one is immune from pulmonary embolism, not even super athletes,” says ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4549753 Fri, 04 Mar 2011 16:00:19 +0100 4549753 http://www.medworm.com/index.php?rid=4517236&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D196 A blood test that can identify obstructive coronary artery disease in its early stages?  Talk about an impact considering over 17 million Americans suffer from coronary artery disease (CAD), a treatable disease if diagnosed early.  Technologies such as PET, CTA, and MRI have come a long way in assisting in diagnosing CAD before a cath lab is required, but due to safety concerns and a cost-sensitive environment, they are not prescribed until symptoms appear. The Corus CAD blood test is designed to measure a patient’s genetic activity as an indicator for CAD and uses 23 genes as biomarkers for plaque build up and inflammatory disease.  Combined with an algorithm that adds clinical data such as age and sex, the test provides a numeric score of 1 to 40; the higher the value, the greater t... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4517236 Thu, 24 Feb 2011 14:33:42 +0100 4517236 http://www.medworm.com/index.php?rid=4512395&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcoronary-stent-thrombosis-and-your-body-clock%2F2011.02.23 Add coronary stent thrombosis to the list of cardiac events influenced by circadian rhythms, with more events occurring during the early morning hours and in a summertime window of late July and early August. Coronary stent thrombosis joins several other adverse cardiac events that also follow a circadian pattern, such as stroke, unstable angina pectoris, acute myocardial infarction and sudden cardiac death, according to researcher published in JACC: Cardiovascular Interventions. Most studies that addressed circadian variations in cardiovascular disease were done before the advent of stents, so, researcher from Mayo Clinic-Rochester conducted a retrospective analysis of medical records and the clinic’s registry, finding 124 patients who presented with coronary stent thrombosis betwee... Better Health blogs http://www.medworm.com/rss/comments.php?id=4512395 Wed, 23 Feb 2011 14:00:00 +0100 4512395 http://www.medworm.com/index.php?rid=4495203&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmri-safe-pacemakers-available-in-u-s-hospitals-soon-what-it-means-for-heart-patients%2F2011.02.18 This was the Guest Blog at Scientific American on February 16th, 2011. New wave of MRI-safe pacemakers set to ship to hospitals This week Medtronic will begin shipping to hospitals in the United States the first pacemaker approved by the FDA as safe for most MRI scans. For consumers, it is a significant step in what is expected to be a wave of new MRI-compatible implanted cardiac devices. But this is an example of one technology chasing another and the one being chased, the MRI scanner, is changing and is a step ahead of the new line of pacemakers. The pacemaker approved for U.S. distribution is Medtronic’s first-generation pacemaker with certain limitations, while its second-generation MRI-compatible pacemaker is already in use in Europe where approval for medical devices is not as dem... Better Health blogs http://www.medworm.com/rss/comments.php?id=4495203 Fri, 18 Feb 2011 21:00:00 +0100 4495203 http://www.medworm.com/index.php?rid=4489685&cid=t_90601_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2F_D8_34_YDQg%2FzBkoSjLrWd0 (video). Renée M. Ned, PhD, MMSc discusses the benefits of cascade screening to identify familial hypercholesterolemia, a common genetic disorder that causes high levels of low-density lipoprotein (or LDL) cholesterol. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images - Blog) Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=4489685 Fri, 18 Feb 2011 05:35:00 +0100 4489685 http://www.medworm.com/index.php?rid=4489686&cid=t_90601_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F7XeH48LCvx8%2Fpeople-who-brushed-their-teeth-less.html A Scottish national population based survey examined if self reported toothbrushing behaviour is associated with cardiovascular disease and markers of inflammation (C reactive protein) and coagulation (fibrinogen).Participants were 12,000 men and women, mean age 50. Oral hygiene was assessed from self reported frequency of toothbrushing. There were a total of 555 cardiovascular disease events over an average of 8 years of follow-up, of which 170 were fatal.Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7).They also had increased concentrations of both C reactive protein and fibrinogen.Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade infla... Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=4489686 Thu, 17 Feb 2011 19:01:52 +0100 4489686 http://www.medworm.com/index.php?rid=4489675&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Foutpatient-cardiology-services-and-an-out-for-hospitals%2F2011.02.16 It’s no surprise that hospitals are acquiring cardiology and primary care groups groups in droves lately. It seems there’s a signficant financial incentive to do so for now, but doctors (and especially cardiologists) should read the tea leaves ahead. From Becker’s Hospital Review: While hospitals are limited to paying fair market value for practices, they can gain an edge over competing hospitals by offering longer employment contract terms or better electronic medical record systems and management services. If hospitals move forward with a transaction, Ms. Kaplan suggests they limit employment contracts to no more than two years if possible and rebase compensation annually based on productivity. “In healthcare you shouldn’t assume anything is permanent,&#8221... Better Health blogs http://www.medworm.com/rss/comments.php?id=4489675 Wed, 16 Feb 2011 23:00:00 +0100 4489675 http://www.medworm.com/index.php?rid=4489781&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D191 First, there was a three-armed surgical robot.  Then, an orthopedic robot came along.  What’s next?  A robotic snake?  As a matter of fact, yes.  Think about being able to reach just about any region of the body with one incision.  Cardiorobotics was first founded in 2005 and is developing the cardioARM™, “a snake robot for minimally-invasive cardiac interventions, such as treatments for patients suffering with heart arrhythmias.”  With the 10mm diameter computer-controlled device that allows for 105 degrees of freedom, a lot can be achieved. Since the first voice-controlled endoscope positioning robot (Aesop 3000) was FDA approved in the late 1990s, the technology has been constantly evolving.  Driven by the promise of more accurate and less invasive surgical procedures, t... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4489781 Wed, 16 Feb 2011 18:50:36 +0100 4489781 http://www.medworm.com/index.php?rid=4482762&cid=t_90601_88_f&fid=38153&url=http%3A%2F%2Fwww.ozemedicine.com%2Fblog%2F%3Fp%3D942 The recently published retrospective Canadian study of 5 year cancer risk following heart attack in 1996-2006 seems to demonstrate a consistent 3% increased risk in cancer per 10 milliSv radiation dose when adjusted for sex, age, comorbities (but strangely, not for smoking status, nor for actual measured radiation dosage but for presumed, estimated dosage based on investigations and procedures which were billed). Nevertheless, the increased risk seems consistently increased as radiation dose increases and thus the results may be plausible. Given the average age of these patients being ~61 years, some 14% were diagnosed with new cancers in the 2-5 years following their AMI, thus a relative increased risk of 3% per 10mSv is something to stress us! See here for the paper. This will inevitably... Oz E Medicine - emergency medicine in Australia blogs http://www.medworm.com/rss/comments.php?id=4482762 Wed, 16 Feb 2011 09:18:57 +0100 4482762 http://www.medworm.com/index.php?rid=4477763&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-physical-and-metaphorical-heart%2F2011.02.14 Listening to NPR on Saturday morning I caught part of Scott Simon’s interview with brothers Stephen Amidon and Thomas Amidon, M.D. discussing their book “The Sublime Engine: A Biography of the Human Heart.” The interview touched on the story of the human heart in science and medicine, history, and culture:  It turns out that the classic red heart symbol we see almost everywhere around Valentine’s Day doesn’t look much like a real human heart at all. “Of all the theories about where that symbol comes from, my favorite is that it is a representation of a sixth century B.C. aphrodisiac from northern Africa,” says Stephen Amidon…”And I kind of like that history because it sort of suggests that early on, people sort of understood the conne... Better Health blogs http://www.medworm.com/rss/comments.php?id=4477763 Mon, 14 Feb 2011 19:00:00 +0100 4477763 http://www.medworm.com/index.php?rid=4472953&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fq3V8lIj6izQ%2F Night shift in the surgical ICU and one of your post-op cardiac patients is showing some worrying rhythms on their ECG monitor. Can you diagnose the problem and keep them alive until the morning? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4472953 Sun, 13 Feb 2011 14:03:59 +0100 4472953 http://www.medworm.com/index.php?rid=4464494&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiologists-as-heart-whisperers%2F2011.02.11 From the Dallas Morning News, a creative moniker if there ever was one, but it should probably be reserved for primary care specialists instead: DALLAS — Heart attacks are the No. 1 cause of death and a major cause of disability in America. For nearly half of the casualties, the first symptom is the last. That’s how cardiovascular disease has earned the nickname “silent killer” — you never know when it will strike. Doctors are trying to change that by treating heart disease as a progressive problem. They are becoming “heart whisperers,” seeking new tests to read the small stresses that can, unchecked, grow into big ones. “By the time someone rolls in with a heart attack, his family will look at me bewildered, and the patient may say, ‘Doc, wha... Better Health blogs http://www.medworm.com/rss/comments.php?id=4464494 Fri, 11 Feb 2011 20:00:00 +0100 4464494 http://www.medworm.com/index.php?rid=4459969&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F4kuUyHw9VaA%2F Review of Peter L Thompson's "Coronary Care Manual (2E)". (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4459969 Thu, 10 Feb 2011 23:20:09 +0100 4459969 http://www.medworm.com/index.php?rid=4441972&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fis-february-heart-marketing-month%2F2011.02.06 Heart disease and February: What relationship could be more cozy? From the scary risks of shoveling snow (yep, you could die, so be sure to lift a little at a time), Mercedes-sponsored red dress parades and government-sponsored National Wear Red Day®, to tips for identifying heart attacks in women (men, you need a different month I guess), February has all the important stories to improve your awareness. Such a polite term “awareness.” But I wonder, now that the Internet is upon us and people are seeing their insurance rates and co-pays skyrocket, if maybe we’re shooting ourselves in the foot with all this heart-month marketing hype. People are sick and tired of testing “just to be sure.” It’s starting to directly cost them a fortune, and people are fr... Better Health blogs http://www.medworm.com/rss/comments.php?id=4441972 Sun, 06 Feb 2011 22:00:00 +0100 4441972 http://www.medworm.com/index.php?rid=4441974&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fputting-your-heart-into-the-super-bowl%2F2011.02.06 Sports fans may literally live and die on their team’s victories, according to researchers who examined cardiac mortality rates after the home team won and lost the Super Bowl. Total and cardiac mortality rates in Los Angeles County increased after the football team’s 1980 Super Bowl loss but overall mortality fell after the 1984 the team’s Super Bowl win, researchers concluded from a review of death certificates reported in Clinical Cardiology. First, authors gave a clinical review. Stress causes a cardiac cascade. The sympathetic nervous system increases and releases catecholamines. This triggers a rise in heart rate and blood pressure, and ventricular contractility increases oxygen demand, causing blood the sheer against and fracture atherosclerotic plaque, the authors... Better Health blogs http://www.medworm.com/rss/comments.php?id=4441974 Sun, 06 Feb 2011 16:00:00 +0100 4441974 http://www.medworm.com/index.php?rid=4429017&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwere-overdosing-on-sodium-whose-responsibility-is-it%2F2011.02.02 I confess to loving Campbell’s tomato bisque soup. I mix it with 1 percent-fat milk and it’s hot and delicious and comforting, but one of the worst food choices I could make because one cup contains more sodium than I should have in a day. Knowing this, I have already relegated it to an occasional treat. But by the end of this blog post I will do more. We are overdosing on sodium and it is killing us. We need to cut the sodium we eat daily by more than half. The guidelines keep coming. The U.S. government has handed out dietary guidelines telling Americans who are over 50, all African Americans, people with high blood pressure, diabetes, or chronic kidney disease to have no more than 1,500 milligrams (mg) — or two thirds of a teaspoon — of sodium daily. That’s the majorit... Better Health blogs http://www.medworm.com/rss/comments.php?id=4429017 Wed, 02 Feb 2011 23:00:00 +0100 4429017 http://www.medworm.com/index.php?rid=4424235&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiovascular-care-costs-could-triple-by-2030%2F2011.02.01 Real total direct medical costs of cardiovascular disease (CVD) could triple, from $273 billion to $818 billion (in 2008 dollars) by 2030. Real indirect costs, such as lost productivity among the employed and unpaid household work, could increase 61 percent, from $172 billion in 2010 to $276 billion. Results appeared in a policy statement of the American Heart Association. CVD is the leading cause of mortality and accounts for 17 percent of national health expenditures, according to the statement. How much so? U.S. medical expenditures rose from 10 percent of the Gross Domestic Product in 1985 to 15 percent in 2008. In the past decade, the medical costs of CVD have grown at an average annual rate of 6 percent and have accounted for about 15 percent of the increase in medical spending... Better Health blogs http://www.medworm.com/rss/comments.php?id=4424235 Tue, 01 Feb 2011 18:00:00 +0100 4424235 http://www.medworm.com/index.php?rid=4414528&cid=t_90601_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fi653ElxDuQ0%2Fatrial-fibrillation-cleveland-clinic.html Atrial Fibrillation - Cleveland Clinic video with information for patients. Dr. Walid Saliba, Cleveland Clinic staff cardiologist, discusses atrial fibrillation, the most common irregular heart rhythm that starts in the atria. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images - Blog) Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=4414528 Sat, 29 Jan 2011 17:58:39 +0100 4414528 http://www.medworm.com/index.php?rid=4411527&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstress-in-life-respond-differently-and-live-longer%2F2011.01.28 This study proved that one such intervention, cognitive behavioral therapy (CBT) for patients who suffered a first heart attack, lowered the risk of fatal and nonfatal recurrent cardiovascular disease events by 41 percent over eight years. Nonfatal heart attacks were almost cut in half. Excitement may be dampened by the fact that all-cause mortality did not statistically differ between the intervention and control groups, but did trend towards an improvement in the eight years of follow up. Definitely less suffering. Maybe less deaths. The authors state that psychosocial stressors have been shown to account for an astounding 30 percent of the attributable risk of having a heart attack. Chronic stressors include low socioeconomic status, low social support, marital problems, and work dist... Better Health blogs http://www.medworm.com/rss/comments.php?id=4411527 Fri, 28 Jan 2011 17:00:39 +0100 4411527 http://www.medworm.com/index.php?rid=4411523&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1284%2F0%2FICD-abomination.mp3 Podcast: When DrRich decided to become an electrophysiologist over 30 years ago, it was because he wanted to help figure out how to prevent sudden death.  Sudden death from cardiac arrhythmias is estimated to kill over 300,000 Americans each year, and at the time, some of the more recent victims of sudden death had been DrRich’s friends or loved ones. Because cardiac arrhythmias – even the lethal ones – can virtually always be stopped if appropriate interventions are available, these deaths can be prevented, at least in theory. DrRich wanted to help turn the theory into reality. In 1982, by virtue of being in the right place at the right time rather than by virtue of his own qualities or qualifications, DrRich’s electrophysiology shop at the University of Pittsbur... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4411523 Fri, 28 Jan 2011 15:52:57 +0100 4411523 http://www.medworm.com/index.php?rid=4399523&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprevention-magazine-pushes-non-evidence-based-heart-screening%2F2011.01.26 The February issue of Prevention magazine has an article entitled “Surprising Faces of Heart Attack” profiling “three women (who) didn’t think they were at high risk. Their stories are proof that you could be in danger without even knowing it.” No, their stories are not proof of that. The story is about three women in their 40s. The story varyingly states that the three should have had the following screening tests: – Advanced cholesterol test, carotid intimal medial thickness test ( CIMT) – Advanced cholesterol test and stress echocardiography – Cardiac calcium scoring and CIMT  There’s an accompanying piece: ”7 Tests You’re Not Having That Could Save Your Life.” I asked one of our HealthNewsReview.org medical edit... Better Health blogs http://www.medworm.com/rss/comments.php?id=4399523 Wed, 26 Jan 2011 16:00:11 +0100 4399523 http://www.medworm.com/index.php?rid=4394441&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1273%2F0%2FDOJ-investigation-EP.mp3 Podcast: Two weeks ago DrRich wrote about the abuse of implantable defibrillator guidelines, as illustrated by a recent JAMA article claiming that over 22% of ICD (implantable cardioverter defibrillator) implantations are “non-evidence based.” The abuse of the guidelines, DrRich showed, was perpetrated less by ICD implanters, and more by the authors of that article. That fact being interesting but irrelevant, DrRich went on to speculate that perhaps the Feds would rouse themselves to take this issue to the next level. It certainly did not take long. Indeed, just a days after DrRich’s post (which ought to completely absolve him of having any direct impact on the Feds’ action), it was revealed that the Department of Justice had already launched an investigation of IC... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4394441 Mon, 24 Jan 2011 16:32:33 +0100 4394441 http://www.medworm.com/index.php?rid=4382767&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fl9KNwZkmmIA%2F Among Scott Weingart’s ED Critical Care Dirty Dozen for 2010 was Dr Smith’s ECG blog. The LITFL team thought it was about team we gave this great blog a shout out too. Dr. Stephen Smith is a faculty emergency physician at Hennepin County Medical Center and an Associate Professor of Emergency Medicine at the University [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4382767 Sat, 22 Jan 2011 00:00:30 +0100 4382767 http://www.medworm.com/index.php?rid=4382826&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D153 Reimbursement for echocardiograms will decrease between 6% and 14% for 2011, which is pretty interesting considering just last year, we saw 7% to 9% increases for the same codes.  This represents an average swing of 17% in the last two years.  There are two primary APC codes that are affected by this change: APC 0269 (Level II echocardiogram, except transesophageal) has received a 14% drop to $389, which could be a readjustment since the 2009 to 2010 7% increase, and APC 0270 (transesophageal echocardiogram) dropped only 6% to $536, which had a 9% increase from 2009 to 2010. When compared to other diagnostic cardiology technology, echocardiograms are one of the cheapest and least invasive methods available for viewing the heart.  Over the years, these advantages have allowed for rapid g... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4382826 Fri, 21 Jan 2011 15:14:03 +0100 4382826 http://www.medworm.com/index.php?rid=4382768&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FoYO9zFFv5OQ%2F Love is dangerous. If you don't believe me, read on to learn about all the ways amorous acts can threaten life, limb and... other body parts. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4382768 Fri, 21 Jan 2011 05:00:16 +0100 4382768 http://www.medworm.com/index.php?rid=4360978&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprotect-your-heart-when-shoveling-snow%2F2011.01.18 After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore. Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers.  What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360978 Tue, 18 Jan 2011 18:00:40 +0100 4360978 http://www.medworm.com/index.php?rid=4360988&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FriBDX0JD8EA%2F Another crazy night in the ED... One of the nurses hands you this ECG. "Will you take a look at this guy? He doesn't look so well..." Can you recognize and treat this life-threatening tachyarrhythmia? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4360988 Tue, 18 Jan 2011 15:16:42 +0100 4360988 http://www.medworm.com/index.php?rid=4343125&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F1239%2F0%2FAbusing-ICD-Guidelines.mp3 Podcast: Last week the newswires hummed with reports that doctors from all over America are grossly over-utilizing implantable cardioverter-defibrillators (ICDs), much to the detriment of patients themselves (whose persons are being physically violated by avaricious and/or ignorant physicians), and to the hard-pressed Medicare budget (ICDs being so incredibly expensive). These reports were based on a study appearing in the Journal of the American Medical Association, which analyzed data from the National Cardiovascular Data Registry (NCDR) in an attempt to determine the proportion of ICD implants in the US which constitute deviations from government guidelines. CNN put it like this: “Of more than 100,000 people who received ICDs, almost 23% did not need them according to evidence-ba... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4343125 Thu, 13 Jan 2011 15:36:57 +0100 4343125 http://www.medworm.com/index.php?rid=4337937&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F%25e2%2580%259cjust-in-case%25e2%2580%259d-heart-tests-can-they-do-more-harm-than-good%2F2011.01.12 Here’s an important equation that all of us — doctors include — should know about healthcare, but don’t: More ≠ Better “More does not equal better” applies to diagnostic procedures, screening tests meant to identify problems before they appear, medications, dietary supplements, and just about every aspect of medicine. That scenario is spelled out in alarming detail in the Archives of Internal Medicine. Clinicians at the Cleveland Clinic describe the case of a 52-year-old woman who went to her community hospital because she had been having chest pain for two days. She wasn’t having symptoms of a heart attack, such as shortness of breath, unexplained nausea, or a cold sweat, and her electrocardiogram and other tests were fine. The woman’s doctors concluded that her ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337937 Wed, 12 Jan 2011 16:00:10 +0100 4337937 http://www.medworm.com/index.php?rid=4331094&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D142 There is great news for cardiology: the reimbursement level for Myeloperoxidase will more than double for FY 2011. Myeloperoxidase is a protein biomarker found in the blood and is more commonly referred to as MPO.  First studied in 2003, it is an early predictor for chest pain patients who are at risk of a heart attack.  