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VIDEO: Why QT-prolongation Occurs in COVID-19 Patients on Hydroxychloroquine and Azithromycin

Coronavirus (COVID-19) | May 28, 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, 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-lable 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:

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

Cardiac Diagnostics

Coronavirus (COVID-19) | May 28, 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, 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-lable 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:

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

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

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. 

 

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Find more news and video from Tufts Medical Center

 

 

Coronavirus (COVID-19) | March 20, 2020

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)

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

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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
 

 

Coronavirus (COVID-19) | March 17, 2020

Interview with Thomas Maddox, M.D., MSc, FACC, the chairman of the American College of Cardiology (ACC) Science and Quality Committee, which recently created the ACC document on novel coronavirus (COVID-19) clinical guidance for the cardiovascular care team. He explains the document and what cardiologists and the cardiac care team needs to know about caring for COVID-19 patients. The document points out COVID-19 combined with the comorbidity of cardiovascular disease has the mortality of any comorbidity, as high as 10.5 percent.

He explains the need for more serious attention to protective equipment, cardiovascular complications seen in COVID-19 (SARS‐CoV‐2) patients, suggestions on how to mitigate exposure if an echo or cath is required, and other considerations for the CV care team. He said the document will be updated on a regular bases and the committee is drafting other sets of related COVID-19 guidelines for cardiology departments.

Updates regarding COVID-19 and cardiology will be posted on the ACC COVID-19 Hub page.

Maddox is also the executive director of the Healthcare Innovation Lab of BJC Healthcare and Washington University School of Medicine, St. Louis. He is also an assistant professor of cardiology at Washington University.

Read more on ACC COVID-19 recommendations for the cardiovascular care team.

 

Additional COVID-19 Resources for Clinicians:

   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
 

 

Related COVID-19 Content:

The Cardiac Implications of Novel Coronavirus

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

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

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Wearables | January 09, 2020

The Consumer Electronic Show (CES) is the world's gathering place for consumer technologies, with more than 175,000 attendees and more than 4,400 exhibiting companies. New healthcare technologies are among the top trends at CES. This video offers a quick look at the trends specific to healthcare technology.

Artificial intelligence (AI) is one of the hottest technology trends across all product across the CES floor this year. There is also discussion by key note speakers that the internet-of-things (IOT) concept introduced at CES nearly a decade ago is now morphing into a new meaning for the interconnectivity-of-things. This can be seen in healthcare products shown here and across all types of consumer and business products. 

The device technology at CES include many examples of how integrated wearables can digitally enable healthcare. The future of healthcare will include system where consumers are continuously monitored with sensors, software and services that can pinpoint digital biomarkers — earlier warning signs that predict health events. This is the prediction of Leslie Saxon, M.D., executive director of the University of Southern California (USC) Center for Body Computing (CBC), is speaking as a panelist about digital health trends and challenges in the session “Proving the Impact of Transformative Technology.” 

Saxon is a board-certified cardiologist and digital health expert who understands how developing technologies can more accurately assess wellness and human performance among elite athletes, military personnel and patients. She explained this digital healthcare model of the future is a vast contrast to the current point-of-care model.

 

 

Artificial Intelligence | November 07, 2019

Piotr J. Slomka, Ph.D., FACC, research scientist in the Artificial Intelligence in Medicine Program, Department of Medicine at Cedars-Sinai, and professor of medicine in-residence of the David Geffen School of Medicine, UCLA. He explains how his team at Cedars-Sinai is working on intelligent patient risk prediction algorithms that will automatically extract information from medical imaging. He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

Find more articles and video on AI

 

Cardiac Diagnostics | October 29, 2019

Clyde Yancy, M.D., MSc, cardiology chief and vice dean for diversity and inclusion at Northwestern University, Feinberg School of Medicine, was a keynote speaker at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. He said the traditional biases of seeing a patient and automatically making clinical assumptions because they are a certain race or gender are obsolete. For example, he said not all black patients have hypertension. Yancy added that genetics, especially with racial intermarriage over the past several generations, no longer predisposes patients to what is typically assumed for certain ethnic or racial backgrounds.

Yancy also said new research is showing how diet plays a major role in patient health and disease progression for things previously thought to be based on genetics. This includes the people who live in "food deserts" in urban areas where there are no sources of fresh food and vegetables, so they consume large amounts of packaged and processed foods that contain high levels of salt, phosphates and preservatives. He said these chemicals and diet may be the root cause of hypertension and diabetes in black populations in low income areas, rather than genetics as previously thought.

