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VIDEO: Radial Access has Fewer Bleeding Complications in RIVAL Trial

Radial Access | April 28, 2011

The RIVAL Trial, the largest randomized trial to compare radial access and femoral access for coronary angiography and intervention, researchers found radial access reduced rates of vascular complications, according to research presented at the American College of Cardiology (ACC) 2011 Scientific Session in New Orleans.[1] The trial also found that radial access did not reduce the primary outcome measure of death, heart attack, stroke and non-CABG-related major bleeding compared to femoral access in the overall study population. The data showed these outcomes were equal for both femoral and radial access procedures.

"Interventional cardiologists can feel reassured both radial and femoral approaches are safe and effective," said Sanjit Jolly, M.D., M.Sc., assistant professor of medicine at McMaster University in Hamilton, Ontario, Canada. Radial access did lead to reductions in the primary outcome measure in patients who underwent the procedure at hospitals that conducted a high volume of radial procedures. For centers that were less experienced with radial access, Jolly said it was clear there is a learning curve, and operators got better and faster with radial procedures with more experience. "The take-home message is practice makes perfect," he said. Jolly explained the high-volume centers using radial access performed very well, but it was clear from the study operators need a lot of radial cases to increase performance.

Read the article RIVAL Trial: Radial Access Reduces Vascular Complications
 

Reference:

1.    Jolly SS, Yusuf S, Cairns J, Kari Niemelä DX, Petr Widimsky, Andrzej Budaj, Matti Niemelä, Vicent Valentin, Basil S Lewis,, Alvaro Avezum PGS, Sunil V Rao, Peggy Gao, Rizwan Afzal, Campbell D Joyner, Susan Chrolavicius, Shamir R Mehta, for the group. “Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial.” Lancet 2011. DOI:https://doi.org/10.1016/S0140-6736(11)60404-2

Recent Videos View all 534 items

EP Lab | July 28, 2020
VIDEO: Impact of COVID-19 on Electrophysiology Programs

Devi G. Nair, M.D., FHRS, director of cardiac electrophysiology, St. Bernards Heart and Vascular Center, Jonesboro, Ark., explains the impact of COVID-19 (SARS-CoV-2) on her EP program and what was done to continue operations and recover procedural volume. She also shares how EP played a role in the team approach to treating coronavirus patients at her center.

Her experience is an example of how centers have dealt with issues related to the pandemic, including shutting down elective procedures, treating emergent cases, reopening services, new safety precautions and how telehealth played a role.

Nair is also chairman for the Heart Rhythm Society (HRS) member engagement sub-committee and is a board member of the Arkansas chapter of the American College of Cardiology (ACC).

Watch Nair in this interview — VIDEO: Overview of LAA Occlusion Using the Watchman FLX

 

 

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Left Atrial Appendage (LAA) Occluders | July 24, 2020
VIDEO: Overview of LAA Occlusion Using the Watchman FLX

Devi G. Nair, M.D., FHRS, director of cardiac electrophysiology, St. Bernards Heart and Vascular Center, Jonesboro, Ark., was an investigator in the PINNACLE FLX clinical trial for the Boston Scientific Watchman FLX left atrial appendage (LAA) occluder device. 

The newest iteration of the Watchman was cleared by the U.S. Food and Drug Administration (FDA) in July 2020. Read more about the Watchman FLX 

The transcatheter implant is used in close the LAA, a pouch that forms part of the left atrium. The LAA is implicated in the formation of blood clots that cause stroke in patients with atrial fibrillation (AF). The Watchman FLX is indicated to reduce the risk of stroke in patients with non-valvular AF (NVAF) who need an alternative to oral anticoagulation therapy by permanently closing off the left atrial appendage.

Nair is currently involved with another trial of the Watchman FLX, OPTION FLX trial, which is examining the use of LAA occlusion in post-ablation patients.

Nair is also chairman for the Heart Rhythm Society (HRS) member engagement sub-committee and is a board member of the Arkansas chapter of the American College of Cardiology (ACC).
 

Watch Nair in this interview — VIDEO: Impact of COVID-19 on Electrophysiology Programs

 

Cardiogenic Shock | July 15, 2020
VIDEO: New Research in Cardiogenic Shock at Tufts Medical Center

Navin Kapur, M.D., FAHA, FACC, FSCAI, director, Acute Mechanical Circulatory Support Program and executive director of The Cardiovascular Center for Research and Innovation (CVCRI), Tufts Medical Center, explains the research being done by the Cardiogenic Shock Working Group, which is headed by Tufts. 

The Cardiogenic Shock Working Group (CSWG) has created a patient registry now includes 15-20 centers in the United States and data on more than 2,000 patients who suffered shock either from heart failure or acute myocardial infarction (MI). It also includes hemodynamic data on more than 1,100 patients. And includes all types of mechanical circulatory support devices, including intra-aortic balloon pump (IABP), or incrementally high levels with a percutaneous Impella pump, TandemHeart, and extracorporeal membrane oxygenation (ECMO).

Research last year showed three types of phenotype profiles in cardiogenic shock patients, including non-congested, cardio-renal and cardio-renal-hepatic. Kapur also said there is evidence that there is venous involvement that needs to be considered.

The large amount of variables in the patient data from the CSWG is partly examined by artificial intelligence (AI), which helped identify the three groups of shock type.

 

 

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VIDEO: How to Reduce Cardiogenic Shock Mortality by 50 Percent

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Cath Lab | July 15, 2020
VIDEO: Overview of the Interventional Labs at Tufts Medical Center

Richard Botto, CVT, RCSA, chief cardiovascular technologist, division of cardiology, cardiac cath lab, offers an overview of the interventional catheterization laboratories at Tufts Medical Center in Boston. 

Botto also explains the last hybrid catheter lab Tufts completed in 2018. The state-of-the-art Cath Lab Room 3, licensed as a hybrid operating room, opened in May 2018. Tufts interventionalists and surgeons use the room to perform some of the most advanced therapeutic procedures, including transcatheter aortic valve replacement (TAVR), MitraClip mitral valve leaflet repairs and acute mechanical circulatory support procedures. Two babies also were delivered in this room due to extreme high risk pregnancies. Tufts is the only facility in Boston to have a fully-functional operating room geographically located within the cardiac catheterization laboratory. 
 

Additional Videos From Tufts Medical Center:

VIDEO: Tufts Uses a Hemodynamic Support Algorithm to Determine What Devices to Use

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Information Technology | April 17, 2019
itnTV "Conversations": Creating an Interoperability Strategy

With Intellispace Enterprise Edition as the foundation, Philips Healthcare is connecting facilities and service areas within enterprises, while developing standards-based interoperability that preserves customers' investments and best of breed systems. 

Hemodynamic Support Devices | March 06, 2019
VIDEO: Complex PCI Involving Prior CABG and Comorbidities

Perwaiz Meraj, M.D., FACC, FSCAI, director of interventional cardiology, assistant professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health System discusses the importance of hemodynamic support to safely perform a percutaneous coronary intervention (PCI) with prior coronary artery bypass graft (CABG) surgery and comorbidities. Learn more at ProtectedPCI.com/DAIC.

