Sponsored Content | Videos | 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

 

Related Impella Video Content:

VIDEO: Complex PCI Involving Prior CABG and Comorbidities — Interview with Perwaiz Meraj, M.D.

VIDEO: The Door-to-Unloading (DTU) STEMI Safety and Feasibility Trial — Interview with Navin Kapur, M.D.

VIDEO: Cardiogenic Shock Case with Impella CP Support — Case study with Michael Amponsah, M.D.,

 

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Structural Heart | May 10, 2021

Philippe Géneréux, M.D., director of the structural heart program at Atlantic Health System’s Morristown Medical Center, is the lead author of the new VARC-3 consensus document that defines endpoints and standardizes taxonomy for aortic valve research.[1] This document is important because it acts as a guide so all structural heart research is comparable and using the same terminology. He said this will become more important as long-term outcomes of 5 to 10 years become available and require apples-to-apples comparisons with newer valve technologies.

Key updates in VARC-3 include a new section on hospitalization or re-hospitalization, defining various levels of valve leaflet thrombosis, also known as hypo-attenuated leaflet thickening (HALT), and defining the stages of bio-prosthetic valve deterioration and valve failure. 

The Valve Academic Research Consortium (VARC), founded in 2010, was intended to identify appropriate clinical endpoints and standardize definitions of these endpoints for transcatheter and surgical aortic valve clinical trials. Rapid evolution of the field, including the emergence of new complications, expanding clinical indications, and novel therapy strategies have mandated further refinement and expansion of these definitions to ensure clinical relevance. This document provides an update of the most appropriate clinical endpoint definitions to be used in the conduct of transcatheter and surgical aortic valve clinical research.

Reference:

1. VARC-3 WRITING COMMITTEE: PhilippeGénéreux, Nicolo Piazza, Maria C. Aluc, Tamim Nazif, Rebecca T.Hahn, Philippe Pibarot, Jeroen J. Bax, Jonathon A.Leipsic, Philipp Blanke, Eugene H.Blackstone, Matthew T.Finn, Samir Kapadia, Axel Linke, Michael J.Mack, Raj Makkar, Roxana Mehranl, Jeffrey J. Popmam, Martin B.Leon, et al. Valve Academic Research Consortium 3: Updated Endpoint Definitions for Aortic Valve Clinical Research. Journal of the American College of Cardiology. Available online 19 April 2021. https://doi.org/10.1016/j.jacc.2021.02.038.

 

Radial Access | May 06, 2021

Arnold Seto, M.D., MPA, FSCAI, chief of cardiology, Long Beach Veterans Affairs Medical Center and director, interventional cardiology research, UCI Health, and Jordan Safirstein, M.D., FSCAI, director of transradial intervention, Atlantic Health's Morriston Medical Center, were involved in a physician-initiated study to find a new way to cut radial artery access site hemostasis by 50 percent. The late-breaking study presented at SCAI 2021 uses a combination of a Statseal patch and the TR Band compression bracelet.

Cardiac catherization is increasingly bing performed using transradial approach, now making up 50 percent or more of the access used for U.S. interventional procedures. The Terumo TR Band is used to close the vascular access site. Standard protocols require the band to be left on for at least two hours following the procedure. 

Shorter compression times can help reduce complications with radial artery occlusion, so it is desirable to find ways to shorten compression times, Seto said. He explained clinicians often start to deflate the wrist band balloon after an hour and watch for ooze or blood. If there are signs the wound is not completely sealed, the band is reinflated. Reinflations occurs more that 67 percent of the time, he explained.

"We found with the Statseal, you almost never have to reinflate," Seto said. 

This study shows that time can be reduced in half and with fewer complications by using the additional patch device, which helps sped the clotting process. This can save staff time and possibly leading to faster patient discharge for same-day PCI programs. 

Read more in the article Radial Hemostasis Time Cut by 50 Percent With StatSeal in Combination With TR Band.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Coronavirus (COVID-19) | May 06, 2021

Payam Dehghani, M.D.,  FRCPC, FACC, FSCAI, co-director of Prairie Vascular Research and associate professor at the University of Saskatchewan, explains the findings of the North American COVID-19 Myocardial Infarction (NACMI) Registry. He presented this late-breaking study data at the at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting.

The study found one third of patients will die who have COVID-19 (SARS-CoV-2) and suffer a ST-elevated myocardial infarction (STEMI), which is alarming high as compared to four-in-100 patients using a pre-pandemic control group.

 The prospective, ongoing observational registry was created under the guidance of the SCAI, Canadian Association of Interventional Cardiology (CAIC) and American College of Cardiology (ACC). The initial results of the registry were published in the Journal for American College of Cardiology (JACC) on April 27, 2021.