 

Related Content: 

VIDEO: Reducing Hypertension Among African-Americans — Interview with Kim Allan Williams, Sr., M.D.

VIDEO: Use of Plant-Based Diet to Reduce Cardiovascular Disease Risk — Interview with Kim Allan Williams, Sr., M.D.

VIDEO: New PLATINUM Diversity Data Shows Early DAPT Cessation OK in Minorities With New Generation Stent — Interview with Roxana Mehran, M.D., 

 

CT Angiography (CTA) | August 08, 2019

This is an example of an automated calcium scoring software to speed review of coronary artery calcium (CAC) scoring cardiac computed tomography (CT) scans. This advanced visualization software from Ziosoft uses artificial intelligence to segment the coronary vessels, identify valves and the aorta and then color code tag the calcium deposits and quantify the amount of calcified plaque in each vessel. It tallies the score into a table and computes an overall Agatston risk score. This risk score correlates to that patient's risk for a heart attack in the future. The software notes calcium in the heart outside the coronaries in valve leaflets and the aorta, but excludes this data. This type of automation is now offered by most advanced visualization and CT system vendors. This automation can save a large amount of post-processing time and make it easier for hospitals to offer low-cost CAC CT screening programs. 

CAC scans can be used to determine if a patient needs to go on statin therapy. An Agatston score of zero means the patient has no risk of coronary disease. 

Calcium in arteries is a marker for damage caused by vessel wall inflammation from atherosclerosis. Calcium can form from previously ruptured necrotic, lipid core plaques, also referred to as vulnerable plaques. These are the types of plaque responsible for heart attacks. When the core of these plaques rupture, the blood reacts to the exposed core similar to a wound and begins to clot, forming a thrombus in the vessel, which can block the blood flow. When the vessel heals over time it calcifies, leaving behind an easily identifiable marker on CT imaging. 

This example of software was demonstrated on the expo floor at the 2019 Society of Cardiovascular Computed Tomography (SCCT) meeting. 

 

Related CT Calcium Scorining Content:

VIDEO: The History of CT Calcium Scoring — Interview with Arthur Agatston, M.D.

VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment — Interview with Matthew Budoff, M.D.

CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

 

 

Cardiac Imaging | July 30, 2019

Nate Bachman, graduate research assistant in the Human Cardiovascular Physiology Lab of the Dept. of Health and Exercise Science at Colorado State University, describes how he and fellow researchers used multiple types of cardiac imaging to evaluate the cardiovascular health of athletes who compete in endurance events lasting six hours or more, and what the results may suggest for future screening.

CT Angiography (CTA) | July 24, 2019

Arthur Agatston, M.D., clinical professor of medicine, Florida International University, Herbert Wertheim College of Medicine, is the name-sake of the Agatston score used in CT calcium scoring. He explains the history of the scoring system from the early 1990s and the evolution of CT technology for cardiac imaging. The latest American Heart Association (AHA) 2018 cholesterol guidelines now include the use of CT calcium scoring, which was a big topic at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

Read the article How the Agatston Calcium Score Was Created and its Impact on Heart Attack Prevention.

See a quick example of a CT calcium scoring exam in the VIDEO: Example of an Automated CT Cardiac Calcium Scoring Exam.

 

 

Related CT Calcium Scorining Content:

VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment — Interview with Matthew Budoff, M.D.

CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

 

Find more SCCT news and videos

 

Cardiovascular Ultrasound | July 01, 2019

Federico Asch, M.D., FASE, director of cardiac imaging research and director of the cardiovascular imaging lab, MedStar Health Research Institute, Washington, D.C., spoke about the cardiovascular impact of chagas disease and the symptoms that should be considered for patients who are from, or visited, South or Central America. He spoke on the topic at the 2019 American Society Of Echocardiography (ASE) meeting.

Chagas, also called trypanosomiasis, is a tropical parasitic disease caused by the protist Trypanosoma cruzi. It is spread through the bite of the triatominae insect, which is also known as the "kissing bug." Link to the Center for Disease Control (CDC) page on Chagas.

Asch served as the co-chair of the group that created the guidelines to image Chagas disease.

Read the guidelines at "Recommendations for Multimodality Cardiac Imaging in Patients with Chagas Disease: A Report from the American Society of Echocardiography in Collaboration With the InterAmerican Association of Echocardiography (ECOSIAC) and the Cardiovascular Imaging Department of the Brazilian Society of Cardiology (DIC-SBC).