In this video, Meraj discuss a complex coronary intervention of a 77-year-old woman with stage 4 CKD, prior CABG, hypertension, hyperlipidemia, diabetes, who presented with angina and NSTEMI with an ejection fraction of 40 percent. The team at Northwell consulted with cardiac surgeons and the heart team, and determined that this patient was too high risk for another bypass surgery. Read more on this case.

 

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VIDEO: Analysis of Outcomes for 15,259 U.S. Patients with AMICS Supported with the Impella Device — Interview with William O'Neill, M.D.

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Heart Failure | February 13, 2019
VIDEO: Analysis of Outcomes for 15,259 U.S. Patients with AMICS Supported with the Impella Device

William O'Neill, M.D., highlights best practice protocols based on Impella Quality database and real-world evidence showing improved outcomes in cardiogenic shock. Learn more at ProtectedPCI.com/DAIC

 

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January 10, 2019
VIDEO: Escalation of Support and Algorithms for Cardiogenic Shock

Mark Anderson, M.D., FACS, vice chair of cardiac surgery services and cardiothoracic surgeon at Hackensack University Medical Group, outlines a multi-disciplinary heart team approach in treament decision-making for patients in cardiogenic shock. Learn more at ProtectedPCI.com/DAIC.

Anderson discusses improving outcomes for patients in cardiogenic shock through the early use of mechanical circulatory support and the development of a shock protocol with the heart team. He outlines Hackensack University Medical Center’s multi-disciplinary, heart team approach in treatment decision-making for patients in cardiogenic shock. The team includes cardiac surgeons, interventional cardiologists, heart failure specialists and intensivists. 

 

 

Conference Coverage View all 398 items

Coronavirus (COVID-19) | May 28, 2020
VIDEO: Why QT-prolongation Occurs in COVID-19 Patients on Hydroxychloroquine and Azithromycin

Interview with Andrew D. Krahn, M.D.,FHRS, head of the division of cardiology at St. Paul’s Hospital, and professor of medicine at the University of British Columbia, and vice president of the Heart Rhythm Society (HRS). He is an expert in long QT syndrome (LQTS) and is involved with the National Long QT Registry. He explains the issues with the drugs being used to treat coronavirus (COVID-19, SARS-CoV-2) patients and why these combined with the cardiac impact of the virus is causing prolonged ECG QT segment prolongation, leading to deadly arrhythmias. COVID-19 can cause myocarditis that causes QT prolongation and the front-line COVID drugs hydroxychloroquine and azithromycin also cause QT prolongation.

The U.S. Food and Drug Administration (FDA) issued a Drug Safety Communication April 23, 2020, reminding doctors there are serious side effects when using hydroxychloroquine and chloroquine in the off-label use to treat COVID-19 patients. This includes potentially life-threatening heart rhythm problems. The FDA said case reports from the FDA Adverse Event Reporting System database, published medical literature and the American Association of Poison Control Centers National Poison Data System are reporting serious heart-related adverse events and patient deaths. Read more about this alert.

The FDA warning confirmed fears from the American Heart Association (AHA), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS). These societies April 8 jointly published a new guidance, “Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 19) Treatment,” to detail critical cardiovascular considerations in the use of hydroxychloroquine and azithromycin for the treatment of COVID-19. The societies warned that use of  these agents in a large number of patients in combination would results in arrhythmias and deaths. Read more.

However, there are numerous advocates that argue hydroxychloroquine needs to be used in less sick patients who are not already hypoxic to treat COVID, but it is being used primarily in very sick patients where it is not effective. Advocates also argue the drug can be used to help prevent coronavirus, similar to the drug's effect in preventing malaria. In terms of drug safety, advocates argue the drug has been used in millions of patients for more than 50 years without a high risk of arrhythmias. Several trials are now underway in the United States to test its use against COVID-19, but enrollment has been hampered because of the FDA warning. There will likely be more interest in hydroxychloroquine after it was revealed May 18, 2020, that President Trump is taking the drug for prophylaxis against COVID-19.

 

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VIDEO: Cardiologists Manage Trial Testing if Hydroxychloroquine Protects Clinicians From COVID-19 — Interview with William O'Neill, M.D.

First Large-scale U.S. Study on Hydroxychloroquine COVID-19 Prophylaxis Begins in Detroit

AHA, ACC, HRS Caution Use of COVID-19 Therapies Hydroxychloroquine and Azithromycin in Cardiac Patients

HRS | May 22, 2020
VIDEO: Top New EP Technologies at Heart Rhythm Society 2020

Interview with Andrew D. Krahn, M.D., FHRS, head of the division of cardiology at St. Paul’s Hospital, and professor of medicine at the University of British Columbia. He is also vice president of the Heart Rhythm Society (HRS). He moderated the late-breaking sessions at 2020 HRS virtual meeting and explains the highlights of the new technologies and data presented. 

Technologies include a nasal spray to stop supraventricular tachycardia, pulsed field ablation technology that may offer improvement over current technology, subcutaneous ICD (S-ICD) technology performing as well as traditional transvenous lead ICDs, contact force sensing ablation improves outcomes, use of smart watches to help atrial fibrillation patients adhere to oral anticoagulation therapy, and the first pacemaker to interface with the patient's smart phone.

Watch another interview with Krahn in the VIDEO: Insights Into How HRS Organized its Virtual Meeting.

Find a complete list of the Heart Rhythm 2020 meeting late-breaking studies with links to articles on each.

Find more news and video from the Heart Rhythm Society.
 

Cardiovascular Education | May 22, 2020
VIDEO: Insights Into How HRS Organized its Virtual Meeting

Andrew D. Krahn, M.D., FHRS, head of the division of cardiology at St. Paul’s Hospital, professor of medicine  at the University of British Columbia and vice president of the Heart Rhythm Society (HRS), explains how HRS organized its virtual meeting after its in-person meeting was cancelled by the COVID-19 pandemic.  

Due to the continued global escalation of the novel coronavirus (COVID-19, SARS-CoV-2), HRS has cancelled its large annual in-person electrophysiology meeting in late-March and began planning for a virtual meeting instead. HRS broke its annual meeting into three online learning sessions over the course of May June and July. The first, which included the late-breaking sessions, was held May 5-9, 2020. Others will be held June 12 and July 1.

Using its online learning platform, Heart Rhythm 365 available on the www.hrsonline.org website, HRS is offering all its sessions at no cost.

Watch another interview with Krahn in the VIDEO: Top New EP Technologies at Heart Rhythm Society 2020.
 

Find a complete list of the Heart Rhythm 2020 meeting late-breaking studies with links to articles on each.
 

 

Coronavirus (COVID-19) | May 07, 2020
VIDEO: CT and POCUS Emerge As Frontline Cardiac Imaging Modalities in COVID-19 Era

Interview with Geoffrey Rose, M.D., president of Sanger Heart and Vascular Institute with Atrium Health, in Charlotte, North Carolina, and a board member with the American Society of Echocardiography (ASE). He explains the impact of COVID-19 (SARS-CoV-2) on the cardiovascular service line and cardiac imaging. He said the virus has led to use of computed tomography (CT) not only as the frontline cardiovascular imaging modality to evaluate chest pain, but also for COVID-19 pneumonia imaging.

