Improving adherence to medications for heart failure: Medtronic says their CRT does it

Posted on by Kurt Jensen

Despite relatively few strong research studies supporting methodologies for improving adherence to medications for patients with heart failure, Medtronic's recent press release suggests their cardiac resynchronization therapy (CRT) implants might do the trick.

Medtronic accounced results of a retrospective analysis of administrative claims data of more than 4,500 patients with heart failure at the 2016 Heart Failure Society of America Scientific Meeting, Monday.

The analysis found that the number of patients "fully compliant" to a regimen of guideline-recommended medications "nearly doubled" at twelve months following CRT implants compared to those who did not receive implants.

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Future of cardiology: personalized care through genetics?

Posted on by Kurt Jensen

Genetic arrhythmia programs are paving new roads for personalized cardiac care—from preventing unnecessary cautionary testing or treatment to improving screening.

Melvin Scheinman, MD—the first person to perform catheter ablation for arrhythmia in a human patient, now chief of the Comprehensive Genetic Arrhythmia Program at the University of California, San Francisco—believes genetic testing will lead to the "ultimate form of personalized medicine," writes Gregory A. Freeman of HealthLeaders Magazine.

"If you examine the genetic background of a patient, you may be able to identify sensitivity to specific drugs, propensity for developing some very serious heart disorders, and at the same time rule out those same things for other people," said Scheinman to HealthLeaders.

"That is really what personalized medicine is all about—delivering the right care to the patient because you truly understand the patient and don't have to treat him or her as just a member of a group with certain statistical risks."

A proliferation of genetic arrhythmia programs "across the country" have been introducing new, measured responses to a sudden cardiac death in the family—preventive healthcare for some, but not all family members.

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Routine Cardiac Catheterization Expanding to Saturdays?

Posted on by Kurt Jensen

Expanding availability of elective, non-emergent cardiac catheterization services to Saturdays might significantly reduce length of stay, with no effect on clinical quality reports a recent economic impact study.

The study, published online in the American Journal of Managed Care found that reduced length of stay did not result in total cost savings, however.

In January 2009, Mayo Clinic Rochester expanded cardiac catheterization service availability (CSA) to Saturdays with the "goal of timely access with improved efficiency of care," write the authors.

Despite succeeding in greatly reducing length of stay—a statistically significant, adjusted average of 1.73 days—total costs of care were similar prior to CSA expansion.

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A new cardiac imaging paradigm for acute chest pain?

Posted on by Kurt Jensen

In the "high-sensitivity cardiac troponin era," will the role of cardiac imaging in the ED change?

As high-sensitivity cardiac troponin (hs-cTn) assays become more and more common, cardiac imaging becomes less necessary for ruling out acute myocardial infarction (AMI) in ED patients with acute chest pain, but might be useful to prevent unnecessary or aggressive treatments write experts in July's volume of the American Heart Journal.

ACVP blog has covered the groundbreaking research on the high-sensitivity cardiac troponin tests since early last year, when we reported a new strategy that could rule out acute myocardial infarction within one hour, and rule it in with 75 percent accuracy. In June, two studies publishes in JAMA Cardiology lent further support to one-hour algorithms.

The speed and safe, accurate "rule out" of acute myocardial infarction through these cardiac biomarker tests "challenges [the] need" for noninvasive imaging prior to patient discharge when troponin values are normal, write the authors of the American Heart Journal article.

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