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Compendium to Research in Cardiology and Telemetry
Cotiga, D., et al. (2007). Acute Conversion of Persistent Atrial Fibrillation During Dofetilide Initiation. Pacing & Clinical Electrophysiology, 30(12), 1527-1530. doi:10.1111/j.1540-8159.2007.00902.x.
The researchers look at the role of Dofetilide (D) as "a highly selective blocker of the rapid component of the delayed rectifier potassium current;" approved for the treatment of atrial fibrillation (AF). The study is a replication of clinical trials that concluded in a satisfactory safety/efficacy profile in patients with left ventricle (LV) dysfunction or heart failure. The participants to the investigation all received at least 6 dosing intervals D. while admitted in the Telemetry unit. Seventy seven percent (77%) of the patients converted to sinus rhythm (SR) after the first 2.2 ± 1.2 doses. Findings to the investigation revealed that: 1) D. had an unusually high pharmacological conversion rate; 2) demonstrated response with incremental dosage; and 3) correlated with a high tolerance which determined a high degree of safety in the study's relatively healthy adult cohort with persistent AF. LA and AF also contributed to the predictability of the duration of the D. dose. The hypothesis proved correct: that acute pharmacological conversion rate of D. is (< or +) than previously assumed if administered to an equivalent population of patients.
Lewalter, T., et al. (2007). Morphology-Enhanced Atrial Event Classification Improves Sensing in Pacemakers. Pacing & Clinical Electrophysiology, 30(12), 1455-1463. doi:10.1111/j.1540-8159.2007.00891.x.
An assessment of morphology-enhanced atrial event classification (MORPH) and potential for improvement of atrial-based pacing (ABP), the study looks at the technology's reliability of atrial arrhythmia diagnostics in heart rhythm devices in detection and discrimination of atrial signals. Methodological application to the study included observation of ambulatory atrial electrograms recorded continuously through monitoring of the telemetry of digital pacemakers. Data analysis was inferred in the dual phase collection of the data: 1) individual morphology parameters that discriminated P-waves from FFRWs in every patient (learning phase); and 2) MORPH algorithm against traditional...
Results to the investigation conclude that in 44 out of 48 patients the data was suitable for analysis, with average P. And FFRW amplitudes at 1.96 mV versus 0.61 mV (P < 0.001). Recommendations drawn from the study attribute improved atrial signal discrimination and morphology analysis of atrial electrograms in high atrial sensitivity settings may increase reliability of atrial arrhythmia diagnostics in heart rhythm devices.
Crossley, G., et al. (2009). Atrial Fibrillation Therapy in Patients with a CRT Defibrillator with Wireless Telemetry. Pacing & Clinical Electrophysiology, 32(1), 13-23. doi:10.1111/j.1540-8159.2009.02171.x.
An international, multi-site study evaluates the efficacy of atrial shock therapy in patients with a cardiac resynchronization therapy defibrillator (CRT-D) to determine safety of new CRT-D, and its effectiveness. The study employed the Medtronic wireless telemetry system (Conexus; Medtronic Inc., Minneapolis, MN, USA), and looks at the effectiveness of a new wireless telemetry system on complications to atrial fibrillation (AF); a major cause of morbidity and mortality in telemetry care; especially in patients with congestive heart failure. Outcomes to the study include a (98.2%) success rate in patients of 168/171, where 138 were induced and 22 spontaneous. Successful cardioversion occurred in 137/138 of the induced-AF episodes (86.1% with 12 joule (J), 13.1% with 24 J, and 0.7% with 35 J). Conclusive to the study is an atrial shock efficacy of (98.2%) in those patients who met standard CRT-D indications. The wireless telemetry system had no reported unanticipated adverse device effects.
Crossley, G. et al. (2007). Automated Left Ventricular Capture Management. Pacing & Clinical Electrophysiology, 30(10), 1190-1200. doi:10.1111/j.1540-8159.2007.00840.x.
