VIDEO: ECMO Hemodynamic Support Effective in Sickest COVID-19 Patients

Recent Videos View all 580 items

ECMO Systems | February 16, 2021

VIDEO: COVID Survivor on ECMO in Hospital 152 Days Reunited With Clinicians Who Saved Her

An emotional reunion with COVID-19 patient Crystal Gutierrez and the clinicians and cardiologist who saved her life at HCA Houston Healthcare Medical Center and Houston Heart. Gutierrez, a young mother who earlier in 2020 fell seriously ill from the effects of COVID-19 after delivering her son Matthew, spent 152 days in the hospital fighting again and recovering from COVID. Due to profound respiratory failure, she was put on extracorporeal membrane oxygenation (ECMO) therapy to take over the oxygenation of her blood from the lungs, and to unload the work of the heart by circulating her blood. The ECMO procedure was performed by Keshava Rajagopal, M.D., Ph.D., at Houston Heart.

Crystal was reunited February 12, 2021, with the doctors and nurses of HCA Houston Healthcare Medical Center and Houston Heart who helped to save her life.

DAIC's focus is coverage of cardiovascular technologies like ECMO, but this video drives home the message that these technologies are used to save lives and the work by clinicians and cardiologists has a profound effect on patients and their families. This is an impact is often academic in discussion and is rarely seen by people who do not work directly with patients in hospitals.

Many hospitals now "clap out" severe COVID patients at discharge. It has become a sort of rite of passage in honor of these patients overcoming adversity and surviving a very dangerous bout with the pandemic virus. It is also often a moral boost to clinicians who participate, having helped the patient fight and survive.

As of the publication of this video on DAIC Feb. 16, 2021, more than 487,000 Americans have died from the COVID-19. Worldwide there have been more than 2.41 million deaths.

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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

Cath Lab | February 04, 2021

VIDEO: Patients Fear COVID More than Heart Attacks

Cindy Grines, M.D., MSCAI, FACC, president of the Society for Cardiovascular Angiography and Interventions (SCAI), and chief scientific officer of the Northside Cardiovascular Institute in Atlanta, explains a survey showing patients fear catching COVID-19 more than heart attacks. The SCAI survey found this fear is now seen as playing a role in preventing people from going to the hospital if they do have a heart attack or stroke, or even seeing their doctors for checkups or for cardiac complaints they might be having. This is leading to an increase in patients showing up very late after the onset of heart attacks, leading to serious cardiac damage and worse outcomes. This was a concern early on in the U.S. spread of the virus, but this recent survey shows patients attitudes and fears have not improved much since last spring.

SCAI Study Shows COVID Fears Continue to Cause Americans to Avoid Doctor Visits

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

Rapid Drop in Heart Attacks and Stroke at Hospitals Concerns ACC

Find more cardiology related COVID content

EP Device Monitoring Systems | December 22, 2020

VIDEO: Rising Interest in Remote Monitoring of EP Devices in the COVID-19 Era

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

FFR Technologies | December 16, 2020

VIDEO: Example of the Medis QFR Angiography Image Derived FFR System

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

Conference Coverage View all 427 items

Cath Lab | February 04, 2021

VIDEO: Patients Fear COVID More than Heart Attacks

Cindy Grines, M.D., MSCAI, FACC, president of the Society for Cardiovascular Angiography and Interventions (SCAI), and chief scientific officer of the Northside Cardiovascular Institute in Atlanta, explains a survey showing patients fear catching COVID-19 more than heart attacks. The SCAI survey found this fear is now seen as playing a role in preventing people from going to the hospital if they do have a heart attack or stroke, or even seeing their doctors for checkups or for cardiac complaints they might be having. This is leading to an increase in patients showing up very late after the onset of heart attacks, leading to serious cardiac damage and worse outcomes. This was a concern early on in the U.S. spread of the virus, but this recent survey shows patients attitudes and fears have not improved much since last spring.

SCAI Study Shows COVID Fears Continue to Cause Americans to Avoid Doctor Visits

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

Rapid Drop in Heart Attacks and Stroke at Hospitals Concerns ACC

Find more cardiology related COVID content

FFR Technologies | December 16, 2020

VIDEO: Example of the Medis QFR Angiography Image Derived FFR System

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

Robotic Systems | December 16, 2020

VIDEO: Corindus CorPath Robotic PCI System For The Cardiac Cath Lab

This is an example of the Siemens Corindus CorPath Cath lab robotic system being used for a percutaneous coronary intervention (PCI) stent implant simulation on the expo floor at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The system is mounted to the rail of the cath lab patient table and is manually loaded with catheters. The operator sits in a lead-lined booth outside the radiation field of the C-arm and uses joysticks to manipulate the catheters and advance them through vessels. The operators has the same controls for contrast and C-arm movement as they do using the tableside controls.

