Category Archives: Cardiology

Cardiology

BLOG: Combining Local Impedance with Contact Force to Perform RF Ablation – Diagnostic and Interventional Cardiology

When performing radiofrequency (RF) ablation to treat cardiac arrhythmia, medical professionals must balance the safety of the patient with the efficacy of the procedure. Several important safety considerations are at play.

Physicians want to avoid mechanical perforation of the cardiac tissue, which can be caused by applying too much force in positioning the catheter. They also want to avoid unintentional damage to tissue or nontargeted structures during RF delivery.

Among the rare but serious complications associated with RF ablation are steam pops, which occur when ablated tissue is heated above 100 C, causing an explosion of steam to be released and unwanted damage to the tissue. In a worst-case scenario, a steam pop can tear a hole in the wall of the cardiac tissue allowing blood to leak into the pericardium. This can lead to cardiac tamponade, when the pressure from the blood surrounding the heart prevents it from beating.

Since the introduction of RF ablation as a cardiac arrhythmia therapy, advances have been made in the technologies and methods of delivering RF. These include the introduction of advanced mapping, multi-electrode and irrigated catheters, contact force, and the use of measures of tissue resistivity, or impedance, as a means to track RF delivery and lesion development.1

Boston Scientific offers RF ablation catheters with technology that enables capture of impedance metrics nearer the tissue to be treated. With the DIRECTSENSE Technology-enabled catheters, impedance can be measured around the tip of the catheter, avoiding the interference of far-field signals and capturing insights on cardiac tissue resistivity.

Local impedance has been demonstrated to more accurately indicate subsurface tissue temperature and lesion formation than does surface temperature. In tissue tests with embedded thermocouples, local impedance drop followed the rate and magnitude of the rise in intra-lesion temperature, demonstrating a correlation between the metric and volumetric heating as it occurs.2 Local impedance has also been found to respond with greater specificity and sensitivity in identifying abnormal substrate all valuable feedback in helping inform optimal delivery of ablation therapy.

Boston Scientific has now incorporated contact force capabilities into their DIRECTSENSE-enabled ablation catheters.

The investigational device INTELLANAV STABLEPOINT Ablation Catheter brings together the handling and inputs of contact force catheters with the ablation feedback offered by DIRECTSENSE local impedance. Available with RHYTHMIA HDx Mapping System (pictured above), the STABLEPOINT catheter is designed to help physicians verify contact, discern tissue characteristics, monitor subsurface tissue heating for predictable and controlled delivery of RF.

With the addition of force technology, the STABLEPOINT catheter can help confirm tissue contact and catheter-tip stability for the duration of RF delivery. In one study, force readings enabled two independent users to maintain a stable average force of +/- 5 grams, compared to starting force, for the full duration of >90 percent of point-by-point PVI applications.3

Using local impedance, physicians gain insights into tissue characteristics and resistivity, input that can help guide the ablation strategy. Changes in local impedance during ablation offer information on lesion development and feedback that can help safeguard against tissue overheating.

Recent studies have examined the STABLEPOINT catheters use in clinical settings. In a multicenter, prospective study conducted across Europe, Asia, and the United States, 299 patients treated for de novo atrial fibrillation (AF) underwent pulmonary vein isolation with the STABLEPOINT catheter guided by RHYTHMIA HDx Mapping System. STABLEPOINT in the NEwTON AF Study met the 30-day and 12-month primary safety endpoints as well as the acute, 6-month and 12-month primary effectiveness performance criteria for the use of the catheter in this patient population.4 At 12 months, data indicated a 4 percent incidence of adverse events. Freedom from atrial flutter and atrial tachycardia in the study group was 90.2 and 97.6 percent, respectively.4

A separate, multicenter study of 212 consecutive patients treated for AF with the STABLEPOINTcatheter assessed results across 13,891 RF applications of a 3 second duration. High-power, short-duration ablation with contact force and local impedance resulted in a 93.3 percent rate of successful first-pass isolation with no reported steam pops or major complications. Researchers also noted that the combination of local impedance drop with good contact led to a reduction in the duration of RF.5

Editor's note: This is the conclusion of a three-part series on cardiac ablation technology.Part one,Pulsed Field Ablation: A New Ablation Method,addressed pulsed field ablation; Part two, Cryoablation Gets New Tech," covers next-generation cryoballoon technology.