Rose said cardiac ultrasound is still used, but requires full personal protective equipment (PPE) and often abbreviated exams because of the close proximity of the sonographer and patient when performing echocardiograms. This has given rise to using dedicated point-of-care ultrasound (POCUS) systems to answer specific clinical questions quickly. Smart-phone based POCUS systems that use an app and a transducer plugged into the phone enable basic echo exams or evaluation of other parts of the anatomy quickly without the need to immediately sterilize an entire cart-based ultrasound system. These small systems also can be completely enclosed inside a transducer sheath and the phone and single transducer are much easier and faster to wipe down. He said the quality of the exams are not as good as fully enabled echocardiography systems, but it allows for quick assessments of ejection fractions and to triage if the patient needs more advanced imaging if the basic questions cannot be answered.

Since hospitals have shut down now for about two months, postponing normal checkups, and elective exams and procedures, Rose said doctors still need to visit with patients who have chronic conditions. Sanger and Atrium Heath modified its ambulatory electronic medical record (EMR) and is using video conferencing to perform virtual appointments now for the majority of these patients. He said telemedicine was not widely used before COVID-19 in his hospital system, but the pandemic will likely alter the care model for the future, with more telemedicine visits being used even after epidemic is over. He said use of POCUS and CT as frontline cardiac imaging modalities will also likely remain in place after the pandemic because of the efficiencies in care these technologies offer.

 

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Cath Lab View all 264 items

Left Atrial Appendage (LAA) Occluders | July 24, 2020
VIDEO: Overview of LAA Occlusion Using the Watchman FLX

Devi G. Nair, M.D., FHRS, director of cardiac electrophysiology, St. Bernards Heart and Vascular Center, Jonesboro, Ark., was an investigator in the PINNACLE FLX clinical trial for the Boston Scientific Watchman FLX left atrial appendage (LAA) occluder device. 

The newest iteration of the Watchman was cleared by the U.S. Food and Drug Administration (FDA) in July 2020. Read more about the Watchman FLX 

The transcatheter implant is used in close the LAA, a pouch that forms part of the left atrium. The LAA is implicated in the formation of blood clots that cause stroke in patients with atrial fibrillation (AF). The Watchman FLX is indicated to reduce the risk of stroke in patients with non-valvular AF (NVAF) who need an alternative to oral anticoagulation therapy by permanently closing off the left atrial appendage.

Nair is currently involved with another trial of the Watchman FLX, OPTION FLX trial, which is examining the use of LAA occlusion in post-ablation patients.

Nair is also chairman for the Heart Rhythm Society (HRS) member engagement sub-committee and is a board member of the Arkansas chapter of the American College of Cardiology (ACC).
 

Watch Nair in this interview — VIDEO: Impact of COVID-19 on Electrophysiology Programs

 

Cardiogenic Shock | July 15, 2020
VIDEO: New Research in Cardiogenic Shock at Tufts Medical Center

Navin Kapur, M.D., FAHA, FACC, FSCAI, director, Acute Mechanical Circulatory Support Program and executive director of The Cardiovascular Center for Research and Innovation (CVCRI), Tufts Medical Center, explains the research being done by the Cardiogenic Shock Working Group, which is headed by Tufts. 

The Cardiogenic Shock Working Group (CSWG) has created a patient registry now includes 15-20 centers in the United States and data on more than 2,000 patients who suffered shock either from heart failure or acute myocardial infarction (MI). It also includes hemodynamic data on more than 1,100 patients. And includes all types of mechanical circulatory support devices, including intra-aortic balloon pump (IABP), or incrementally high levels with a percutaneous Impella pump, TandemHeart, and extracorporeal membrane oxygenation (ECMO).

Research last year showed three types of phenotype profiles in cardiogenic shock patients, including non-congested, cardio-renal and cardio-renal-hepatic. Kapur also said there is evidence that there is venous involvement that needs to be considered.

The large amount of variables in the patient data from the CSWG is partly examined by artificial intelligence (AI), which helped identify the three groups of shock type.

 

 

Related Cardiogenic Shock and Hemodyanmic Support Content:

VIDEO: Door-to-Unloading (DTU) Trial May Change STEMI Care

VIDEO: Tufts Uses a Hemodynamic Support Algorithm to Determine What Devices to Use

VIDEO: Hemodynamic Support Protocols at Henry Ford Hospital

VIDEO: Cardiogenic Shock Initiative Continues to Reduce Mortality by 50 Percent

 

VIDEO: How to Reduce Cardiogenic Shock Mortality by 50 Percent

SCAI Releases New Consensus Document on Classification Stages of Cardiogenic Shock

Cardiogenic Shock Survival Rates Improve in Three Years Since Impella FDA Approval

VIDEO: The Importance of Ventricular Unloading in AMI and Cardiogenic Shock

 

VIDEO: Escalation of Support and Algorithms for Cardiogenic Shock

10 Reasons Why it is Time to Learn More About Cardiogenic Shock

New Approaches to Reduce Cardiogenic Shock Mortality

 

Find more content on Tufts Medical Center 

 

Cath Lab | July 15, 2020
VIDEO: Overview of the Interventional Labs at Tufts Medical Center

Richard Botto, CVT, RCSA, chief cardiovascular technologist, division of cardiology, cardiac cath lab, offers an overview of the interventional catheterization laboratories at Tufts Medical Center in Boston. 

Botto also explains the last hybrid catheter lab Tufts completed in 2018. The state-of-the-art Cath Lab Room 3, licensed as a hybrid operating room, opened in May 2018. Tufts interventionalists and surgeons use the room to perform some of the most advanced therapeutic procedures, including transcatheter aortic valve replacement (TAVR), MitraClip mitral valve leaflet repairs and acute mechanical circulatory support procedures. Two babies also were delivered in this room due to extreme high risk pregnancies. Tufts is the only facility in Boston to have a fully-functional operating room geographically located within the cardiac catheterization laboratory. 
 

Additional Videos From Tufts Medical Center:

VIDEO: Tufts Uses a Hemodynamic Support Algorithm to Determine What Devices to Use

VIDEO: Overview of the Structural Heart Program at Tufts Medical Center

VIDEO: Tufts Medical Center Spearheads Innovation With its Preclinical Cath Lab

VIDEO: Developing a Heart Failure Care Team

VIDEO: Overview of the TAVR Program at Tufts Medical Center

Additional videos and articles on Tufts Medical Center Channel

 

 

Cath Lab | July 13, 2020
VIDEO: Explaining The Ring of Vieussen's in Coronary Artery Anatomy

The Vieussens’ arterial ring (VAR) is a connection between the conus artery and the left anterior descending (LAD) coronary artery’s proximal right ventricular branch. VAR is present in about 48 percent of the population as an embryonic conotruncal ring remnant. This ring can be exploited as an alternative coronary artery revascularization route in patients where this anatomy is present. Guidewires can be navigated from the right coronary artery through the conus to the LAD.

Jay Mohan, D.O., RPVI, interventional cardiology fellow at William Beaumont Hospital, Royal Oak, Michigan, created this video to briefly explain the use of the Vieussens’ arterial ring in interventional cardiology.  

Mohan is board certified in cardiology, internal medicine, echocardiography and nuclear cardiology. He also serves as vice president of the Dr. Ramesh Kumar Foundation. 

Mohan shares regular updates on Twitter about recent cardiology technology devices, takeaway points from conferences and short educational videos he produces. Follow or contact him via Twitter or Instagram at @cardiologyoncall.

