China
Africa
Explore chapters and articles related to this topic
Assessing and responding to sudden deterioration in the adult
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
You read that Mrs Patel had a cardiac monitor attached postoperatively. The paramedics would have attached cardiac monitoring to Mary, which will be continued on her arrival at the hospital. Cardiac monitoring is carried out for many acutely ill individuals and where heart rhythm is, or may become, abnormal (e.g. cardiac conditions, electrolyte imbalance, poisoning, hypothermia). You may have seen this equipment on placement or in the skills laboratory.
Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Cardiac arrhythmia (irregular heart rhythm) is a common cause of the sensation of palpitation and may cause dizziness if the cardiac output is affected. There are many other possible causes including psychological causes that must be excluded by careful history and examination. If arrhythmia is confirmed on ECG (standard or ambulatory monitoring) it may be managed medically but increasingly is managed by radiofrequency ablation of abnormal or malfunctioning areas of the cardiac nerve conduction pathways [27].
Physiological assessment of coronary lesion severity
Published in John Edward Boland, David W. M. Muller, Interventional Cardiology and Cardiac Catheterisation, 2019
Usaid Allahwala, Ravinay Bhindi
Administration of adenosine can be performed via intracoronary bolus administration of between 100–480 µg, but IV administration is preferable and should be performed for at least 90 seconds at a dose of 140 µg/kg/minute. Side effects with adenosine are common and patients should be warned of these. The commonest side effects are of dyspnoea and chest heaviness, reported by 20% and 7.2% of patients respectively.3 Less common side effects include heart rhythm disturbances (~5%), hypotension, nausea and vomiting, ventricular arrhythmia and bronchospasm. Given the very short half-life of adenosine these adverse effects are transient, but should be recognised, with appropriate provisions for emergent management available. In the case of intracoronary boluses, repeat procedures may be performed to ensure reproducibility. Following acquisition of an FFR value, the sensor should be withdrawn to a location proximal to the lesion to ensure the Pd/Pa is 1 and ensure there has been ‘no drift’. If a significant change in the Pd/Pa is noticed – repeat equalisation and subsequent repeat FFR measurements may be necessary (Figure 26.2, top panel).
The use of digital health in heart rhythm care
Published in Expert Review of Cardiovascular Therapy, 2023
Donald P. Tchapmi, Chris Agyingi, Antoine Egbe, Gregory M. Marcus, Jean Jacques Noubiap
Digital health technologies, such as wearable devices and smartphone apps, can contribute to diagnostics, heart rhythm monitoring, patient education and shared decision making, management, medication adherence, and research. There is evidence that these digital health tools can improve various health outcomes, including in the field of arrhythmia. Digital health technologies play a pivotal role in diagnosing and monitoring arrhythmias. Besides conventional heart rhythm monitoring devices such as Holter, telemetry, external and internal loop recorders, new handheld devices, wearables patches, smartphones, and smartwatches offer opportunities for arrhythmia screening, especially in low-risk individuals. Smartphone applications have also been developed for the education of patients, to assist them in decision making, and to improve their management, including medication adherence, preprocedural planning, and patient rehabilitation. Digital health technologies also bring unprecedented opportunities for large-scale studies in the population and clinical settings. Despite these remarkable advances, important challenges remain in integrating digital health technologies into healthcare systems. Some of these challenges include insufficient data regarding optimal integration to positively affect clinically relevant outcomes, concerns about patient privacy, system interoperability, physician liability for assessing data provided by wearables, difficulties in analyzing real-time information from wearables and incorporating them into electronic medical records, and reimbursement for digital health services.
Cardiac implantable electronic devices and cybersecurity
Published in Expert Review of Medical Devices, 2021
Bhakti Patel, Amgad N. Makaryus
The implantable loop recorder is a device that is inserted into the patient’s subcutaneous tissue. It functions to diagnose heart rhythm disorders by monitoring the heart rhythm and has the ability to record and store ECGs when a patient is in bradycardia or tachycardia [6]. The remote monitoring feature with the implantable loop recorder provides great benefits, such as decreasing the time it takes to diagnose a patient’s condition as well as the follow-up treatment plan [6]. In a study by Drak-Hernandez et al., the mean time from implant to diagnosis was compared in patients with remote monitoring to those with conventional follow-up appointments following an implantable loop recorder. The results showed that patients with the remote monitoring feature had significantly shorter time to diagnosis and targeted treatment [7]. Additionally, remote monitoring with implantable loop recorders not only enables more timely diagnosis, but also allows data to be transferred in order to prevent memory overflow. This decreases the risk for information loss as a result of memory overflow as well as decreased outpatient visits to record/upload data [7]. For patients with heart failure, the implanted left-ventricular assist device (LVAD) helps the left-ventricle pump blood to the body. Remote monitoring of the LVAD increases the early detection of problems and their treatment [8]. Overall, remote monitoring serves as an advantage for many cardiac devices as it allows for efficient and quick data transfer to the physician as well as early diagnosis of a heart condition.
Predictors of recurrent atrial fibrillation following catheter ablation
Published in Expert Review of Cardiovascular Therapy, 2021
Sanghamitra Mohanty, Domenico G Della Rocca, Carola Gianni, Chintan Trivedi, Angel Quintero Mayedo, Bryan MacDonald, Andrea Natale
While discussing about the predictors of recurrence following AF ablation, it is important to consider the definition of recurrence first. The consensus documents, issued by the Heart Rhythm Society starting from 2007 to 2017, have consistently formalized the definition of ablation failure as any arrhythmia episode lasting for 30 seconds or more. Numerous randomized and prospective observational trials have reported the ablation outcome based on the same parameter, which has brought uniformity in the scale of measuring the procedural success. However, in our experience, the clinical outcome of the ablation procedure, despite such brief recurrent episodes is often satisfactory as patients experience fewer symptoms and a better overall quality of life. Therefore, it is debatable whether to continue using this 30-second gold standard to evaluate ablation success or to look for more clinically meaningful characterization of AF recurrence.