 

Find more news and video from ASE 2019

 

Cardiovascular Ultrasound | July 01, 2019

Partho Sengupta, M.D., MBBS, chief of cardiology, West Virginia Heart and Vascular Institute, explains how wearable, smartphone-based apps and medical devices, and artificial intelligence (AI) might be used to cost-effectively triage larger numbers of patients in rural areas and in the developing world for serious diseases. He spoke at the 2019 American Society Of Echocardiography (ASE) meeting.

Sengupta is involved with a pilot program using the Butterfly app and transducer to turn a smartphone into an inexpensive ultrasound system. He said the idea is to have novice ultrasound users screen more patients with these types of devices and the exams either being sent to a remote hospital for reading. He said AI algorithms also could be used to help flag any exams that show abnormalities, which would greatly speed reads and getting these patients treatment. 

Watch the related VIDEO: How Smartphones May Revolutionize Healthcare in the Developing World — Interview with Jacques Kpodonu, M.D.,

Find more news and video from ASE 2019

 

Wearables | June 21, 2019

Jacques Kpodonu, M.D., FACC, cardiac surgeon, Beth Israel Deaconess Medical Center, and professor at Harvard Medical School, explains how medical devices and wearables that interface with smartphones and apps might be used to eliminate healthcare disparities in rural areas of the developed world and help raise the level of care in the developing world. He spoke at the 2019 AI-Med Cardiology conference. 

 

Related Smartphone and Wearable Content:

VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — Interview with Robert Klempfner, M.D.

VIDEO: Use of Wearables to Track Electrophysiology Patients — Interview with Khaldoun Tarakji, M.D.

Smartphones Used to Successfully Screen More than 60,000 for Atrial Fibrillation

VIDEO: The Future of Wearables in Healthcare — Interview with Karl Poterack, M.D.

VIDEO: Artificial Intelligence Applications for Cardiology — Interview with Anthony Chang, M.D.
 

Atrial Fibrillation | June 21, 2019

Sanjaya Gupta, M.D., electrophysiologist, St. Luke's Mid America Heart Institute, and assistant professor, University of Missouri–Kansas City School of Medicine, explains how his center developed an artificial intelligence (AI) application to automatically risk stratify atrial fibrillation (AFib) patients. The Epic-based app stratifies patients into those who should be placed on anticoagulation and those who are candidates for left atrial appendage (LAA) occlusion. He spoke at the 2019 AI-Med Cardiology conference

His center hopes to develop similar guidelines based AI apps for other types of cardiac risk scoring. Gupta said he is looking for other centers to partner with to co-develop and test these AI apps.    

 

Related Cardiology AI Content:

VIDEO: Overview of Artificial Intelligence and its Use in Cardiology — Interview with Anthony Chang, M.D.

VIDEO: ACC Efforts to Advance Evidence-based Implementation of AI in Cardiovascular Care — Interview with John Rumsfeld, M.D.

VIDEO: Artificial Intelligence Applications for Cardiology — Interview with Anthony Chang, M.D.

PODCAST: Fitting Artificial Intelligence Into Cardiology — Interview with Anthony Chang, M.D.

VIDEO: How Hospitals Should Prepare for Artificial Intelligence Implementation — Interview with Paul Chang, M.D.

Technology Report: Artificial Intelligence 

Artificial Intelligence | June 20, 2019

John Rumsfeld, M.D., Ph.D., FACC, American College Cardiology (ACC) chief innovation officer, and professor of medicine at the University of Colorado School of Medicine, explains how the ACC is working with artificial intelligence (AI) vendors to directly impact cardiac care. He said there is a tremendous amount of investment in and hype surrounding AI in healthcare, but to date there has been very little of this has translated in to changes in the way cardiology care is delivered. He outlines several areas to successfully apply AI to improve cardiovascular care and outcomes. He also discussed the current ACC efforts to advance evidence-based implementation of AI in cardiac care including applications for the NCDR.

He spoke at the 2019 Cardiology AI-Med conference

Watch the related VIDEO: Overview of Artificial Intelligence and its Use in Cardiology, an interview with Anthony Chang, M.D., chief artificial intelligence officer, Children’s Hospital of Orange County (CHOC), and founder of AIMed.  

 

 

 

Cardiac Diagnostics | March 26, 2019

Kim Allan Williams, Sr., M.D., chief of the Division of Cardiology and the James B. Herrick Professor at Rush University Medical Center, , and former American College of cardiology (ACC) president, discusses the importance of a plant-based diet to improve cardiovascular health and why he went vegan.