 

Related Cardiovascular Educational Videos Created by Jay Mohan, D.O.:

VIDEO: The Latest Data on COVID-19 and Cardiovascular Disease

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Cardiac Imaging View all 250 items

Cath Lab | July 15, 2020
VIDEO: Overview of the Interventional Labs at Tufts Medical Center

Richard Botto, CVT, RCSA, chief cardiovascular technologist, division of cardiology, cardiac cath lab, offers an overview of the interventional catheterization laboratories at Tufts Medical Center in Boston. 

Botto also explains the last hybrid catheter lab Tufts completed in 2018. The state-of-the-art Cath Lab Room 3, licensed as a hybrid operating room, opened in May 2018. Tufts interventionalists and surgeons use the room to perform some of the most advanced therapeutic procedures, including transcatheter aortic valve replacement (TAVR), MitraClip mitral valve leaflet repairs and acute mechanical circulatory support procedures. Two babies also were delivered in this room due to extreme high risk pregnancies. Tufts is the only facility in Boston to have a fully-functional operating room geographically located within the cardiac catheterization laboratory. 
 

Additional Videos From Tufts Medical Center:

VIDEO: Tufts Uses a Hemodynamic Support Algorithm to Determine What Devices to Use

VIDEO: Overview of the Structural Heart Program at Tufts Medical Center

VIDEO: Tufts Medical Center Spearheads Innovation With its Preclinical Cath Lab

VIDEO: Developing a Heart Failure Care Team

VIDEO: Overview of the TAVR Program at Tufts Medical Center

Additional videos and articles on Tufts Medical Center Channel

 

 

Coronavirus (COVID-19) | May 29, 2020
VIDEO: Creating a Home COVID-19 Decontamination Area for the Clinician

Jay Mohan, D.O., RPVI, interventional cardiology fellow at William Beaumont Hospital, Royal Oak, Michigan, created this video. It shows other clinicians how he set up his home COVID-19 decontamination area where he changes clothes, shoes and sterilizes before entering his house in order to protect his family. He has been involved with direct care of COVID-19 patients the past two months.

Since the start of the SAR-CoV-2 pandemic, clinicians and first-responders who are in contact with, or possible contact with, COVID-19 patients have developed ways to not bring and viral contamination home with them. This often includes on transition spot in the garage or designed room where they can change out of work clothing and shoes and into new clothing and shoes. Shoes and coats are separated into ones used for home and those dedicated for use at work only. Those who wear and reuse N95 masks also have developed ways to take the mask off by the straps only so they do not touch it and strapping it over a tupperware container that can then be sealed, or stored inside a disposable paper or plastic bag.

Mohan is board certified in cardiology, internal medicine, echocardiography and nuclear cardiology. He also serves as vice president of the Dr. Ramesh Kumar Foundation. 

Mohan shares regular updates on Twitter about recent cardiology technology devices, takeaway points from conferences and short educational videos he produces. Follow or contact him via Twitter or Instagram at @cardiologyoncall.

Watch a video animation he created — VIDEO: The Latest Data on COVID-19 and Cardiovascular Disease.
 

Find more cardiovascular related COVID-19 content

Coronavirus (COVID-19) | May 07, 2020
VIDEO: CT and POCUS Emerge As Frontline Cardiac Imaging Modalities in COVID-19 Era

Interview with Geoffrey Rose, M.D., president of Sanger Heart and Vascular Institute with Atrium Health, in Charlotte, North Carolina, and a board member with the American Society of Echocardiography (ASE). He explains the impact of COVID-19 (SARS-CoV-2) on the cardiovascular service line and cardiac imaging. He said the virus has led to use of computed tomography (CT) not only as the frontline cardiovascular imaging modality to evaluate chest pain, but also for COVID-19 pneumonia imaging.

Rose said cardiac ultrasound is still used, but requires full personal protective equipment (PPE) and often abbreviated exams because of the close proximity of the sonographer and patient when performing echocardiograms. This has given rise to using dedicated point-of-care ultrasound (POCUS) systems to answer specific clinical questions quickly. Smart-phone based POCUS systems that use an app and a transducer plugged into the phone enable basic echo exams or evaluation of other parts of the anatomy quickly without the need to immediately sterilize an entire cart-based ultrasound system. These small systems also can be completely enclosed inside a transducer sheath and the phone and single transducer are much easier and faster to wipe down. He said the quality of the exams are not as good as fully enabled echocardiography systems, but it allows for quick assessments of ejection fractions and to triage if the patient needs more advanced imaging if the basic questions cannot be answered.

Since hospitals have shut down now for about two months, postponing normal checkups, and elective exams and procedures, Rose said doctors still need to visit with patients who have chronic conditions. Sanger and Atrium Heath modified its ambulatory electronic medical record (EMR) and is using video conferencing to perform virtual appointments now for the majority of these patients. He said telemedicine was not widely used before COVID-19 in his hospital system, but the pandemic will likely alter the care model for the future, with more telemedicine visits being used even after epidemic is over. He said use of POCUS and CT as frontline cardiac imaging modalities will also likely remain in place after the pandemic because of the efficiencies in care these technologies offer.

 

Related Coronavirus Content:

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS)

Cardiac Imaging Best Practices During the COVID-19 Pandemic

RSNA Publishes COVID-19 Best Practices for Radiology Departments

ASE Guidelines for the Protection of Echocardiography Providers During the COVID-19 Outbreak
 

New CT Scoring Criteria for Timely Diagnosis, Treatment of Coronavirus Disease

FDA Issues New Policy for Imaging Systems During COVID-19

VIDEO: COVID-19 Precautions for Cardiac Imaging —  Interview with Stephen Bloom, M.D.

A Review of Studies Cautions Against Chest CT for Coronavirus Diagnosis

 

New Research Finds Chest X-ray Not Reliable Diagnostic Tool for COVID-19

VIDEO: Radiology Industry Responding to COVID-19

 

University of Washington Issues Radiology Policies for COVID-19

VIDEO: Best Practices for Nuclear Cardiology During the COVID-19 Pandemic — Interview with Hicham Skali, M.D.

New Research Highlights Blood Clot Dangers of COVID-19

Survey Reveals Most Medical Practices are Now Using Telehealth Due to COVID-19

 

CMS Offers Recommendations on Reopening Healthcare in Areas of Low COVID-19 Cases

CT Provides Best Diagnosis for Novel Coronavirus (COVID-19)

Radiology Lessons for Coronavirus From the SARS and MERS Epidemics

Radiologists Describe Coronavirus CT Imaging Features

 

CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia

ACC COVID-19 recommendations for the cardiovascular care team

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

 

 

 

Coronavirus (COVID-19) | April 18, 2020
VIDEO: COVID-19 Precautions for Cardiac Imaging

Stephen Bloom, M.D., FASNC, director of nonivasive cardiology (cardiac CT, nuclear cardiology and echocardiography) at Midwest Heart and Vascular Associates, Overland Park, Kansas. He is also a member of the American Society of Nuclear Cardiology (ASNC) Board of Directors, explains some of the issues involved and protocols used for cardiac imaging during the COVID-19 pandemic. His discussion includes computed tomography, cardiac ultrasound and nuclear imaging.