Important key findings from the registry data include:
   • Minorities were disproportionally affected: 55 percent of the STEMI patients had minority ethnicity, which was about evenly divided between Hispanics and blacks.
   • In-hospital mortality was high: 33 percent (4 percent for controls without COVID).
   • Symptoms were unique: majority (54 percent) presented with respiratory symptoms (shortness of breath) rather than chest pain.
   • Significant proportion of COVID-positive patients presented with high-risk STEMI: cardiogenic shock (18 percent) and cardiac arrest (11 percent), which may explain the high fatality rate.
   • Primary angioplasty remained the dominant revascularization modality during the pandemic with small treatment delays (at about 15 minutes). 
   • Diabetics are known to have some of the worst outcomes if they contract COVID, and this was reflected in the study, with 45 percent of patients having diabetes. 

Read more in the artice Third of COVID Patients With STEMI Heart Attacks Die.

Find more COVID-19 news and video

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

 

Cath Lab | May 05, 2021

Ashwin Nathan M.D., a cardiology fellow in the division of Cardiovascular Medicine at the Hospital of the University of Pennsylvania, presented a late-breaking study at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting that looked at hospital-level percutaneous coronary intervention (PCI) performance data and simulated if what would happen if hospitals removed their highest risk patients. The findings suggest this risk avoidance strategy does not necessarily mean the hospital will get higher performance scores.

Read more in the article Avoiding High-risk Cath Lab Procedures Does Not Necessarily Improve Hospital Scores.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Sponsored Videos View all 41 items

Information Technology | April 17, 2019

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

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.

 

Related Impella Video Content:

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

VIDEO: The Door-to-Unloading (DTU) STEMI Safety and Feasibility Trial — Interview with Navin Kapur, M.D.

VIDEO: Cardiogenic Shock Case with Impella CP Support — Case study with Michael Amponsah, M.D.,

 

 

Heart Failure | February 13, 2019

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

 

Related Impella Video Content:

VIDEO: Complex PCI Involving Prior CABG and Comorbidities — Interview with Perwaiz Meraj, M.D.

VIDEO: The Door-to-Unloading (DTU) STEMI Safety and Feasibility Trial — Interview with Navin Kapur, M.D.

VIDEO: Cardiogenic Shock Case with Impella CP Support — Case study with Michael Amponsah, M.D.,

 

January 10, 2019

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 432 items

Radial Access | May 06, 2021

Arnold Seto, M.D., MPA, FSCAI, chief of cardiology, Long Beach Veterans Affairs Medical Center and director, interventional cardiology research, UCI Health, and Jordan Safirstein, M.D., FSCAI, director of transradial intervention, Atlantic Health's Morriston Medical Center, were involved in a physician-initiated study to find a new way to cut radial artery access site hemostasis by 50 percent. The late-breaking study presented at SCAI 2021 uses a combination of a Statseal patch and the TR Band compression bracelet.

Cardiac catherization is increasingly bing performed using transradial approach, now making up 50 percent or more of the access used for U.S. interventional procedures. The Terumo TR Band is used to close the vascular access site. Standard protocols require the band to be left on for at least two hours following the procedure. 

Shorter compression times can help reduce complications with radial artery occlusion, so it is desirable to find ways to shorten compression times, Seto said. He explained clinicians often start to deflate the wrist band balloon after an hour and watch for ooze or blood. If there are signs the wound is not completely sealed, the band is reinflated. Reinflations occurs more that 67 percent of the time, he explained.

"We found with the Statseal, you almost never have to reinflate," Seto said. 

This study shows that time can be reduced in half and with fewer complications by using the additional patch device, which helps sped the clotting process. This can save staff time and possibly leading to faster patient discharge for same-day PCI programs. 

Read more in the article Radial Hemostasis Time Cut by 50 Percent With StatSeal in Combination With TR Band.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Coronavirus (COVID-19) | May 06, 2021

Payam Dehghani, M.D.,  FRCPC, FACC, FSCAI, co-director of Prairie Vascular Research and associate professor at the University of Saskatchewan, explains the findings of the North American COVID-19 Myocardial Infarction (NACMI) Registry. He presented this late-breaking study data at the at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting.

The study found one third of patients will die who have COVID-19 (SARS-CoV-2) and suffer a ST-elevated myocardial infarction (STEMI), which is alarming high as compared to four-in-100 patients using a pre-pandemic control group.

 The prospective, ongoing observational registry was created under the guidance of the SCAI, Canadian Association of Interventional Cardiology (CAIC) and American College of Cardiology (ACC). The initial results of the registry were published in the Journal for American College of Cardiology (JACC) on April 27, 2021.