 

Other Interviews With Dr. Williams:

VIDEO: Reducing Hypertension Among African-Americans

VIDEO: Imaging in the Assessment of Preventive Cardiology

 

Wearables | March 26, 2019

Khaldoun Tarakji, M.D., MPH, staff physician in the Section of Electrophysiology and Pacing in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute at the Cleveland Clinic, explains how wearable devices and smart phone apps can be used to aid electrophysiologists in patient care. He said the devices offer a constant remote monitoring of patient heart data, which can be helpful in diagnosing various types of arrhythmias and cardiac conditions. However, the main issue is how to sort through the large volumes of data and to figure out what the clinical value of some of this consumer data is through studies.  He spoke at the American College of Cardiology (ACC) 2019 meeting.

 

Other Cardiac Wearable Content:

VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — Interview with Robert Klempfner, M.D.

VIDEO: The Future of Wearables in Healthcare — Interview with Karl Poterack, M.D.

 

 

Wearables | March 08, 2019

Karl Poterack, M.D., medical director, applied clinical informatics, Mayo Clinic, explains the role wearable devices will play in healthcare. He presented in several sessions at the 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.

Poterack said there is a brewing tsunami of data in wearable technologies that healthcare systems will have to figure out how to integrate in the coming years. He said the key issue with wearable data is that there needs to be outcomes data showing the value of how many steps a patient accumulates, changes in heart rate over time, or blood pressure changes in patients with specific aliments. Without this , he said there is limited value in the information. 

Watch the related VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation.

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

ECG | March 05, 2019

This is a quick demo of the Schiller Cardiovit FT-1 electrocardiograph (ECG) system displayed at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. It has a 3-D rendering of a patient showing where each lead needs to be placed. The user can rotate the images on the touch screen to see where the leads go and can easily identify where any issues are when the system automatically alerts them about misplaced leads. The goal is to improve and speed ECGs using a better form of visualization than the traditional black and white 2-D pictures. The system changes the lead place placements of the body rending based on the type of exam being performed using a drop down menu.

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

Artificial Intelligence | March 04, 2019

Anthony Chang, M.D., chief intelligence and innovation officer, Children's Hospital of Orange County (CHOC), and medical director of the Sharon Disney Lund Medical Intelligence and Innovation Institute. He is expert in artificial intelligence (AI). He spoke in several sessions at Healthcare Information and Management Systems Society (HIMSS) 2019 meeting on the integration of AI in healthcare. 

He said AI will play a big roll in imaging assessments of adult congenital heart disease to help relieve the burden on the small number of congenital cardiologists. 

Chang also explained there is a tsunami of data about to wash over healthcare as wearable devices begin to be integrated into patient care. AI will play a key role in sorting through all this data by monitoring the information to identify trends or disease markers and alert clinicians and the patient.

He was a keynote speaker at HIMSS19 with his session "Synergies Between Man and Machine — Future AI apps can be directed to help mitigate physician burnout by decreasing the EHR burden, improving medical education, and automating quality improvement."

Chang is head of the artificial intelligence organization AIMed, which hosts educational sessions and an annual meeting on AI applications in medicine.

Listen to Chang in the PODCAST: Fitting Artificial Intelligence Into Cardiology.
 

Read the article 6 Key Health Information Technology Trends at HIMSS 2019.

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

Wearables | February 28, 2019

Robert Klempfner, M.D., director of the Cardiovascular Prevention Institute, Sheba Medical Center, Israel,  discusses his center's use of wearable devices to manage a remote cardiac rehabilitation program. He spoke on the topic at 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.   

Sheba Medical Center in Israel has adopted an app that interfaces with various wearables and Bluetooth-enabled patient monitoring devices to create remote cardiac rehabilitation and heart failure programs. It now remotely monitors hundreds of patients and does not require them to come to the hospital for sessions, which has helped increase patient satisfaction and aided in increasing physical activity compliance. The app is able to transfer device data to an EMR so progress and tasks assigned to patients can be monitored without the need for them to come into the hospital for sessions. Klempfner recently wrote a paper on this topic

Watch the related VIDEO: The Future of Wearables in Healthcare 

VIDEO: Mobile App Links Wearable Data to Electronic Medical Records — The Datos software used by Sheba

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

 

Wearables | February 28, 2019

How wearable devices will play a role in healthcare was a big topic at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. The biggest question is how to attached the data from consumer devices into a usable format for clinicians that interfaces with the electronic medical record (EMR). A good example of how wearables are being integrated in clinical care was demonstrated by the company Datos. It offers software that can integrate data from a wide variety of wearable devices from several makers into a mobile app, It can transfer the information to an EMR. The app also offers two way communication between the patient and the doctor’s office. It can prompt patients with a list of things they need to do each day to reach physician specified goals and displays analytics on a patient’s health data, including charts and graphs.