Right now, Bloom said it is difficult to test everybody and there is a shortage of masks, gowns and other personal protective equipment (PPE), and the imaging equipment needs to be sanitized each time it is used. He said it is just is not possible to image all the patients who need imaging right now. Hospitals also are trying to limit the number of healthy people people coming into hospitals for routine visits and tests to reduce their potential exposure to the novel coronavirus (COVID-19, SARS-CoV-2) and help containment efforts. 

"The tests should be done, very simply, if it changes the care of the patient. If it doesn't change the care of the patient, and it can be postponed, it should be postponed," Bloom explained. "I would say 80 percent of our cardiac imaging exams have stopped. It has been very dramatic."

 

Related Imaging Precautions During COVID-19 Content:

Cardiac Imaging Best Practices During the COVID-19 Pandemic

Best Practices for Nuclear Cardiology Laboratories During the Coronavirus (COVID-19) Pandemic

ASE Guidelines for the Protection of Echocardiography Providers During the COVID-19 Outbreak 

VIDEO: Best Practices for Nuclear Cardiology During the COVID-19 Pandemic — Interview with Hicham Skali, M.D.

VIDEO: Cancelling Non-essential Cardiac Procedures During the COVID-19 Outbreak — Interview with Ehtisham Mahmud, M.D. 

VIDEO: 9 Cardiologists Share COVID-19 Takeaways From Across the U.S.  

VIDEO: Telemedicine in Cardiology and Medical Imaging During COVID-19 — Interview with Regina Druz, M.D.

VIDEO: Use of Teleradiology During the COVID-19 Pandemic — an interview with radiologist John Kim, M.D.

Study Looks at CT Findings of COVID-19 Through Recovery

Experts Stress Radiology Preparedness for COVID-19

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with emergency physician Mike Stone, M.D.,

VIDEO: How China Leveraged Health IT to Combat COVID-19 — Interview with Jilan Liu, M.D., CEO for the HIMSS Greater China

ACR Recommendations for the Use of Chest Radiography and CT for Suspected COVID-19 Cases

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

 

Cardiac Diagnostics View all 63 items

Coronavirus (COVID-19) | May 28, 2020
VIDEO: Why QT-prolongation Occurs in COVID-19 Patients on Hydroxychloroquine and Azithromycin

Interview with Andrew D. Krahn, M.D.,FHRS, head of the division of cardiology at St. Paul’s Hospital, and professor of medicine at the University of British Columbia, and vice president of the Heart Rhythm Society (HRS). He is an expert in long QT syndrome (LQTS) and is involved with the National Long QT Registry. He explains the issues with the drugs being used to treat coronavirus (COVID-19, SARS-CoV-2) patients and why these combined with the cardiac impact of the virus is causing prolonged ECG QT segment prolongation, leading to deadly arrhythmias. COVID-19 can cause myocarditis that causes QT prolongation and the front-line COVID drugs hydroxychloroquine and azithromycin also cause QT prolongation.

The U.S. Food and Drug Administration (FDA) issued a Drug Safety Communication April 23, 2020, reminding doctors there are serious side effects when using hydroxychloroquine and chloroquine in the off-label use to treat COVID-19 patients. This includes potentially life-threatening heart rhythm problems. The FDA said case reports from the FDA Adverse Event Reporting System database, published medical literature and the American Association of Poison Control Centers National Poison Data System are reporting serious heart-related adverse events and patient deaths. Read more about this alert.

The FDA warning confirmed fears from the American Heart Association (AHA), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS). These societies April 8 jointly published a new guidance, “Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 19) Treatment,” to detail critical cardiovascular considerations in the use of hydroxychloroquine and azithromycin for the treatment of COVID-19. The societies warned that use of  these agents in a large number of patients in combination would results in arrhythmias and deaths. Read more.

However, there are numerous advocates that argue hydroxychloroquine needs to be used in less sick patients who are not already hypoxic to treat COVID, but it is being used primarily in very sick patients where it is not effective. Advocates also argue the drug can be used to help prevent coronavirus, similar to the drug's effect in preventing malaria. In terms of drug safety, advocates argue the drug has been used in millions of patients for more than 50 years without a high risk of arrhythmias. Several trials are now underway in the United States to test its use against COVID-19, but enrollment has been hampered because of the FDA warning. There will likely be more interest in hydroxychloroquine after it was revealed May 18, 2020, that President Trump is taking the drug for prophylaxis against COVID-19.

 

Related Hydroxychloroquine Content:

FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine for COVID-19

WHO Database Shows Serious Health Impact of Hydroxychloroquine and Azithromycin Being Used to Treat COVID-19

VIDEO: Overview of Hydroxychloroquine and FDA Warning in its use to Treat COVID-19 — Interview with Marianne Pop, Pharm.D.

WHO Database Shows Serious Health Impact of Hydroxychloroquine and Azithromycin Being Used to Treat COVID-19

COVID-19 Hydroxychloroquine Treatment Brings Prolonged QT Arrhythmia Issues

 

FDA Reports of Deaths and Injuries From Use of Antimalarial hydroxychloroquine in COVID-19 Patients

VIDEO: Cardiologists Manage Trial Testing if Hydroxychloroquine Protects Clinicians From COVID-19 — Interview with William O'Neill, M.D.

First Large-scale U.S. Study on Hydroxychloroquine COVID-19 Prophylaxis Begins in Detroit

AHA, ACC, HRS Caution Use of COVID-19 Therapies Hydroxychloroquine and Azithromycin in Cardiac Patients

Coronavirus (COVID-19) | April 22, 2020
VIDEO: Multiple Cardiovascular Presentations of COVID-19 in New York

Justin Fried, M.D., Attending cardiologist at Columbia University Irving Medical Center, New York City, and assistant professor at at Columbia University and lead author on a report that explains the cardiovascular presentations of COVID-19. The study looked at four patient cases where cardiology became involved in the patient's care.

Novel coronavirus (COVID-19, SARS-CoV-2) can present as a cardiovascular issue, or patients can develop myocarditis or cardiogenic shock as the virus progresses. SARS-CoV-2 has a much higher mortality rate in patients with comorbiditities, but is highest in patients with comorbidities like heart failure and coronary artery disease. Fried said these conditions are exacerbated by COVID-19.

"We tried to put together some of the observations we noted in our early experiences in these patients at out center with manifestations of COVID-19," explained Fried. "We are seeing significant cardiac involvement, but it is important to note that many of our patients with underlying cardiovascular disease, notably heart failure and coronary disease, are developing significant effects form COVID-19 that is destabilizing conditions, and that presents unique challenge. I worry most about our patients who have underlying cardiovascular disease, which can be exacerbated by COVID-19."

Read more details in the article "New York City Physicians Note Multiple Cardiovascular Presentations of COVID-19."

 

Other Impact of COVID-19 on Cardiology Content:

VIDEO: 9 Cardiologists Share COVID-19 Takeaways From Across the U.S.

VIDEO: Impact of COVID-19 on the Interventional Cardiology Program at Henry Ford Hospital — Interview with William O'Neill, M.D.

Image Gallery Showing Impact of the COVID-19 Pandemic

ACC COVID-19 Clinical Guidance For the Cardiovascular Care Team

VIDEO: COVID-19 Precautions for Cardiac Imaging — Interview with Stephen Bloom, M.D.