Important key findings from the registry data include:
   • Minorities were disproportionally affected: 55 percent of the STEMI patients had minority ethnicity, which was about evenly divided between Hispanics and blacks.
   • In-hospital mortality was high: 33 percent (4 percent for controls without COVID).
   • Symptoms were unique: majority (54 percent) presented with respiratory symptoms (shortness of breath) rather than chest pain.
   • Significant proportion of COVID-positive patients presented with high-risk STEMI: cardiogenic shock (18 percent) and cardiac arrest (11 percent), which may explain the high fatality rate.
   • Primary angioplasty remained the dominant revascularization modality during the pandemic with small treatment delays (at about 15 minutes). 
   • Diabetics are known to have some of the worst outcomes if they contract COVID, and this was reflected in the study, with 45 percent of patients having diabetes. 

Read more in the artice Third of COVID Patients With STEMI Heart Attacks Die.

Find more COVID-19 news and video

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

 

Cath Lab | May 05, 2021

Ashwin Nathan M.D., a cardiology fellow in the division of Cardiovascular Medicine at the Hospital of the University of Pennsylvania, presented a late-breaking study at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting that looked at hospital-level percutaneous coronary intervention (PCI) performance data and simulated if what would happen if hospitals removed their highest risk patients. The findings suggest this risk avoidance strategy does not necessarily mean the hospital will get higher performance scores.

Read more in the article Avoiding High-risk Cath Lab Procedures Does Not Necessarily Improve Hospital Scores.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Structural Heart | April 30, 2021

Ashwin Nathan M.D., a cardiology fellow at the Hospital of the University of Pennsylvania, presented a late-breaking study on the socioeconomic and geographic access to transcatheter aortic valve replacement (TAVR) programs at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 Scientific Sessions.

The findings reveal inequitable access to TAVR programs for non-metropolitan or lower income areas across the country. Between 2012 and 2018, 554 hospitals developed new TAVR programs including 543 (98%) in metropolitan areas, and 293 (52.9%) in metropolitan areas with pre-existing TAVR programs. Compared with hospitals that did not start TAVR programs, hospitals that did start TAVR programs treated patients with higher median household incomes (difference $1,305, 95% CI $134 to $12,477, p=0.03). Furthermore, TAVR rates per 100,000 Medicare beneficiaries were higher in areas with higher median income, despite adjusting for age and clinical comorbidities.

The authors also acknowledge that increasing access to TAVR and structural heart programs will require foresight into how clinical trials and approval for procedures and technologies at hospitals are distributed.

Read more about this study

Find more news from the SCAI 2021 virtual meeting

Cath Lab View all 299 items

Structural Heart | May 10, 2021

Philippe Géneréux, M.D., director of the structural heart program at Atlantic Health System’s Morristown Medical Center, is the lead author of the new VARC-3 consensus document that defines endpoints and standardizes taxonomy for aortic valve research.[1] This document is important because it acts as a guide so all structural heart research is comparable and using the same terminology. He said this will become more important as long-term outcomes of 5 to 10 years become available and require apples-to-apples comparisons with newer valve technologies.

Key updates in VARC-3 include a new section on hospitalization or re-hospitalization, defining various levels of valve leaflet thrombosis, also known as hypo-attenuated leaflet thickening (HALT), and defining the stages of bio-prosthetic valve deterioration and valve failure. 

The Valve Academic Research Consortium (VARC), founded in 2010, was intended to identify appropriate clinical endpoints and standardize definitions of these endpoints for transcatheter and surgical aortic valve clinical trials. Rapid evolution of the field, including the emergence of new complications, expanding clinical indications, and novel therapy strategies have mandated further refinement and expansion of these definitions to ensure clinical relevance. This document provides an update of the most appropriate clinical endpoint definitions to be used in the conduct of transcatheter and surgical aortic valve clinical research.

Reference:

1. VARC-3 WRITING COMMITTEE: PhilippeGénéreux, Nicolo Piazza, Maria C. Aluc, Tamim Nazif, Rebecca T.Hahn, Philippe Pibarot, Jeroen J. Bax, Jonathon A.Leipsic, Philipp Blanke, Eugene H.Blackstone, Matthew T.Finn, Samir Kapadia, Axel Linke, Michael J.Mack, Raj Makkar, Roxana Mehranl, Jeffrey J. Popmam, Martin B.Leon, et al. Valve Academic Research Consortium 3: Updated Endpoint Definitions for Aortic Valve Clinical Research. Journal of the American College of Cardiology. Available online 19 April 2021. https://doi.org/10.1016/j.jacc.2021.02.038.