Each year, over 5 million patients seek treatment for chest pain in an ER and encounter a long list of possible chest pain causes; some causes can be ruled out with basic tests.  EKGs have been an excellent test for heart problems, but in more recent years, MPO has proven very effective as an early indicator.  When discovered early, physicians can prescribe preventative treatment before damage can occur.  However, reimbursement, in most cases was below the cost of the... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4331094 Tue, 11 Jan 2011 14:24:35 +0100 4331094 http://www.medworm.com/index.php?rid=4331269&cid=t_90601_175_f&fid=39258&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FInsidePaTraining%2F%7E3%2FIFLCLKfYf7I%2Ftoughest-quarter-pa-training The Real Fun Begins Winter quarter is here, and with it, all the brain-bending goodness of what everyone tells us is the the hardest quarter of our PA training program.  We hear that this is because: Now that we are two quarters (6 months) into the program, our instructors feel secure that we know what [...]Visit us at Inside PA Training - Becoming A Physician Assistant (Source: Palpating the Field) Palpating the Field blogs http://www.medworm.com/rss/comments.php?id=4331269 Mon, 10 Jan 2011 18:14:11 +0100 4331269 http://www.medworm.com/index.php?rid=4314006&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhenrietta-lacks-and-her-immortal-cells%2F2011.01.05 If you like science, true history, and an engaging story, pick up the new book by journalist Rebecca Skloot, “The Immortal Life of Henrietta Lacks” and prepare for a great read. I knew nothing about the young black woman whose cells were taken back in 1951 by a scientist at Johns Hopkins Hospital and how those cells have revolutionized modern cell biology and research. The HeLa (named after HEnrietta LAcks) cells were taken as she lay dying on the “colored” ward at Johns Hopkins Hospital of aggressive cervical cancer at age 30. Everyone who studies basic cell biology has heard of HeLa cells because they were the first human cell line to be successfully grown in culture and they are alive today. HeLa cells were sent to researchers all across the globe and have been... Better Health blogs http://www.medworm.com/rss/comments.php?id=4314006 Wed, 05 Jan 2011 20:00:00 +0100 4314006 http://www.medworm.com/index.php?rid=4294639&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F7uC772wbUbI%2F A teenager in atrial fibrillation... A worrying family history... A very unusual looking ECG... Can you put together the pieces of the puzzle? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4294639 Tue, 28 Dec 2010 09:17:37 +0100 4294639 http://www.medworm.com/index.php?rid=4294630&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftop-cardiology-stories-of-2010-and-predictions-for-2011%2F2010.12.27 The end of the year marks a time for list-intensive posts. Recently Larry Husten from CardioExchange and CardioBrief asked for my opinion on the three most important cardiology-related news stories of 2010. Additionally, he wanted three predictions for 2011. Here goes: Top Cardiology Stories Of 2010: 1. By far, the #1 heart story of 2010 was the release of the novel blood-thinning drug dabigatran (Pradaxa) for the prevention of stroke in atrial fibrillation. Until this October, the only way to reduce stroke risk in AF was warfarin, the active ingredient in rat poison. Assuming that there aren’t any post-market surprises, Pradaxa figures to be a true blockbuster. Doctors and patients have waited a long time to say goodbye to warfarin. 2. The Dr. Mark Midei stent story: Whether D... Better Health blogs http://www.medworm.com/rss/comments.php?id=4294630 Mon, 27 Dec 2010 22:00:00 +0100 4294630 http://www.medworm.com/index.php?rid=4272289&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-musical-chairs-of-medical-speciality%2F2010.12.19 The consolidation of physician specialty practices into larger corporate healthcare systems in urban areas is creating a new challenge for today’s doctors when the music stops: There might not be a chair available. There are simply many fewer hospital systems in large urban areas than there are specialy practices, so the number of specialist positions a large healthcare system is willing to absorb might be limited. As doctors and hospital systems coalesce into as-yet-to-be-clearly-defined “accountable care organizations,” the cost of too many specialists in an organization is being carefully weighed. (more…) *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4272289 Sun, 19 Dec 2010 20:00:00 +0100 4272289 http://www.medworm.com/index.php?rid=4265740&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdefibrillators-on-the-top-10-health-technology-hazards-list%2F2010.12.16 In a desperate attempt to reach an even number it seems, hospital defibrillators were added to ECRI.org’s “Top 10 Health Technology Hazards” list of devices that threaten