The system is used by Sheba Medical Center in Israel for a remote cardiac rehabilitation program. It now remotely monitors hundreds of patients and does not require them to come to the hospital for sessions, which has helped increase patient satisfaction and aided in increasing physical activity compliance. Watch the VIDEO: Use of Wearable Medical Devices for Cardiac Rehabilitation — an interview with Robert Klempfner, M.D., director of the Cardiovascular Prevention Institute, Sheba Medical Center.
 

Look through a photo gallery of other new technologies at HIMSS19. 

Find news and videos from HIMSS 2019.

Heart Failure | November 15, 2018

James Januzzi, M.D., Hutter Family Professor at Harvard Medical School and a cardiologist at Mass General Hospital,, Boston, spoke at the 2018 American Heart Association (AHA) meeting about blood biomarkers that can aid in assessing reverse remodeling in heart failure patients with reduced ejection fraction (HFrEF). 

Januzzi mentions the use of high sensitivity troponin in this video. Watch a VIDEO interview with Januzzi on his research with high sensitivity troponin.

 

 

Computed Tomography (CT) | November 14, 2018

Matthew Budoff, M.D., professor of medicine, David Geffen School of Medicine, UCLA, spoke at the 2018 American Heart Association (AHA) meeting on the new AHA guidelines for cholesterol, including the use of computed tomography (CT) calcium scoring scans to assess patient risk. Budoff has been involved in several of the coronary artery calcium (CAC) trials that supported the new recommendation.

 

 

Related CT Calcium Scorining Content:

VIDEO: New Cholesterol Guidelines Support CT Calcium Scoring for Risk Assessment — Interview with Matthew Budoff, M.D.

CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

VIDEO: The History of CT Calcium Scoring — Interview with Arthur Agatston, M.D.

 

 

 

Hypertension | November 07, 2018

Kim Allan Williams, Sr., M.D., chief of the Division of Cardiology and the James B. Herrick Professor at Rush University Medical Center, discusses the efforts being made by the Association of Black Cardiologists to reduce systemic hypertension in the African-American community. Williams is speaking on this topic at the American Heart Association 2018 meeting.

 

 

Womens Cardiovascular Health | October 01, 2018

Cindy Grines, M.D., chair and professor, department of cardiology, Zucker School of Medicine, Hostra/Northwell, spoke on this topic in sessions at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) conference. 

 

Related Women's Heart Health Content:

VIDEO: Sex Differences in Diagnosing Heart Disease in Women — Interview with Doreen DeFaria Yeh, M.D.

Cindy Grines Becomes SCAI President

VIDEO: How to Build a Successful Women’s Heart Center — Interview with Malissa Wood, M.D.

VIDEO: Creating a Cardio-Obstetrics Team — Doreen DeFaria Yeh, M.D.

Diagnostic Differences in Women’s Heart Health

Find more articles on women's heart issues in the Women's Cardiovascular Health channel

Cardiac Imaging | September 10, 2018

Leslee Shaw, Ph.D., professor of cardiology and radiology, Weill Cornell Medical Center, New York, and past-president of the Society of Cardiovascular Computed Tomography (SCCT), explains how cardiac imaging will be used in the ISCHEMIA Trial to assess treatment strategies for patients with stable ischemic heart disease. The trial was discussed by Shaw at the 2018 American Society of Nuclear Cardiology (ASNC) meeting.

Watch the related VIDEO Role of Cardiac CT in Value-based Medicine, an interview with Shaw at SCCT 2017.

Nuclear Imaging | August 22, 2018

Kim A. Williams, Sr., M.D., MACC, MASNC, FAHA, FESC, cardiology division chief and James B. Herrick professor at Rush University Medical Center, discusses the importance of nuclear cardiology in preventive medicine, and previews his upcoming keynote lecture at the 2018 annual meeting of the American Society of Nuclear Cardiology (ASNC), Sept. 6-9 in San Francisco.