 

Radial Access | May 06, 2021

Arnold Seto, M.D., MPA, FSCAI, chief of cardiology, Long Beach Veterans Affairs Medical Center and director, interventional cardiology research, UCI Health, and Jordan Safirstein, M.D., FSCAI, director of transradial intervention, Atlantic Health's Morriston Medical Center, were involved in a physician-initiated study to find a new way to cut radial artery access site hemostasis by 50 percent. The late-breaking study presented at SCAI 2021 uses a combination of a Statseal patch and the TR Band compression bracelet.

Cardiac catherization is increasingly bing performed using transradial approach, now making up 50 percent or more of the access used for U.S. interventional procedures. The Terumo TR Band is used to close the vascular access site. Standard protocols require the band to be left on for at least two hours following the procedure. 

Shorter compression times can help reduce complications with radial artery occlusion, so it is desirable to find ways to shorten compression times, Seto said. He explained clinicians often start to deflate the wrist band balloon after an hour and watch for ooze or blood. If there are signs the wound is not completely sealed, the band is reinflated. Reinflations occurs more that 67 percent of the time, he explained.

"We found with the Statseal, you almost never have to reinflate," Seto said. 

This study shows that time can be reduced in half and with fewer complications by using the additional patch device, which helps sped the clotting process. This can save staff time and possibly leading to faster patient discharge for same-day PCI programs. 

Read more in the article Radial Hemostasis Time Cut by 50 Percent With StatSeal in Combination With TR Band.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Coronavirus (COVID-19) | May 06, 2021

Payam Dehghani, M.D.,  FRCPC, FACC, FSCAI, co-director of Prairie Vascular Research and associate professor at the University of Saskatchewan, explains the findings of the North American COVID-19 Myocardial Infarction (NACMI) Registry. He presented this late-breaking study data at the at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting.

The study found one third of patients will die who have COVID-19 (SARS-CoV-2) and suffer a ST-elevated myocardial infarction (STEMI), which is alarming high as compared to four-in-100 patients using a pre-pandemic control group.

 The prospective, ongoing observational registry was created under the guidance of the SCAI, Canadian Association of Interventional Cardiology (CAIC) and American College of Cardiology (ACC). The initial results of the registry were published in the Journal for American College of Cardiology (JACC) on April 27, 2021.

Important key findings from the registry data include:
   • Minorities were disproportionally affected: 55 percent of the STEMI patients had minority ethnicity, which was about evenly divided between Hispanics and blacks.
   • In-hospital mortality was high: 33 percent (4 percent for controls without COVID).
   • Symptoms were unique: majority (54 percent) presented with respiratory symptoms (shortness of breath) rather than chest pain.
   • Significant proportion of COVID-positive patients presented with high-risk STEMI: cardiogenic shock (18 percent) and cardiac arrest (11 percent), which may explain the high fatality rate.
   • Primary angioplasty remained the dominant revascularization modality during the pandemic with small treatment delays (at about 15 minutes). 
   • Diabetics are known to have some of the worst outcomes if they contract COVID, and this was reflected in the study, with 45 percent of patients having diabetes. 

Read more in the artice Third of COVID Patients With STEMI Heart Attacks Die.

Find more COVID-19 news and video

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

 

Cath Lab | May 05, 2021

Ashwin Nathan M.D., a cardiology fellow in the division of Cardiovascular Medicine at the Hospital of the University of Pennsylvania, presented a late-breaking study at the Society of Cardiovascular Angiography and Interventions (SCAI) 2021 meeting that looked at hospital-level percutaneous coronary intervention (PCI) performance data and simulated if what would happen if hospitals removed their highest risk patients. The findings suggest this risk avoidance strategy does not necessarily mean the hospital will get higher performance scores.

Read more in the article Avoiding High-risk Cath Lab Procedures Does Not Necessarily Improve Hospital Scores.

SCAI 2021 Late-breaking Clinical Study Results

Find more news from the SCAI 2021 virtual meeting

Cardiac Imaging View all 264 items

Point-of-Care Ultrasound (POCUS) | April 01, 2021

Here are two quick clinical examples of point-of-care ultrasound (POCUS) lung imaging and cardiac imaging using a GE Vscan Air device. The examples show an abnormal lung image with B-lines. The second clip shows a healthy heart in a parasternal color Doppler image.

The GE Healthcare Vscan Air is a cutting-edge, wireless pocket-sized ultrasound that provides crystal clear image quality, whole-body scanning capabilities, and intuitive software. The pocket-sized ultrasound system was originally introduced in 2010, and as of early 2021, there are over 30,000 Vscan systems in use. The new Vscan Air features a wireless ultrasound probe.