to kill or maim patients: The Top 10 Health Technology Hazards list is updated each year based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis, and expertise of the organization’s multidisciplinary staff. Many of the items on this year’s list are well-recognized hazards with numerous reported incidents over the years. If one honestly looks at the number of lives saved versus the number of deaths from defibrillators, I wonder how m... Better Health blogs http://www.medworm.com/rss/comments.php?id=4265740 Thu, 16 Dec 2010 23:00:00 +0100 4265740 http://www.medworm.com/index.php?rid=4258877&cid=t_90601_90_f&fid=34474&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FA2wYhSPTrwk%2Fcorrecting-vitamin-d-deficiency-may.html In a recent study, 9,400 patients had an average vitamin D level of 19.3 nanograms per milliliter - levels of 30 are generally considered "normal". At their next follow-up visit, 50% of patients had raised their vitamin D levels to above 30 nanograms per milliliter.Compared with patients whose vitamin D levels were still low, patients who raised their vitamin D levels were 33% less likely to have a heart attack, 20% less likely to develop heart failure, and 30% less likely to die between the two visits (source: WebMD)."While normal has generally been considered to be 30, some people have suggested 40 or 50 is better. People who increased their vitamin D blood level to 43 nanograms per milliliter had the lowest rates of heart disease and stroke. But increasing it beyond that, say to 60 or 7... Clinical Cases and Images - Blog blogs http://www.medworm.com/rss/comments.php?id=4258877 Tue, 14 Dec 2010 13:43:00 +0100 4258877 http://www.medworm.com/index.php?rid=4253138&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-heart-and-the-holidays%2F2010.12.12 The human heart resides in a lighltless 98.6-degree chest cavity. Its contracting muscles are further cushioned by the well-lubricated glistening smooth pericardial sac. One wouldn’t think that the heart could sense the time of year. The heart’s rhythm should remain independent of the holiday season. But then there is December in the EP lab. They are as busy as the malls. Is it the depressing weather? Or the short days? Or a post-Thanksgiving hangover? It’s hard to say, but every year for as many as I can remember, the EP lab rocks in November and December. And with the advent of deductible health plans, this holiday phenomenon has only intensified. The I-90 of the heart, the AV node, seems to give out more in the holidays. I’ll never forget the Saturday in Decembe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4253138 Sun, 12 Dec 2010 21:00:00 +0100 4253138 http://www.medworm.com/index.php?rid=4245310&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FiEWyIYEbmWY%2F The most important distinction is whether the rhythm is ventricular (VT) or supraventricular (SVT with aberrancy), as this will significantly influence how you manage the patient. SVTs usually respond well to AV-nodal blocking drugs, whereas patients with VT may suffer precipitous haemodynamic deterioration if erroneously administered an AV-nodal blocking agent. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4245310 Thu, 09 Dec 2010 04:09:30 +0100 4245310 http://www.medworm.com/index.php?rid=4237902&cid=t_90601_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FS0UKl-csoWc%2F A 26-year old man presents to ED by ambulance after an episode of syncope while playing soccer. He begins to deteriorate in the resuscitation room. Can you make the ECG diagnosis that will save his life... and possibly the lives of his children? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4237902 Tue, 07 Dec 2010 22:45:41 +0100 4237902 http://www.medworm.com/index.php?rid=4233264&cid=t_90601_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D111 Noninvasive, quick, accurate, and at a lower cost.  If that doesn’t make the top of the list, then what does?  Not that long ago, I was asked by the CEO of a forward-thinking hospital to share my views on emerging medical technology because the hospital’s board of directors was looking for a second opinion on their wish list of high-dollar new technology.  Interestingly enough, my presentation coincided perfectly with a recently-recruited cardiologist’s presentation that preceded mine.  For years, the “gold standard” for diagnosing chest pain has been a cath lab procedure.  However, along with being invasive and costly, it is a time-consuming procedure.  Coronary CT angiography has been an evolving technology for years.  Early 8- and 16-slice systems offered limited abilit... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4233264 Mon, 06 Dec 2010 14:52:15 +0100 4233264 http://www.medworm.com/index.php?rid=4225246&cid=t_90601_87_f&fid=39182&url=http%3A%2F%2Fcovertrationingblog.com%2Fcardiology-topics%2Fnot-just-any-joe-smith DrRich is delighted to note that a very good and longtime friend and former colleague has been named as one of the HealthLeaders 20 for 2010 – that is, as one of 20 people, chosen by HealthLeaders Media, who are changing healthcare for the better. DrRich has known this man for nearly two decades, and from the very beginning he has insisted his real name is Joe Smith. So let’s go with that. Joe’s recognition by HealthLeaders is very well deserved. Joe is chief medical and science officer of the West Wireless Health Institute in San Diego, a non-profit institution whose mission is to bring wireless technologies to the patient, technologies to diagnose, monitor and treat health conditions in the patient’s own home. Joe is uniquely qualified for this role, having earned... The Covert Rationing Blog blogs http://www.medworm.com/rss/comments.php?id=4225246 Fri, 03 Dec 2010 15:28:32 +0100 4225246 http://www.medworm.com/index.php?rid=4214108&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Funderstanding-treatment-the-communication-disconnect-between-doctors-and-patients%2F2010.11.30 Over the long week­end I caught up on some read­ing. One arti­cle* stands out. It’s on informed con­sent, and the stun­ning dis­con­nect between physi­cians’ and patients’ under­stand­ing of a procedure’s value. The study, pub­lished in the Sept 7th Annals of Inter­nal Med­i­cine, used sur­vey meth­ods to eval­u­ate 153 car­di­ol­ogy patients’ under­stand­ing of the poten­tial ben­e­fit of per­cu­ta­neous coro­nary inter­ven­tion (PCI or angio­plasty). The inves­ti­ga­tors, at Baystate Med­ical Cen­ter in Mass­a­chu­setts, com­pared patients’ responses to those of car­di­ol­o­gists who obtained con­sent and who per­formed the pro­ce­dure. As out­lined in the article’s intro­duc­tion, PCI reduces heart attacks in patients wi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4214108 Tue, 30 Nov 2010 17:00:42 +0100 4214108 http://www.medworm.com/index.php?rid=4203160&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Flots-of-thanksgiving%2F2010.11.25 A mom who took care of us kids far better than she did herself, always. A Dad whose advice grew better with years, although it was good then. Two brothers and a sister to share a driveway basketball court with, rain or shine. The infinite love of grandparents, who lived within hollering distance over an old Connecticut stone wall. A high school guidance counselor who said I wasn’t smart enough to go to medical school. A college biology professor who rolled out a cart of beers on that first Friday evening research conference. That I watched the movie “Hoosiers” and thought to look at Indiana University for residency, and while there met so many dedicated cardiology teachers. That I have so many great colleagues to work with now. Immersing oneself in a sea of committed peo... Better Health blogs http://www.medworm.com/rss/comments.php?id=4203160 Thu, 25 Nov 2010 22:00:00 +0100 4203160 http://www.medworm.com/index.php?rid=4200560&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthanksgiving-a-heart-attack-for-dessert%2F2010.11.25 It seems the Washington Post, cloaked under an anonymous author, wants to use scare tactics to keep most of us from enjoying Thanksgiving with their ominously titled article, “And for dessert, a heart attack?” They spew all kinds of garbage with very little data about how eating a high-fat diet might give you a heart attack. If you want to know more, consider this article* from some pretty smart folks at Harvard. Then eat, drink, and be merry without guilt (courtesy of Dr. Wes). Happy Thanksgiving! - WesMusings of a cardiologist and cardiac electrophysiologist. *REFERENCE: Renata, M. and Mozaffarian, D. “Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence.” Lipids, 31 Mar 2010. [Photo credit: La... Better Health blogs http://www.medworm.com/rss/comments.php?id=4200560 Thu, 25 Nov 2010 18:00:00 +0100 4200560 http://www.medworm.com/index.php?rid=4190157&cid=t_90601_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsudden-cardiac-arrest-how-fast-does-it-cause-unconsciousness%2F2010.11.21 How fast does sudden cardiac arrest cause unconsciousness? In just seconds. Here’s a video of Salamanca soccer player Miguel Garcia’s episode. At the start of the video, Mr. Garcia can be seen in the background of the image kneeling behind the players in the foreground. Watch carefully as he stands after tying his shoes. Although it is difficult to see, it appears an automatic external defibrillator arrives in about two minutes, though given the fact his shirt is still on as he’s taken from the field, we note the device is on his gurney as he’s hurried to a nearby ambulance. Reportedly, he survived this sudden cardiac arrest event: This was NOT a heart attack, but rather a loss of cardiac function caused by a rapid, often disorganized heart rhythm disorder. Compar... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190157 Sun, 21 Nov 2010 19:00:00 +0100 4190157