Rapid Drop in Heart Attacks and Stroke at Hospitals Concerns ACC 

VIDEO: Cancelling Non-essential Cardiac Procedures During the COVID-19 Outbreak — an interview with SCCT President Ehtisham Mahmud, M.D.

VIDEO: Telemedicine in Cardiology and Medical Imaging During COVID-19 — Interview with Regina Druz, M.D.

The Cardiac Implications of Novel Coronavirus

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

FFR Technologies | March 26, 2020
VIDEO: Use of FFR-CT to Non-invasively Evaluate Coronary Lesion Severity

James Udelson, M.D., chief of the division of cardiology, Tufts Medical Center, explains how cardiac computed tomography (CT) scans are being used to create image-derived fractional flow reserve (FFR) values to determine if a coronary lesion is flow limiting. The FFR-CT can help determine if the patient needs a stent, or if the disease can be treated with medication. Tufts uses FFR-CT evaluations on non-emergency chest pain patients to reduce the need for diagnostic catheterizations. 

 

Related FFR-CT Content:

Image-based FFR May Replace Pressure Wires and Adenosine

New Technology Directions in Fractional Flow Reserve (FFR)

8 Cardiovascular Technologies to Watch in 2020

VIDEO: Using FFR-CT in Everyday Practice

FFR-CT is Ready for Prime-time Evaluation of Coronary Disease

6 Hot Topics in Interventional Cardiology at TCT 2019

FFR-CT: Is It Radiology or Cardiology?

 

Find more news and video from Tufts Medical Center

 

 

Coronavirus (COVID-19) | March 20, 2020
VIDEO: Cancelling Non-essential Cardiac Procedures During the COVID-19 Outbreak

An interview with Ehtisham Mahmud, M.D., FSCAI, chief, Division of Cardiovascular Medicine, executive director of medicine, Cardiovascular Institute, director of  interventional cardiology and cardiac cath lab at UC San Diego Medical Center, and president of the Society for Cardiovascular Angiography and Interventions (SCAI). He explains the how cardiology departments in the U.S. are now postponing cardiovascular procedures due to novel coronavirus (COVID-19, SARS-CoV-2) containment efforts and new guidelines from Medicare calling for delay of all elective procedures in the country. 

Mahmud explains how patients are being prioritized, with acute myocardial infarction patients or others with acute, life-threatening conditions, or at high risk for a near term hospital admission, will still receive cardiac catheterizations, cardiovascular surgery or structural heart procedures for MitraClip and transcatheter aortic replacement (TAVR) under certain circumstances. All other procedures are being postponed until further notice based in the spread and infection rates of COVID-19. He said most hospitals, including his own, are moving to telehealth visits via phone or online to continue clinic work with patients, including those with chronic conditions such as heart failure.

The Centers for Medicare and Medicaid Services (CMS) announced March 18, 2020, that all elective surgeries, and non-essential medical, surgical and dental procedures should be delayed during the coronavirus outbreak. This move is three-fold. 
   1. It is to help with containment efforts by reducing patient and family travel to hospitals, which are at the center of the COVID-19 outbreak. 
   2. Delaying procedures will help preserve and inventory of personal protective equipment (PPE), hospital beds and ventilators and other medical supplies. 
   3. With the start of social distancing and the shut down of all large gatherings, this has severely impacted blood drives and other blood donations, so the nation's blood banks have severely limited supplies.

“The reality is clear and the stakes are high — we need to preserve personal protective equipment for those on the front lines of this fight,” said CMS Administrator Seema Verma.

This will not only preserve equipment but also free up the healthcare workforce to care for the patients who are most in need. Additionally, as states and the nation as a whole work toward limiting the spread of COVID-19, healthcare providers should encourage patients to remain home, unless there is an emergency, to protect others while also limiting their exposure to the virus. 

Read Mahmud's SCAI President's letter The Evolving Pandemic of COVID-19 and Interventional Cardiology

 

Related Cardiology Related COVID-19 Content:

ACC COVID-19 recommendations for the cardiovascular care team

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

ESC Council on Hypertension Says ACE-I and ARBs Do Not Increase COVID-19 Mortality

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS)

CT Provides Best Diagnosis for Novel Coronavirus (COVID-19)

Radiology Lessons for Coronavirus From the SARS and MERS Epidemics

Deployment of Health IT in China’s Fight Against the COVID-19 Epidemic

Emerging Technologies Proving Value in Chinese Coronavirus Fight

Radiologists Describe Coronavirus CT Imaging Features

Coronavirus Update from the FDA

CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia

CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV)

Chest CT Findings of Patients Infected With Novel Coronavirus 2019-nCoV Pneumonia 

 

Additional COVID-19 Resources for Clinicians:

   ACC COVID-19 Hub page   

   Johns Hopkins Coronavirus Resource Center with inteavtive map of cases in U.S. and worldwide 

   World Health Organization (WHO) COVID-19 situation reports

   World Health Organization (WHO) coronavirus information page

   U.S. Food and Drug Administration (FDA) COVID-19 information page

   Centers for Disease Control (CDC) COVID-19 information page

   Centers for Medicare and Medicaid Services (CMS) frequently asked questions and answers (FAQs) for healthcare providers regarding COVID-19 related payments
 

 

EP Lab View all 71 items

EP Lab | July 28, 2020
VIDEO: Impact of COVID-19 on Electrophysiology Programs

Devi G. Nair, M.D., FHRS, director of cardiac electrophysiology, St. Bernards Heart and Vascular Center, Jonesboro, Ark., explains the impact of COVID-19 (SARS-CoV-2) on her EP program and what was done to continue operations and recover procedural volume. She also shares how EP played a role in the team approach to treating coronavirus patients at her center.

Her experience is an example of how centers have dealt with issues related to the pandemic, including shutting down elective procedures, treating emergent cases, reopening services, new safety precautions and how telehealth played a role.

Nair is also chairman for the Heart Rhythm Society (HRS) member engagement sub-committee and is a board member of the Arkansas chapter of the American College of Cardiology (ACC).

Watch Nair in this interview — VIDEO: Overview of LAA Occlusion Using the Watchman FLX

 

 

Related COVID-19 Cardiology Content:

VIDEO: Why QT-prolongation Occurs in COVID-19 Patients on Hydroxychloroquine and Azithromycin — Interview with Andrew Krahn, M.D.

The Cardiovascular Impact of COVID-19

How Cardiology Dealt With the COVID-19 Surge in New York City

Kawasaki-like Inflammatory Disease Affects Children With COVID-19 

 

VIDEO: Impact of COVID-19 on the Interventional Cardiology Program at Henry Ford Hospital — Interview with William O'Neill, M.D.

ACC COVID-19 Clinical Guidance For the Cardiovascular Care Team

FDA Reports of Deaths and Injuries From Use of Antimalarial hydroxychloroquine in COVID-19 Patients

New Research Highlights Blood Clot Dangers of COVID-19

 

How to Manage AMI Patients During the COVID-19 Pandemic 

Older Critically Ill COVID-19 Patients May Have Increased Risk of Bradycardia With Lopinavir and Ritonavir

VIDEO: Where Have all the STEMI Cases Gone Amid COVID-19? — Interview with Thomas Maddox, M.D.