Read more in the article GE Healthcare Unveils Vscan Air Wireless Handheld Ultrasound

Find more POCUS news and video

FFR Technologies | December 16, 2020

This is an example of the Medis Medical Imaging Quantitative Flow Ratio (QFR) system that offers a fractional flow reserve (FFR) blood flow measure in coronary vessels based on angiography imaging analysis alone. The FDA-cleared product allows the FFR-angio derived analysis to be performed table side in the cath lab when the patient is on the table for a procedure to determine if a patient requires a stent.

The QRF technology uses two angiography images with contrast, shot from different angles are used to create a 3-D model of the vessel segment and calculate FFR flow past a lesion. The model also can help plan for stenting.

This example was recorded by DAIC Editor Dave Fornell at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting.

Read more about this technology 

Coronavirus (COVID-19) | November 10, 2020

Keith Ellis, M.D., is the director of cardiovascular services and the director of the Chest Pain Center at Houston Methodist Sugar Land Hospital, and has been the director of nuclear cardiology for Diagnostic Cardiology of Houston. He explains how his department has implemented protocols and new technology to mitigate COVID-19 contamination risks and to prevent readmissions. New technologies include the use of telemedicine, CT angiography, and a contrast reduction system in the cath lab to prevent kidney injury that would result in a patient readmission. The hospital also is using techniques to help cut procedure times, including use of radial access in the cath lab and abbreviated nuclear scan protocols to shorten exam times.

He said there can be a lot of cardiovascular involvement in severe COVID patients, ranging from development of myocarditis, STEMI with and without clots, arrhythmias, venous thromboembolism (VTE), and the need for hemodynamic support, including ECMO. He said the most surprising management issue with the COVID patients has been the large amount of VTE, often resulting in deep vein thrombosis and pulmonary embolism (PE). Ellis said this often requires interventional strategies, including the use of Ekos ultrasonic catheter based thrombolysis to break up the clots.

 

Related Cardiac COVID-19 Content:

COVID-19 Positive STEMI Patients Have Higher Mortality 

VIDEO: ECMO Hemodynamic Support Effective in Sickest COVID-19 Patients — Interview with Ryan Barbaro, M.D.

The Cardiovascular Impact of COVID-19

VIDEO: Multiple Cardiovascular Presentations of COVID-19 in New York — Interview with Justin Fried, M.D., explaining a case that used VV-ECMO abnd VAV-ECMO

 

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

Kawasaki-like Inflammatory Disease Affects Children With COVID-19 

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

Find more cardiology related COVID-19 content

 

Artificial Intelligence | September 25, 2020

Ernest Garcia, Ph.D., MASNC, FAHA, endowed professor in cardiac imaging, director of nuclear cardiology R&D laboratory, Emory University, developer of the Emory Cardiac Tool Box used in nuclear imaging and past-president of the American Society of Nuclear Cardiology (ASNC), explains the use of artificial intelligence (AI) in cardiac imaging. He said there is a tsunami of new AI applications that are starting to flood the FDA for market approval, and there are several examples of AI already in use in cardiac imaging. He spoke on this topic in a keynote session at the 2020 ASNC meeting.

Related Artificial Intelligence in Cardiology Content:

VIDEO: Machine Learning for Diagnosis and Risk Prediction in Nuclear Cardiology — Interview with Piotr J. Slomka, Ph.D.,

Artificial Intelligence Applications in Cardiology

VIDEO: Artificial Intelligence May Improve Cath Lab Interventions — Interview with Nick West, M.D., Abbott CMO

How Artificial Intelligence Will Change Medical Imaging

VIDEO: Artificial Intelligence for Echocardiography at Mass General — Interview with Judy Hung, M.D.

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

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

For more AI in cardiology content

 

Cardiac Diagnostics View all 68 items

EP Device Monitoring Systems | December 22, 2020

Robert Kowal, M.D., chief medical officer of the Medtronic cardiac rhythm and heart failure division, said there has been a large increase in interest in remote monitoring and programing capabilities of implantable electrophysiology (EP) devices since the start of the COVID-19 pandemic. 

Cardiologists are looking for ways to care for their patients without the need to have them come into the office for close, personal meetings and interrogation of their implanted EP devices. Remote monitoring of these devices has been around for a decade and the Heart Rhythm Society (HRS) urged use of this technology in a 2015 consensus statemement. However, it has been COVID that has really pushed clinicians and patients to use this technolgy to its fullest as a way to watch patients closely from a distance and not require them to have to come into the office. It also enables EP practices to reprogram devices or alerts remotely where ever the have access to an internet connection. 