The main advantages of this systems are very precise catheter movements and removing the operator from the radiation field, so they can perform the procedure sitting down and without the need to wear heavy protective aprons.

The system is being tested to enable remote expert operators at one hospital to use high speed internet connections to perform a robotic PCI at another hospital many miles aways.
Read more

EP Lab | December 04, 2020

VIDEO: Early Ablation Improved Outcomes in Atrial Fibrillation Patients

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).

Cath Lab View all 289 items

Cath Lab | February 04, 2021

VIDEO: Patients Fear COVID More than Heart Attacks

Cindy Grines, M.D., MSCAI, FACC, president of the Society for Cardiovascular Angiography and Interventions (SCAI), and chief scientific officer of the Northside Cardiovascular Institute in Atlanta, explains a survey showing patients fear catching COVID-19 more than heart attacks. The SCAI survey found this fear is now seen as playing a role in preventing people from going to the hospital if they do have a heart attack or stroke, or even seeing their doctors for checkups or for cardiac complaints they might be having. This is leading to an increase in patients showing up very late after the onset of heart attacks, leading to serious cardiac damage and worse outcomes. This was a concern early on in the U.S. spread of the virus, but this recent survey shows patients attitudes and fears have not improved much since last spring.

SCAI Study Shows COVID Fears Continue to Cause Americans to Avoid Doctor Visits

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

Rapid Drop in Heart Attacks and Stroke at Hospitals Concerns ACC

Find more cardiology related COVID content

FFR Technologies | December 16, 2020

VIDEO: Example of the Medis QFR Angiography Image Derived FFR System

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

Robotic Systems | December 16, 2020

VIDEO: Corindus CorPath Robotic PCI System For The Cardiac Cath Lab

This is an example of the Siemens Corindus CorPath Cath lab robotic system being used for a percutaneous coronary intervention (PCI) stent implant simulation on the expo floor at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The system is mounted to the rail of the cath lab patient table and is manually loaded with catheters. The operator sits in a lead-lined booth outside the radiation field of the C-arm and uses joysticks to manipulate the catheters and advance them through vessels. The operators has the same controls for contrast and C-arm movement as they do using the tableside controls.

The main advantages of this systems are very precise catheter movements and removing the operator from the radiation field, so they can perform the procedure sitting down and without the need to wear heavy protective aprons.

The system is being tested to enable remote expert operators at one hospital to use high speed internet connections to perform a robotic PCI at another hospital many miles aways.
Read more

Coronavirus (COVID-19) | November 10, 2020

VIDEO: How to Reduce COVID Exposure, Speed Exams and Cut Readmissions in Cardiology Departments

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:

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Cardiac Imaging View all 263 items

Cardiac Diagnostics View all 68 items

EP Device Monitoring Systems | December 22, 2020

VIDEO: Rising Interest in Remote Monitoring of EP Devices in the COVID-19 Era

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

VIDEO: What Are The Long-term Cardiac Impacts of COVID-19 Infection

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

VIDEO: Screening for Atrial Fibrillation Using Single Lead ECG in the VITAL-AF Trial

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

VIDEO: Video Game Helps Diagnose COVID-19 Patients and Manage Their Cardiac Complications

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.

Video Game Format Used to Train Cardiologists

EP Lab View all 77 items

EP Device Monitoring Systems | December 22, 2020

VIDEO: Rising Interest in Remote Monitoring of EP Devices in the COVID-19 Era

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

EP Lab | December 04, 2020

VIDEO: Early Ablation Improved Outcomes in Atrial Fibrillation Patients

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).

Atrial Fibrillation | November 18, 2020

VIDEO: Screening for Atrial Fibrillation Using Single Lead ECG in the VITAL-AF Trial

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

VIDEO: Overview of Left Atrial Appendage (LAA) Closure Technology and New Innovations

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

VIDEO: Example of the Medis QFR Angiography Image Derived FFR System

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

VIDEO: Use of Artificial Intelligence in Nuclear Imaging

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.

VIDEO: ECMO Hemodynamic Support Effective in Sickest COVID-19 Patients

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