Left Atrial Appendage (LAA) Occluders | July 24, 2020
VIDEO: Overview of LAA Occlusion Using the Watchman FLX

Devi G. Nair, M.D., FHRS, director of cardiac electrophysiology, St. Bernards Heart and Vascular Center, Jonesboro, Ark., was an investigator in the PINNACLE FLX clinical trial for the Boston Scientific Watchman FLX left atrial appendage (LAA) occluder device. 

The newest iteration of the Watchman was cleared by the U.S. Food and Drug Administration (FDA) in July 2020. Read more about the Watchman FLX 

The transcatheter implant is used in close the LAA, a pouch that forms part of the left atrium. The LAA is implicated in the formation of blood clots that cause stroke in patients with atrial fibrillation (AF). The Watchman FLX is indicated to reduce the risk of stroke in patients with non-valvular AF (NVAF) who need an alternative to oral anticoagulation therapy by permanently closing off the left atrial appendage.

Nair is currently involved with another trial of the Watchman FLX, OPTION FLX trial, which is examining the use of LAA occlusion in post-ablation patients.

Nair is also chairman for the Heart Rhythm Society (HRS) member engagement sub-committee and is a board member of the Arkansas chapter of the American College of Cardiology (ACC).
 

Watch Nair in this interview — VIDEO: Impact of COVID-19 on Electrophysiology Programs

 

Coronavirus (COVID-19) | May 29, 2020
VIDEO: Creating a Home COVID-19 Decontamination Area for the Clinician

Jay Mohan, D.O., RPVI, interventional cardiology fellow at William Beaumont Hospital, Royal Oak, Michigan, created this video. It shows other clinicians how he set up his home COVID-19 decontamination area where he changes clothes, shoes and sterilizes before entering his house in order to protect his family. He has been involved with direct care of COVID-19 patients the past two months.

Since the start of the SAR-CoV-2 pandemic, clinicians and first-responders who are in contact with, or possible contact with, COVID-19 patients have developed ways to not bring and viral contamination home with them. This often includes on transition spot in the garage or designed room where they can change out of work clothing and shoes and into new clothing and shoes. Shoes and coats are separated into ones used for home and those dedicated for use at work only. Those who wear and reuse N95 masks also have developed ways to take the mask off by the straps only so they do not touch it and strapping it over a tupperware container that can then be sealed, or stored inside a disposable paper or plastic bag.

Mohan is board certified in cardiology, internal medicine, echocardiography and nuclear cardiology. He also serves as vice president of the Dr. Ramesh Kumar Foundation. 

Mohan shares regular updates on Twitter about recent cardiology technology devices, takeaway points from conferences and short educational videos he produces. Follow or contact him via Twitter or Instagram at @cardiologyoncall.

Watch a video animation he created — VIDEO: The Latest Data on COVID-19 and Cardiovascular Disease.
 

Find more cardiovascular related COVID-19 content

Coronavirus (COVID-19) | May 28, 2020
VIDEO: Why QT-prolongation Occurs in COVID-19 Patients on Hydroxychloroquine and Azithromycin

Interview with Andrew D. Krahn, M.D.,FHRS, head of the division of cardiology at St. Paul’s Hospital, and professor of medicine at the University of British Columbia, and vice president of the Heart Rhythm Society (HRS). He is an expert in long QT syndrome (LQTS) and is involved with the National Long QT Registry. He explains the issues with the drugs being used to treat coronavirus (COVID-19, SARS-CoV-2) patients and why these combined with the cardiac impact of the virus is causing prolonged ECG QT segment prolongation, leading to deadly arrhythmias. COVID-19 can cause myocarditis that causes QT prolongation and the front-line COVID drugs hydroxychloroquine and azithromycin also cause QT prolongation.

The U.S. Food and Drug Administration (FDA) issued a Drug Safety Communication April 23, 2020, reminding doctors there are serious side effects when using hydroxychloroquine and chloroquine in the off-label use to treat COVID-19 patients. This includes potentially life-threatening heart rhythm problems. The FDA said case reports from the FDA Adverse Event Reporting System database, published medical literature and the American Association of Poison Control Centers National Poison Data System are reporting serious heart-related adverse events and patient deaths. Read more about this alert.

The FDA warning confirmed fears from the American Heart Association (AHA), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS). These societies April 8 jointly published a new guidance, “Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 19) Treatment,” to detail critical cardiovascular considerations in the use of hydroxychloroquine and azithromycin for the treatment of COVID-19. The societies warned that use of  these agents in a large number of patients in combination would results in arrhythmias and deaths. Read more.

However, there are numerous advocates that argue hydroxychloroquine needs to be used in less sick patients who are not already hypoxic to treat COVID, but it is being used primarily in very sick patients where it is not effective. Advocates also argue the drug can be used to help prevent coronavirus, similar to the drug's effect in preventing malaria. In terms of drug safety, advocates argue the drug has been used in millions of patients for more than 50 years without a high risk of arrhythmias. Several trials are now underway in the United States to test its use against COVID-19, but enrollment has been hampered because of the FDA warning. There will likely be more interest in hydroxychloroquine after it was revealed May 18, 2020, that President Trump is taking the drug for prophylaxis against COVID-19.

 

Related Hydroxychloroquine Content:

FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine for COVID-19

WHO Database Shows Serious Health Impact of Hydroxychloroquine and Azithromycin Being Used to Treat COVID-19

VIDEO: Overview of Hydroxychloroquine and FDA Warning in its use to Treat COVID-19 — Interview with Marianne Pop, Pharm.D.

WHO Database Shows Serious Health Impact of Hydroxychloroquine and Azithromycin Being Used to Treat COVID-19

COVID-19 Hydroxychloroquine Treatment Brings Prolonged QT Arrhythmia Issues

 

FDA Reports of Deaths and Injuries From Use of Antimalarial hydroxychloroquine in COVID-19 Patients

VIDEO: Cardiologists Manage Trial Testing if Hydroxychloroquine Protects Clinicians From COVID-19 — Interview with William O'Neill, M.D.

First Large-scale U.S. Study on Hydroxychloroquine COVID-19 Prophylaxis Begins in Detroit

AHA, ACC, HRS Caution Use of COVID-19 Therapies Hydroxychloroquine and Azithromycin in Cardiac Patients

Information Technology View all 148 items

Coronavirus (COVID-19) | March 26, 2020
VIDEO: Telemedicine in Cardiology and Medical Imaging During COVID-19

Regina Druz, M.D., FASNC, a member of the American Society of Nuclear Cardiology (ASNC) Board of Directors, chairwomen of the American College of Cardiology (ACC) Healthcare Innovation Section, and a cardiologist at Integrative Cardiology Center of Long Island, N.Y., explains the rapid expansion of telemedicine with the U.S. spread of novel coronavirus (COVID-19, SARS-CoV-2).

Druz spoke on the unprecedented expansion of telemedicine in the U.S. under COVID-19, seeing more use in the last two months, as opposed to the past two decades. The Centers for Medicare and Medicaid Services (CMS) previously only reimbursed for Telehealth in rural areas it determined had a shortage of doctors. However, in early March 2020, CMS dropped the geographic requirements and allowed Telehealth usage across th country as a way to mitigate person-to-person contact and keep vulnerable, older patients at home for routine check ups with doctors.