Find more EP news and video

Coronavirus (COVID-19) | December 07, 2020

Todd Hurst, M.D., a cardiologist at Banner University Medicine Heart Institute, and an associate professor at the University of Arizona, explains some of the long-term COVID-19 (SARS-CoV-2) post-infection cardiovascular impacts. 

After the coronavirus is gone, many COVID-19 patients are finding they have long-term problems with shortness of breath, arrhythmias, fatigue and cognitive issues. Clinicians are now referring to these patients as "long-hauler" COVID patients. COVID is known to cause myocarditis in many seriously ill patients, but post mortal studies of COVID patients also show the virus kills heart cells and the long term impact of this is not yet known.

VIDEO: Lingering Myocardial Involvement After COVID-19 Infection — Interview with Aaron Baggish, M.D.
 

 

Atrial Fibrillation | November 18, 2020

Steven Lubitz, M.D., MPH, cardiac electrophysiologist, Massachusetts General Hospital, presented the late-breaking VITAL-AF Trial at the 2020 American Heart Association (AHA) virtual meeting this week. The study looked at screening for atrial fibrillation (AF) in older adults at primary care visits using the AliveCor single-lead electrocardiogram (ECG) device that interfaces with a smartphone or iPad.

The study found screening for AF using a single-lead ECG at primary care visits was not associated with a significant increase in new AF diagnoses among individuals aged 65 years or older compared to usual care. However, screening may be associated with an increased likelihood of diagnosing AF among individuals aged 85 years or older. 

Undiagnosed AFib is associated with increased risk of stroke. There is uncertainty about how best to screen for AF and guidelines differ regarding screening using ECGs. Methods: We conducted a cluster-randomized trial to evaluate whether screening using single-lead ECGs at primary care visits is effective for diagnosing AF. 

Sixteen clinics were randomized 1:1 to an AF screening intervention which offered an AliveCor single-lead ECG to patients aged 65 years or older during routine vital sign assessments, or usual care. AliveCor readings were over-read by cardiologists. Confirmatory diagnostic testing and treatment decisions were made by the primary care provider. 

New AF diagnoses were ascertained based on electronic case identification and manually adjudicated by a clinical endpoint committee. Results: 35,308 patients were included in the trial (n=17,643 intervention [91% screened], n=17,655 control). Patient characteristics were well-balanced between the intervention and control groups, including 12.7% versus 13.2% with prevalent AF, respectively. At one year, 1.52% of individuals in the screening group had new AF diagnosed versus 1.39% in the control group (relative risk [RR] 1.10; 95% confidence interval [CI] 0.92-1.30; P=0.30). New AF diagnoses in the screening and control groups varied by age (0.95% versus 1.00% for age 65-74; P=0.74; 1.84% versus 1.70% for age 75-84; P=0.58; 4.05% versus 2.68% for age 85+; P=0.02) (see figure). New anticoagulation was prescribed in 2.98% versus 2.90% of individuals in the screening and control groups, respectively, overall (RR 1.03; 95%CI 0.91-1.18; P=0.61), and in 72.8% versus 71% with new AF diagnoses (RR 1.02; 95%CI 0.92-1.14; P=0.70).

Find more AHA news, video and late-breakers

Coronavirus (COVID-19) | November 12, 2020

Eric Gantwerker, M.D., vice president and medical director at clinical video game simulator company Level Ex, and associate professor, Department of Otolaryngology Head and Neck Surgery at Loyola University, explains a smartphone video game simulator to help clinicians become more proficient in diagnosing and managing COVID-19 (SARS-CoV-2) patients. Level Ex has created video game modules for interventional cardiology and is expanding this to cardiovascular complications in COVID patients, based on real patient case studies.

The app offers several patient cases where the player can decide what questions to ask the patient or tests to perform, but the player is limited in the number of actions they can take. The app offers several potential reasons for the patient's presentation that may, or may not, be COVID and the player needs to take clinical actions to eliminate other disease possibilities from the list. Management of COVID cases with cardiac complications are also offered to test a clinician's ability to keep the patient stable and enable discharge.

Related Content:

IVUS and iFR Video Game App Training Offered by Philips and Level Ex

Video Game Format Used to Train Cardiologists

 

 

 

EP Lab View all 77 items

EP Device Monitoring Systems | December 22, 2020

Robert Kowal, M.D., chief medical officer of the Medtronic cardiac rhythm and heart failure division, said there has been a large increase in interest in remote monitoring and programing capabilities of implantable electrophysiology (EP) devices since the start of the COVID-19 pandemic. 

