Video: researchers use light to defibrillate arrhythmias in mice

Scientists from Johns Hopkins University and the University of Bonn in Germany have applied advances in optogenetics to terminate arrhythmias in mice.

In a new study published online yesterday in the Journal of Clinical Investigation, authors prove the concept of optogenetic defibrillation, where epicardial illumination can effectively terminate ventricular tachycardia—a potential alternative to implantable defibrillators.

"Strong electrical shocks can damage the heart and cause severe pain," write the authors. "Our results... could potentially be translated into humans to achieve nondamaging and pain-free termination of ventricular arrhythmia."

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Future of cardiology: personalized care through genetics?

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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Taking Telemetry Out of the Hospital Improves Outcomes, Reduces Alarm Fatigue

A new study suggests the use of an off-site cardiac telemetry central monitoring unit (CMU) could improve telemetry alarms for non-intensive care unit patients and reduce the number of monitored patients—without increasing cardiopulmonary arrest events.

The study, published August 2 in the Journal of the American Medical Association, studied all non-intensive care unit patients at Cleveland Clinic and three other regional hospitals over a period of thirteen months. An off-site CMU applied "standardized cardiac telemetry" for 99,048 patients during that time.

The Data

Among the study's population, emergency response team (ERT) activation occurred for 3,243 patients. 979 of those patients had rhythm or rate changes occurring up to one hour prior to the ERT activation. The CMU detected and provided accurate notification for 772—or 79 percent—of those events, according to the study's abstract.

For 105 patients, the CMU provided "discretionary direct ERT notification" for events requiring urgent clinical intervention, reads the abstract. Slightly more than one in four of those patients went on to experience cardiopulmonary arrest events—27 patients, or 26 percent. Return to circulation was achieved in 25 of those patients, or 93 percent.

Telemetry standardization also reduced the number of patients monitored by 15.5 percent per week through eliminating low-risk patients.

How the Central Monitoring Unit Works

The study's model used one monitoring technician to provide continuous cardiac monitoring for up to 48 patients, providing blood pressure, pulse oximetry, and respiratory rate notifications on request, according to the JAMA media release. A lead technician also provided oversight and supervision for real-time rhythm interpretation.

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“Absorb” Approved; Bioresorbable, Drug-coated Stent to Roll Out “in a Phased Way”

Yesterday, the Food and Drug Administration approved Abbott's Absorb stent, the first fully dissolving stent to be approved by the FDA.

A 10-person FDA advisory panel, including Dr. George Vetrovec of Virginia Commonwealth University, voted unanimously in March to affirm that the stent's benefits and efficacy outweigh its risks. The same panel voted 9-1 in favor of its safety profile, despite the risk of blood clots for some patients.

"This is presumably a better technology going forward - at least that's the theory - but it will take years to prove," said Vetrovec to the Associated Press.

FDA approves Absorb with advisory panel warning

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