1. Habibi M, Berger RD, Calkins, H. Radiofrequency ablation: technological trends, challenges, and opportunities. EP Europace. 2021;23(4): 511519. doi.org/10.1093/europace/euaa328

2. Garrott KE, et al. Intra-lesion temperature rise and local impedance drop predictive of lesion growth on RF ablation catheter with mini electrodes. Abstract. Heart Rhythm Annual Meeting. May 2020.

3. Internal BSC Report 92464384.

4. NEwTON AF: Clinical Evaluation of the STABLEPOINTTM Catheter and Force Sensing System for Paroxysmal Atrial Fibrillation. NEwTON AF Study (NCT04580914) presented at AHA, November 2023.

5. Lepillier A, Maggio R, De Sanctis V, et al. Insight into contact force local impedance technology for predicting effective pulmonary vein isolation. Front Cardiovasc Med. 2023;10. doi.org/10.3389/fcvm.2023.1169037

Caution: Investigational device. Limited by Federal (or U.S.) law to investigational use only. Not available for sale. 2023 Boston Scientific Corporation or its affiliates. All rights reserved. All trademarks are the property of their respective owners. EP-1755903-AA

Read the original:

BLOG: Combining Local Impedance with Contact Force to Perform RF Ablation - Diagnostic and Interventional Cardiology

Cardiology

Saint Mary’s sues Renown Health again over alleged cardiology monopoly – Reno Gazette Journal

rgj.com wants to ensure the best experience for all of our readers, so we built our site to take advantage of the latest technology, making it faster and easier to use.

Unfortunately, your browser is not supported. Please download one of these browsers for the best experience on rgj.com

View original post here:

Saint Mary's sues Renown Health again over alleged cardiology monopoly - Reno Gazette Journal

Cardiology

Michelle Bloom, MD, Named System Director of Cardio-Oncology at NYU Langone Health – NYU Langone Health

A renowned expert in cardio-oncology and heart failure, Michelle Bloom, MD, has joined NYU Langone Health as system director of the Cardio-Oncology Program, which provides specialized care to protect patients heart health throughout cancer treatment and survivorship.

Dr. Bloom is a professor in the Department of Medicine and a member of the Division of Cardiology at NYU Grossman Long Island School of Medicine. She has a secondary appointment as clinical professor in the Department of Medicine and is a member of the Leon H. Charney Division of Cardiology at NYU Grossman School of Medicine. Before joining the institution December 1, she was at Stony Brook University Hospital, where she served as co-director of the Cardio-Oncology Program, director of outpatient services for the Heart Failure and Cardiomyopathy Center, and associate professor in the Department of Medicine at Stony Brook School of Medicine.

We are thrilled to welcome Dr. Bloom to NYU Langone Heart, where she will provide valuable expertise as we expand our cardio-oncology program, said Glenn I. Fishman, MD, the William Goldring Professor of Medicine in the Department of Medicine and director of the Leon H. Charney Division of Cardiology. Her experience as a clinician, educator, and researcher will further enhance the NYU Langone community. We look forward to a phase of significant clinical and academic advancement under her leadership in our program.

As a well-recognized and accomplished heart failure specialist, Dr. Bloom will also continue a robust heart failure practice at several NYU Langone locations on Long Island, including NYU Langone Cardiology AssociatesMineola.

As a specialist in the field of cardio-oncology, Dr. Bloom focuses on early prevention, detection, treatment, and management of the potential cardiac effects of cancer treatments, so that patients can safely continue their therapies. She will lead the system-wide program, which unites cardiologists, oncologists, immunologists, and researchers from both NYU Langone Heart and NYU Langones Perlmutter Cancer Center to coordinate personalized cardiac care designed with our patients with cancer in mind. Dr. Bloom and the team also offer specialized treatment to cancer survivors so that their risk of cardiovascular disease can be recognized early and minimized. Dr. Bloom has been a pioneer in the field, publishing in peer-reviewed journals on how to best provide cardio-oncology care.