The investigation demonstrates that the Cardiac resynchronization therapy (CRT) based LVCM algorithm therapy is safe, accurate, and highly reliable method of reaching both ventricles. LVCM worked with different types of leads and different lead locations. According to the research, the stimulation thresholds of left ventricular (LV) leads tend to be less reliable than conventional leads. An evaluation of a novel algorithm for the automatic measurement…
The stent-based antenna can be used in monitoring of blood pressure from a minimally invasive device inserted for tracking the pulmonary artery in diagnostic and early warning system for cardiac health. In cardiac diagnostics, the foremost challenge in using a like device is the wireless transfer of data and power from within the blood vessel to external devices; whilst maintaining unrestricted blood flow through the artery.
Paoletti, R., Suess, T., Lesko, M., Feroli, A., Kennel, J., Mahler, J., et al. (2007). Using bar-code technology and medication observation methodology for safer medication administration. American Journal of Health-System Pharmacy, 64(5), 536-543. doi:10.2146/ajhp060140.
A three (3) inpatient nursing unit study on the implementation of a multidisciplinary approach to systematically decrease medication errors through the use of observation methodology and the deployment of electronic medication administration records (EMARs) and bar-coded-medication administration (BCMA) is discussed. Testing of two (2) intervention groups: 1) 20-bed cardiac control group in the telemetry unit; 2) a 36-bed medical-surgical unit. Testing was conducted utilizing a direct observation technique for data collection, the measurement of medication errors used the observation process was conducted in two (2) phases: 1) reimplementation; and 2) postimplementation. In the first phase of the study evaluating the medication administration process associated with a manual five (5) day medication administration record (MAR), a total of 188 errors were reported. During the second phase of the study, evaluation of the MAR process using EMAR and BCMA technology implemented under direct-observation. Accuracy rate in reporting before BCMA concluded at (86.5%); after BCMA, the rate rose to (97%). A (54%) reduction of errors to the MAR was observed following implementation the group's approach to medication safety.
Echocardiogram is another important non-invasive diagnostic tool for AF. This test uses sound waves to produces an image of the heart and helps the cardiologist observe the different regions of the heart and assess their performance. [NIH] Treatment for AF involves different approaches and may also be decided by the cardiologist depending on the nature of the AF. Paroxysmal AF, which lasts for a short duration (maximum few days) is
After ICI discharge daily ECG or predischarge (Jansen et al., 1986; Evrard et al., 2000) Holter monitoring was used to detect arrhythmias. In some cases the monitoring may be continued beyond the hospital stay for 30 (Guarnieri et al., 1999) up to 90 days (Weber et al., 1990). The use of the Holter monitor makes extended monitoring more feasible than when ECG was the only option. Several anomalies have been
Atrial Fibrillation Simply stated, atrial fibrillation describes a condition in which the human heart beats at an excessively rapid rate that can result in diminished blood flow to the body. While the condition is not typically life-threatening, atrial fibrillation still requires immediate medical care because left untreated, the condition can result in adverse, long-term complications. To determine the facts, this paper reviews the relevant literature concerning the etiology and pathogenesis
Lessening the Incidence of Postoperative Atrial Fibrillation The issue of reducing or preventing atrial fibrillation (AF) after cardiac surgery has been the subject of numerous studies. Existing studies sought to establish which agents are effective in this process since multiple agents are used to prevent AF. Reduction of incidence of postoperative atrial fibrillation is critical in order to promote the outcomes of patients undergoing cardiac surgery. In addition to flutter, atrial
Nursing Diagnosis Care Plan Assessment Data Analysis a) Patient is a 65-year-old male Mexican-born retired bus driver with a relevant past medical history of atrial fibrillation and deep vein thrombosis treated with Coumadin who presents with hematuria. Patient sought care after witnessing blood in his urine and feeling generally weak. In addition, the patient has history of hypertension, stroke, DVT, BPH, gout, depression, anxiety, chronic bronchitis and a remote history of chicken
Efficacy and Safety of Dabigatran vs. Warfarin for Stroke After more than five decades as the preferred anticoagulant worldwide, warfarin is being challenged by a new rival that doesn't require careful dosage monitoring. Pradaxa (dabigatran) was unanimously approved by the FDA on October 19, 2010 for treating atrial fibrillation (AF) patients, who are at an increased risk for suffering stroke and systemic embolisms (U.S. Food and Drug Administration). Dabigatran acts by