July-August 2012

Digital Version
Advances in Electrophysiology at Heart Rhythm Society 2012
The latest trends and newest cardiac rhythm management technology were highlighted during the biggest electrophysiology (EP) meeting in the world, Heart Rhythm Society (HRS) 2012 in May, held in Boston. Several new advances were showcased that may have a major impact on the future of EP.  
Seven Reasons Why to Use Automated Blood Pressure Measurement for Cardiac Stress Testing
While there are plenty of automated blood pressure (BP) monitors designed to be used for clinical applications, most of these devices will not work in cardiac stress test applications. Only motion-tolerant blood pressure monitors designed specifically for handling the high noise, high motion environment of a stress lab can accurately and reliably collect BP measurements. Ideally, the BP monitor should distinguish Korotkoff sounds (K-sounds) from the large amount of background noise generated during a stress test.    
Most Innovative Heart Centers: Chicago’s Mercy Hospital
Cath lab volumes have gone down in recent years for several reasons, but one of the biggest reasons might be market saturation. This is certainly the case in Chicago, where nearly every hospital has a cath lab, resulting in relatively low volumes at most centers, despite the fact they are located in the largest city in the Midwest. 
Comparison of Transradial to Transfemoral Access in Community Hospital STEMI Cases
  There is much discussion about the possibility of using transradial artery access to help reduce door-to-balloon times in ST-elevation myocardial infarction (STEMI) patients. Northside Hospital, Tampa Bay Heart Institute in St. Petersburg, Fla., tested this theory and found transradial helped lower door-to-balloon times and hospital length-of-stay.     
Latest Cardiac CT Trends
There are currently three major trends in cardiovascular computed tomography (CT) technology — lowering radiation dose, development of myocardial perfusion imaging and the use of CT datasets for procedural planning, especially for transcatheter aortic valve replacement (TAVR). 
An Introduction to Atherectomy Systems
Atherectomy devices are used in the cath lab to debulk lesions by cutting or laser ablating plaque, calcium and tissue hyperplasia from vessel walls, allowing recanalization of the vessel lumen as an end in itself, or in preparation for stenting. While some devices have an indication for the coronaries, the primary use of these devices is forperipheral artery disease (PAD) in the legs. 
Obstacles to the Expansion of Coronary CT Angiography
Coronary computed tomography angiography (CCTA) is a noninvasive tool that can be used for identifying myocardial ischemia and coronary artery plaques. It acts as a proven prognostic/diagnostic tool for patients who are asymptomatic as well as in the mild- to medium-risk spectrum of coronary artery disease (CAD).
Trends in ECG Stress Test Systems
The electrocardiogram (ECG) stress test remains one of the most widely used diagnostic tools for detecting coronary heart disease. While the basics of stress test systems have changed little since their adoption, technologies continue to evolve to improve waveform analysis as well as connectivity to electronic medical records (EMRs) and wireless data acquisition capabilities.  
The Offbeat: Your Car as Your Doctor
An unusual exhibitor that seemed very out of place on the expo floor of the Heart Rhythm Society 2012 annual meeting was Ford Motor Company.  Engineers, standing next to a brand new Ford sport utility vehicle,  were there to get feedback from electrophysiologists on the use of car seats that can automatically monitor the driver’s electrocardiogram (ECG) whenever they are driving.   
Something Old is New Again in Cardiac Technology
Each year, I find it interesting that some “new” technology being introduced by a vendor is actually an old, recycled idea.