Druz has subspecialty certifications in nuclear cardiology, adult echocardiography and cardiac computed tomography (CT) and explains how Telehealth can be used to pre-screen patients and get patient sign off on procedures prior to coming in for an exam, helping speed the process in the hospital and limit personal contact.

Concerns about the rpaid spread of COVID-19 also has driven many radiology departments to convert to wider use of teleradiology to allow more radiologists to work from home and reduce person-to-person contact within the hospitals. 

The U.S. Federal Communications Commission (FCC) adopt a $200 million telehealth program to support healthcare providers responding to the
ongoing coronavirus pandemic on April 2, 2020. Read more from the FCC.

CMS Expand Medicare Telehealth Benefits During COVID-19 Outbreak, including dropping requirements for rural health locations only, opening telehealth for use across the United States.

Watch the related VIDEO: Use of Teleradiology During the COVID-19 Pandemic — an interview with John Kim, M.D., chairman, Department of Radiology, THR Presbyterian Plano, Texas, and chief technology officer at Texas Radiology Associates.

Recommendations from Druz are also included in the Best Practices for Nuclear Cardiology Laboratories During the Coronavirus (COVID-19) Pandemic
 

 

Related COVID-19 Content:

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with emergency physician Mike Stone, M.D.,

VIDEO: How China Leveraged Health IT to Combat COVID-19 — Interview with Jilan Liu, M.D., CEO for the HIMSS Greater China

Study Looks at CT Findings of COVID-19 Through Recovery

Experts Stress Radiology Preparedness for COVID-19

ACR Recommendations for the Use of Chest Radiography and CT for Suspected COVID-19 Cases

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

 

 

FFR Technologies | March 26, 2020
VIDEO: Use of FFR-CT to Non-invasively Evaluate Coronary Lesion Severity

James Udelson, M.D., chief of the division of cardiology, Tufts Medical Center, explains how cardiac computed tomography (CT) scans are being used to create image-derived fractional flow reserve (FFR) values to determine if a coronary lesion is flow limiting. The FFR-CT can help determine if the patient needs a stent, or if the disease can be treated with medication. Tufts uses FFR-CT evaluations on non-emergency chest pain patients to reduce the need for diagnostic catheterizations. 

 

Related FFR-CT Content:

Image-based FFR May Replace Pressure Wires and Adenosine

New Technology Directions in Fractional Flow Reserve (FFR)

8 Cardiovascular Technologies to Watch in 2020

VIDEO: Using FFR-CT in Everyday Practice

FFR-CT is Ready for Prime-time Evaluation of Coronary Disease

6 Hot Topics in Interventional Cardiology at TCT 2019

FFR-CT: Is It Radiology or Cardiology?

 

Find more news and video from Tufts Medical Center

 

 

Coronavirus (COVID-19) | March 20, 2020
VIDEO: Cancelling Non-essential Cardiac Procedures During the COVID-19 Outbreak

An interview with Ehtisham Mahmud, M.D., FSCAI, chief, Division of Cardiovascular Medicine, executive director of medicine, Cardiovascular Institute, director of  interventional cardiology and cardiac cath lab at UC San Diego Medical Center, and president of the Society for Cardiovascular Angiography and Interventions (SCAI). He explains the how cardiology departments in the U.S. are now postponing cardiovascular procedures due to novel coronavirus (COVID-19, SARS-CoV-2) containment efforts and new guidelines from Medicare calling for delay of all elective procedures in the country. 

Mahmud explains how patients are being prioritized, with acute myocardial infarction patients or others with acute, life-threatening conditions, or at high risk for a near term hospital admission, will still receive cardiac catheterizations, cardiovascular surgery or structural heart procedures for MitraClip and transcatheter aortic replacement (TAVR) under certain circumstances. All other procedures are being postponed until further notice based in the spread and infection rates of COVID-19. He said most hospitals, including his own, are moving to telehealth visits via phone or online to continue clinic work with patients, including those with chronic conditions such as heart failure.

The Centers for Medicare and Medicaid Services (CMS) announced March 18, 2020, that all elective surgeries, and non-essential medical, surgical and dental procedures should be delayed during the coronavirus outbreak. This move is three-fold. 
   1. It is to help with containment efforts by reducing patient and family travel to hospitals, which are at the center of the COVID-19 outbreak. 
   2. Delaying procedures will help preserve and inventory of personal protective equipment (PPE), hospital beds and ventilators and other medical supplies. 
   3. With the start of social distancing and the shut down of all large gatherings, this has severely impacted blood drives and other blood donations, so the nation's blood banks have severely limited supplies.

“The reality is clear and the stakes are high — we need to preserve personal protective equipment for those on the front lines of this fight,” said CMS Administrator Seema Verma.

This will not only preserve equipment but also free up the healthcare workforce to care for the patients who are most in need. Additionally, as states and the nation as a whole work toward limiting the spread of COVID-19, healthcare providers should encourage patients to remain home, unless there is an emergency, to protect others while also limiting their exposure to the virus. 

Read Mahmud's SCAI President's letter The Evolving Pandemic of COVID-19 and Interventional Cardiology

 

Related Cardiology Related COVID-19 Content:

ACC COVID-19 recommendations for the cardiovascular care team

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

ESC Council on Hypertension Says ACE-I and ARBs Do Not Increase COVID-19 Mortality

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS)

CT Provides Best Diagnosis for Novel Coronavirus (COVID-19)

Radiology Lessons for Coronavirus From the SARS and MERS Epidemics

Deployment of Health IT in China’s Fight Against the COVID-19 Epidemic

Emerging Technologies Proving Value in Chinese Coronavirus Fight

Radiologists Describe Coronavirus CT Imaging Features

Coronavirus Update from the FDA

CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia

CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV)

Chest CT Findings of Patients Infected With Novel Coronavirus 2019-nCoV Pneumonia 

 

Additional COVID-19 Resources for Clinicians:

   ACC COVID-19 Hub page   

   Johns Hopkins Coronavirus Resource Center with inteavtive map of cases in U.S. and worldwide 

   World Health Organization (WHO) COVID-19 situation reports

   World Health Organization (WHO) coronavirus information page

   U.S. Food and Drug Administration (FDA) COVID-19 information page

   Centers for Disease Control (CDC) COVID-19 information page

   Centers for Medicare and Medicaid Services (CMS) frequently asked questions and answers (FAQs) for healthcare providers regarding COVID-19 related payments
 

 

RSNA | January 13, 2020
VIDEO: Editors Choice of the Most Innovative New Medical Imaging Technology at RSNA 2019

DAIC/ITN Editor Dave Fornell takes a tour of some of the most innovative new medical imaging technologies displayed on the expo floor at the Radiological Society of North America (RSNA) 2019 meeting. 

Technology examples include a robotic arm to perform remote ultrasound exams, integration of artificial intelligence (AI) to speed or automate radiology workflow, holographic medical imaging display screens, a new glassless digital radiography (DR) X-ray detector, augmented reality for transesophageal echo (TEE) training, moving DR X-ray images, 3-D printed surgical implants created from a patient's CT imaging, DR X-ray tomosynthesis datasets, radiation dose management and analytics software, and new computed tomography (CT) technologies.

 

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