Watch the related VIDEO ASNC 2018 Program Preview, where Rami Doukky, M.D., professor of medicine, preventive medicine and radiology, and chief of the Division of Cardiology at Cook County Health and Hospitals System, discusses new additions to the ASNC meeting program for 2018.

Watch the VIDEO MACRA's Impact on Cardiology, an interview with Williams on the impact of healthcare reform on cardiology and specifically on nuclear perfusion imaging.

Artificial Intelligence | July 10, 2018

Partho Sengupta, M.D., DM, FACC, FASE, chief division of cardiology, director of cardiac imaging, West Virginia University Heart and Vascular Institute, explains how artificial intelligence is being integrated into echocardiography and used to mine big data to better assess patients at the American Society of Echocardiography (ASE) 2018 meeting. 

Watch the VIDEO: Ultrasound's Integration of Artificial Intelligence and Robotic Echo, with Senguta at the ASE 2017 meeting

 

 

 

 

ACC | March 21, 2018

DAIC Editor Dave Fornell takes a tour of some of the most interesting new technologies on the expo floor at the 2018 meeting of the American College of Cardiology (ACC). Find links to other videos and the ACC 2018 Late-Breaking Trials.
 

 

Womens Cardiovascular Health | March 21, 2018

A discussion with Doreen DeFaria Yeh, M.D., associate director, Massachusetts General Hospital Adult Congenital Heart Disease Program and MGH Cardiovascular Disease and Pregnancy Service, at the 2018 American College of Cardiology (ACC) meeting. Yeh explains the differences between men and women for the clinical presentation of heart attacks and other causes for chest pain.  

 

Related Women's Heart Health Content:

Diagnostic Differences in Women’s Heart Health

VIDEO: Differences in Cardiac Complications and Presentation Between Men and Women — Interview with Cindy Grines, M.D.

DAIC's Women's Cardiovascular Health Channel

VIDEO: How to Build a Successful Women’s Heart Center — Interview with Malissa Wood, M.D.

VIDEO: Creating a Cardio-Obstetrics Team — Doreen DeFaria Yeh, M.D.

Wearables | January 29, 2018

Take a video tour of some of the medical devices designed to improve patient care, improve patient engagement and increase physiologic monitoring highlighted at the 2018 Consumer Electronics Show (CES). One of the most interesting technologies is a flexible electronics ECG monitor that can bend and twist with the skin and interfaces with a smartphone app. The exhibition includes more than 3,000 vendors and more than 170,000 attendees. For more examples of future healthcare technologies, watch the VIDEO “Editor's Choice of Future Healthcare Technologies at HIMSS.” 
 

Magnetic Resonance Imaging (MRI) | December 13, 2017

Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pittsburgh Medical Center, explains the new mobile application he developed, which lets users visually model the forces at work during an MRI exam on patients with implanted medical devices, at the 2017 Radiological Society of North America (RSNA) meeting.

Read the related article “The Changing Relationship Between MRIs and Pacemakers.”

TCT | November 15, 2017

DAIC Editor Dave Fornell shows some of the innovations displayed on the expo floor at the 2017 Transcatheter Cardiovascular Therapeutics (TCT). Hear what Cardiovascular Research Foundation (CRF) President and CEO Juan Granada, M.D., feels are the hottest technologies to watch. 

Cardiovascular Ultrasound | October 12, 2017

Sharon Mulvagh, M.D., FRCPC, FACC, FAHA, FASE, professor, Division of Cardiology, Department of Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Canada, and emeritus professor at Mayo Clinic, discusses how ultrasound can be used to assess plaque burden at the 2017 American  Society of Echocardiography (ASE) annual meeting. Read the article highlighting new technologies at ASE 2017 "A Glimpse Into the Future of Cardiac Ultrasound." Watch her presentation on the use of point-of-care echo for plaque burden risk assessment from ASE 2017.
 

 

Cardiovascular Ultrasound | August 30, 2017

This video educational session, provided in partnership with the American Society of Echocardiography (ASE), is titled "Atherosclerosis Assessment by Ultrasound in Everyday Practice." It is presented by Sharon Mulvagh M.D., FASE, FACC, FRCPC, professor of medicine, Dalhousie University, Halifax, Nova Scotia, Canada, and Mayo Clinic. This is one of the sessions presented at the ASE 2017 annual scientific sessions, one of the premier meetings for cardiac ultrasound education. For more information, visit asescientificsessions.org. 

For more educational videos on echocardiography, visit the DAIC education channel.