I take care of people for years beyond their cancer treatment and cherish these relationships, loving my patients like they are my own family, said Dr. Bloom. After spending more than a decade managing the heart health of thousands of patients on Long Island, Im honored to join the NYU Langone community, where theres a strong culture of innovation and patient-centeredness. With the dedication of our team, I know we can make further significant advancements in the field that will result in improved outcomes for our patients.

We are very fortunate to have Dr. Bloom, with her background and expertise, join our faculty and patient care operations, said Joseph J. Greco, MD, senior vice president and chief of hospital operations at NYU Langone HospitalLong Island. The combination of her personal experiences and training translates to exceptional, personalized patient care for our Long Island community and beyond.

An alumna of Rutgers Robert Wood Johnson Medical School, Dr. Bloom completed her residency in internal medicine at Montefiore Medical Center. She went on to complete a fellowship in cardiology and advanced training in heart failure, mechanical device support, and cardiac transplant at the Icahn School of Medicine at Mount Sinai before joining the faculty at Stony Brook in 2011.

Katie Ullman Phone: 646-483-3984 Kathryn.Ullman@NYULangone.org

Continued here:

Michelle Bloom, MD, Named System Director of Cardio-Oncology at NYU Langone Health - NYU Langone Health

Cardiology

Northwest Health La Porte Among Nation’s Top Performing Hospitals for Treatment of Heart Attack Patients – NWI.Life

Northwest Health La Porte has received the American College of Cardiologys NCDR Chest Pain- MI Registry Platinum Performance Achievement Award for 2023. This is the highest honor awarded by the American College of Cardiology for the treatment of heart attack patients and Northwest Health La Porte is one of only 262 hospitals nationwide, and the only hospital in Northwest Indiana to receive the honor.

This achievement is due to the expertise of the cardiologists, emergency room physicians, nurses, and other caregivers on staff at the hospital, said Jami Jackson, BSN, RN, chest pain coordinator for Northwest Health La Porte. The Chest Pain - MI Registry empowers our health care team to consistently treat heart attack patients according to the most current, science-based guidelines. This establishes a national standard for understanding and improving the quality, safety and outcomes of care provided for our patients with coronary artery disease.

According to the American College of Cardiology, the award recognizes Northwest Health La Portes commitment and success in implementing a higher standard of care for heart attack patients and signifies that Northwest Health La Porte has reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations.

To receive the Chest Pain-MI Registry Platinum Performance Achievement Award, Northwest Health La Porte has demonstrated sustained achievement in the Chest Pain- MI Registry for two consecutive years (2021 and 2022), and performed at the highest level for specific performance measures. Full participation in the registry engages hospitals in a robust quality improvement process using data to drive improvements in adherence to guideline recommendations and overall quality of care provided to heart attack patients.

It is an honor to award Northwest Health La Porte with the Platinum Performance Award for their valuable national leadership and dedication to meeting comprehensive performance measures in patient care, said Michael C. Kontos, MD, FACC, chair of the NCDR Chest Pain MI Registry Steering Subcommittee, and cardiologist at Virginia Commonwealth University Medical Center. The receipt of this award indicates that Northwest Health La Porte remains committed to providing top quality, guideline-driven care for heart attack patients. Their success ensures patients are receiving the highest quality cardiovascular care.

The Centers for Disease Control estimates that over 800,000 Americans suffer a heart attack each year. A heart attack occurs when a blood clot in a coronary artery partially or completely blocks blood flow to the heart muscle. Treatment guidelines include administering aspirin upon arrival and discharge, timely restoration of blood flow to the blocked artery, smoking cessation counseling and cardiac rehabilitation, among others.

About Northwest Health

Northwest Health is a comprehensive healthcare system committed to providing communities in Northwest Indiana with high-quality, accessible healthcarefrom highly specialized care and surgical services to more routine primary care. The system of more than 60 access points includes three hospitals, five emergency departments, urgent care centers, outpatient surgery centers, an ambulance service, and physician offices. A team of more than 3,000 employees work together with the more than 700 physicians on its medical staffs. For more information, visit NWHealthIN.com.

