One Minute, Shared Decision-Making Aid Reduces Unnecessary Hospitalization

Posted on by Kurt Jensen

Additional cardiac imaging often unnecessary

Last week, Mayo Clinic researchers showed that using a shared decision-making aid to involve more patients in care decisions can prevent both unnecessary hospitalization and more advanced cardiac tests for patients with low-risk chest pain.

The "Chest Pain Choice" shared decision-making aid is one of the latest evidence-based practices built on high-sensitivity troponin rule-out of acute coronary syndrome for ED patients reporting acute chest pain. After the one-hour test, an additional "one minute" discussion to educate patients about their risk and reach a shared decision can prevent further unnecessary and costly testing.

ACVP Blog has discussed decision-making for acute chest pain before, suggesting that the fact the cardiac biomarker test can safely and accurately rule-out acute coronary syndrome within one hour "challenges [the] need" for commonly-used noninvasive imaging prior to patient discharge.

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Cath innovation: Cardioband repairs first leaky tricuspid

Posted on by Kurt Jensen

Valtech Cardio's Cardioband system brings direct annuloplasty to the field of percutaneous coronary intervention—for catheter-based mitral valve repair and now, tricuspid valve repair.

A team from the University Hospital Zurich led by Francesco Maisano, MD recently succeeded in the first ever minimally invasive procedure using Cardioband to repair a leaky tricuspid valve, according to yesterday's press release from the University of Zurich.

The news comes shortly after Valtech shared follow-up data from a multi-center Cardioband Mitral study at the PCR London Valves 2016 conference. Results showed a "significant and consistent reduction in MR" with a "safety profile similar to equivalent transcatheter procedures" according to the session slides.

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Video: researchers use light to defibrillate arrhythmias in mice

Posted on by Kurt Jensen

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?

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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