November/December 2012

Leveraging Telemedicine in the Developing World
Echocardiography is a natural application for telemedicine, as handheld ultrasound devices and cloud-based transmission solutions make it possible to perform a test at a remote location and have consultation, in real time, by an expert thousands of miles away. Telemedicine can eliminate the need for travel, reduce wait time for test results, and is cost effective.  
Mount Sinai School of Medicine Gives Pocket Ultrasound Devices to Its Students
First-year medical students at Mount Sinai School of Medicine will be the first in New York to be introduced to a digital-age ultrasound device that can visualize inside the body, and fit directly into the pockets of their brand new white coats.
Eight Tips to Make Radial Access Successful
Radial access has been a standard for most patient cases for several years at both the University of Illinois at Chicago (UIC) Medical Center and the Jesse Brown VA Medical Center. The centers are located within two blocks of each other, and the two staffs work very closely.  Part of their coordination has been developing training programs and best practices and protocols for radial artery access techniques. 
FDA Clears First Subcutaneous ICD System
The U.S. Food and Drug Administration (FDA) in October granted Boston Scientific Corp. regulatory approval for its S-ICD System, the world’s first commercially available subcutaneous implantable cardioverter defibrillator (S-ICD).  The system sits entirely just below the skin without the need for implantable lead to be placed inside the heart. This offers patients an alternative to transvenous ICDs, which require leads to be placed in the heart itself.
Trends and Advances in ECG Management Systems
As electronic medical records become more sophisticated and healthcare moves to an increasingly paperless system, electrocardiogram (ECG) integration has become a priority for many hospitals. For hospitals that have been using ECG management systems, many are upgrading to newer systems that offer better integration with their ECG systems, interoperability with other software systems, or offer Web-access and smart phone access. 
Impella May Create a New Gold Standard for Hemodynamic Support
Two key news items in September made me think about the future direction of hemodynamic support, and that intra-aortic balloon pumps (IABP) will increasingly face a more serious challenge from small percutaneous left ventricular assist devices (pLVAD).  This was reinforced when I received a cardiology market analysis from GlobalData agreeing with this assessment.
Increasing Efficiency, Quantification With New MRI Software
Increasingly software applications are providing many of the major advancements in magnetic resonance imaging (MRI) rather than hardware. In recent years, this has translated into software that enables physicians to do more in less time, extract more diagnostic information from imaging exams and provide more accurate quantification. While a hospital may not spend millions to upgrade its MRI system, it frequently takes advantage of the lower cost option of other vendors’ software to assess and manipulate those images. 
ECG Review on Smart Phones
As mobile devices become more integrated into the healthcare workflow, immediate anywhere access to ECGs can help improve collaboration and speed door-to-balloon times. Physician smart phone and tablet PC use has exploded over the last few years, allowing widespread, immediate access to patient electronic medical record (EMR) information. One trend in cardiology is the ability to use this technology to immediately view dynamic electrocardiogram (ECG) waveforms anywhere, untethering them from hospital workstations.
Novel Percutaneous Approaches for Mitral Valve Regurgitation
For functional mitral valve regurgitation, the results of open repair are poor, but the next generation of transcatheter heart valve repair technologies in development may offer new hope for these patients.