Cardiologists are looking for ways to care for their patients without the need to have them come into the office for close, personal meetings and interrogation of their implanted EP devices. Remote monitoring of these devices has been around for a decade and the Heart Rhythm Society (HRS) urged use of this technology in a 2015 consensus statemement. However, it has been COVID that has really pushed clinicians and patients to use this technolgy to its fullest as a way to watch patients closely from a distance and not require them to have to come into the office. It also enables EP practices to reprogram devices or alerts remotely where ever the have access to an internet connection. 

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EP Lab | December 04, 2020

Oussama Wazni, M.D., section head, electrophysiology, Cleveland Clinic, discusses the results of the recent STOP AF First and Early AF trials. Both showed effectiveness in using early catheter ablation rather than drugs in atrial fibrillation (AF) patients. Both trials used cryo-ballon ablation, but Wazni said it is translatable to use of all cather ablation technologies.

Wazni a principal investigator for the STOP AF First trial and he shares information on the Early AF trial presented as a late-breaking study at the 2020 American Heart Association (AHA).

 

Related EP Ablation Technology Content:

VIDEO: Early Ablation Improved Outcomes in Atrial Fibrillation Patients —interview with Oussama Wazni, M.D.

Esophageal Cooling May Help Prevent Injury From Cardiac Ablations

VIDEO: Top New EP Technologies at Heart Rhythm Society 2020 — Interview with Andrew Krahn, M.D.

Biotronik Partners With Acutus Medical to Offer More Efficient Arrhythmia Diagnosis and Treatment

Contact Force Sensing Catheter Improved Outcomes in Persistent Atrial Fibrillation Ablation

New Technologies to Improve Atrial Fibrillation Ablation

VIDEO: Current State of Atrial Fibrillation Ablation Technologies, an interview with Hugh Calkins, M.D., at HRS 2017.

Find more EP technology news and video

 

Atrial Fibrillation | November 18, 2020

Steven Lubitz, M.D., MPH, cardiac electrophysiologist, Massachusetts General Hospital, presented the late-breaking VITAL-AF Trial at the 2020 American Heart Association (AHA) virtual meeting this week. The study looked at screening for atrial fibrillation (AF) in older adults at primary care visits using the AliveCor single-lead electrocardiogram (ECG) device that interfaces with a smartphone or iPad.

The study found screening for AF using a single-lead ECG at primary care visits was not associated with a significant increase in new AF diagnoses among individuals aged 65 years or older compared to usual care. However, screening may be associated with an increased likelihood of diagnosing AF among individuals aged 85 years or older. 

Undiagnosed AFib is associated with increased risk of stroke. There is uncertainty about how best to screen for AF and guidelines differ regarding screening using ECGs. Methods: We conducted a cluster-randomized trial to evaluate whether screening using single-lead ECGs at primary care visits is effective for diagnosing AF. 

Sixteen clinics were randomized 1:1 to an AF screening intervention which offered an AliveCor single-lead ECG to patients aged 65 years or older during routine vital sign assessments, or usual care. AliveCor readings were over-read by cardiologists. Confirmatory diagnostic testing and treatment decisions were made by the primary care provider. 

New AF diagnoses were ascertained based on electronic case identification and manually adjudicated by a clinical endpoint committee. Results: 35,308 patients were included in the trial (n=17,643 intervention [91% screened], n=17,655 control). Patient characteristics were well-balanced between the intervention and control groups, including 12.7% versus 13.2% with prevalent AF, respectively. At one year, 1.52% of individuals in the screening group had new AF diagnosed versus 1.39% in the control group (relative risk [RR] 1.10; 95% confidence interval [CI] 0.92-1.30; P=0.30). New AF diagnoses in the screening and control groups varied by age (0.95% versus 1.00% for age 65-74; P=0.74; 1.84% versus 1.70% for age 75-84; P=0.58; 4.05% versus 2.68% for age 85+; P=0.02) (see figure). New anticoagulation was prescribed in 2.98% versus 2.90% of individuals in the screening and control groups, respectively, overall (RR 1.03; 95%CI 0.91-1.18; P=0.61), and in 72.8% versus 71% with new AF diagnoses (RR 1.02; 95%CI 0.92-1.14; P=0.70).

Find more AHA news, video and late-breakers

Left Atrial Appendage (LAA) Occluders | October 02, 2020

Horst Sievert, M.D., is the director of the Cardiovascular Center Frankfurt, and associate professor of internal medicine-cardiology at the University of Frankfurt. He discusses left atrial appendage (LAA) device advances and new developments for more effective LAA closure to reduce the stroke risk in atrial fibrillation (AFib or AF) patients and new developments for more effective LAA closure to reduce the stroke risk in atrial fibrillation (AFib or AF) patients.

He said there are current limitations using the Boston Scientific Watchman FLX and Abbott Amplatzer Amulet devices. One of the new concepts in transcatheter LAA occlusion technology from Append Medical is a suture delivery system that eliminate permanent metal implants and mimics a surgical suture closure without the need for an open chest procedure.

Sievert has more than 30 years experience in cardiology and has been the principal investigator in a number of clinical trials and has authored more than 130 manuscripts and 500 abstracts in peer-reviewed journals and 50 books and book contributions. He is also chairman of Scientific Advisory for Append Medical, developer of a novel LAA closure device.

Read more about the Append device — First-Of-Its-Kind, No-Implant LAA Occluder Noted for Innovation at 2019 ICI Meeting
 

Find more LAA occluder technology news

 

Information Technology View all 157 items

FFR Technologies | December 16, 2020

This is an example of the Medis Medical Imaging Quantitative Flow Ratio (QFR) system that offers a fractional flow reserve (FFR) blood flow measure in coronary vessels based on angiography imaging analysis alone. The FDA-cleared product allows the FFR-angio derived analysis to be performed table side in the cath lab when the patient is on the table for a procedure to determine if a patient requires a stent.

The QRF technology uses two angiography images with contrast, shot from different angles are used to create a 3-D model of the vessel segment and calculate FFR flow past a lesion. The model also can help plan for stenting.

This example was recorded by DAIC Editor Dave Fornell at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting.

Read more about this technology 

Artificial Intelligence | September 25, 2020

Ernest Garcia, Ph.D., MASNC, FAHA, endowed professor in cardiac imaging, director of nuclear cardiology R&D laboratory, Emory University, developer of the Emory Cardiac Tool Box used in nuclear imaging and past-president of the American Society of Nuclear Cardiology (ASNC), explains the use of artificial intelligence (AI) in cardiac imaging. He said there is a tsunami of new AI applications that are starting to flood the FDA for market approval, and there are several examples of AI already in use in cardiac imaging. He spoke on this topic in a keynote session at the 2020 ASNC meeting.

Related Artificial Intelligence in Cardiology Content:

VIDEO: Machine Learning for Diagnosis and Risk Prediction in Nuclear Cardiology — Interview with Piotr J. Slomka, Ph.D.,

Artificial Intelligence Applications in Cardiology

VIDEO: Artificial Intelligence May Improve Cath Lab Interventions — Interview with Nick West, M.D., Abbott CMO

How Artificial Intelligence Will Change Medical Imaging

VIDEO: Artificial Intelligence for Echocardiography at Mass General — Interview with Judy Hung, M.D.

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

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

For more AI in cardiology content

 

Artificial Intelligence | September 21, 2020

Nick West, M.D., chief medical officer for Abbott, explains the details from a survey of 1,400 patients, physicians and healthcare executives in an effort to understand the needs to guide future technology development. Artificial intelligence (AI) is being looked at as a way to better personalize medicine. In the cath lab, AI might be used to help interpret intravascular images as a second set of eyes for the physician. AI also might enable immediate feedback on how to proceed with a case based on current guidelines and clinical evidence.

Read more about the survey in the article "Emerging Technology and Data Key to Closing Treatment Gaps to Improve Cardiovascular Care."

See Part 1 of this video where west describes the key findings of the survey in the VIDEO: Survey Shows Large Disconnect in Medical Technology Across Continuum of Care.

 

 

Cardiovascular Business | September 14, 2020

Nick West, M.D., chief medical officer for Abbott, explains the details from a survey of 1,400 patients, physicians and healthcare executives in an effort to understand the high-level issues regarding the use of technology in medicine, the gaps in communication, and patient perceptions to guide future technology development. 

Four high-level observations emerged from our study:

1. Patients are frustrated by the level of care they’re receiving – they understandably want a personalized healthcare experience “tailored for me,” across the care continuum.

2. Physicians lament the lack of time they have to spend with patients, their limited visibility into patient adherence to treatment and lifestyle changes, and challenges with other key factors that influence the quality of care they can provide.

3. Administrators are pressured to deliver patient satisfaction and reduce costs across multiple departments.

4. Diagnostic and data-driven technology holds the promise to move care from a point-in-time, intervention-only focus to a more holistic “whole patient” view by improving the accuracy of
diagnosis, appropriate interventions as required, and evidence-based post-procedural care.

Read more about the survey in the article "Emerging Technology and Data Key to Closing Treatment Gaps to Improve Cardiovascular Care."

See Part 2 of this video where West describes the how AI might be used in interventional cardiology in the VIDEO: Artificial Intelligence May Improve Cath Lab Interventions.