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its more than 56,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.

Go here to see the original:

Northwest Health La Porte Among Nation's Top Performing Hospitals for Treatment of Heart Attack Patients - NWI.Life

Cardiology

Erlanger Cardiology Receives Accreditation From The American College Of Cardiology – The Chattanoogan

The American College of Cardiology has recognized Erlanger Cardiology for its "demonstrated expertise and commitment to treating patients with chest pain."

Erlanger Cardiology was awarded Chest Pain Center Accreditation with Primary PCI (Percutaneous Coronary Intervention) based on rigorous onsite evaluation of the staffs ability to evaluate, diagnose and treat patients who may be experiencing a heart attack.

"Hospitals that have earned ACC Chest Pain Center with Primary PCI Accreditation have proven exceptional competency in treating patients with heart attack symptoms and have primary PCI available 24/7, every day of the year," officials said.

"Percutaneous coronary intervention (PCI) is also known as coronary angioplasty. It is a non-surgical procedure that opens narrowed or blocked coronary arteries with a balloon to relieve symptoms of heart disease or reduce heart damage during or after a heart attack."

Erlanger Cardiology is proud to be recognized again by the American College of Cardiology for having a dedicated team of professionals in heart care, said Jan McMahan, Chest Pain Program manager at Erlanger Cardiology. Erlanger utilizes a multi-disciplinary approach to providing our heart patients with the best care available, and this designation shows our commitment to the community. We will continue to advance in heart care and provide the most up-to-date services to our heart patients.

Officials said, "Hospitals receiving Chest Pain Center with Primary PCI Accreditation from the ACC must participate in a multi-faceted clinical process that involves completing a gap analysis, examining variances of care, developing an action plan, conducting a rigorous onsite review and monitoring for sustained success. Improved methods and strategies of caring for patients include streamlining processes, implementing guidelines and standards, and adopting best practices in the care of patients experiencing the signs and symptoms of a heart attack. Facilities that achieve accreditation meet or exceed an array of stringent criteria and have organized a team of doctors, nurses, clinicians and other administrative staff that earnestly support the efforts leading to better patient education and improved patient outcomes."

This is the second time Erlanger has received this accreditation. The accreditation is renewed every three years.

Read the rest here:

Erlanger Cardiology Receives Accreditation From The American College Of Cardiology - The Chattanoogan

Cardiology

Statins and CKD; Farxiga’s Limited Symptom Improvement; Stop Wasted TNKase – Medpage Today

The prevalence of lower extremity artery disease was an estimated 9.7% around the world, reaching a high of 14.5% in South-Central Asia. (European Journal of Preventive Cardiology)

Removal of race stratification did not improve the performance of the pooled cohort risk equations in the prospective REGARDS cohort. (JAMA Cardiology)

Older veterans with stage 3-4 chronic kidney disease and no history of atherosclerotic cardiovascular disease had lower odds of poor clinical events if they started statin therapy. (JAMA Network Open)

A woman diagnosed with severe vasospastic angina was able to get pregnant and give birth without angina attacks after initiating diltiazem therapy. (JACC: Case Reports)

The SGLT2 inhibitor dapagliflozin (Farxiga) showed that its improvement of certain symptoms may be limited to heart failure patients with reduced ejection fraction in the DETERMINE trials. (Circulation)

For patients admitted to home hospital for heart failure, a retrospective analysis showed no unexpected deaths and the most common reason for escalation was progressive renal dysfunction. (Circulation: Cardiovascular Quality and Outcomes)

Across countries, spouses in the same household often share concordant hypertension diagnoses. (Journal of the American Heart Association)

Getinge's Cardiohelp Emergency Drive is under class I recall due to an issue with the hand crank getting stuck, the FDA alerted.

Given that tenecteplase is only available in 50-mg vials, it is feasible to thaw previously frozen half-vials for treating stroke in order to reduce waste, one hospital found. (Stroke)

COVID pandemic waves were not accompanied by malignant ventricular arrhythmias, according to records from the Midi-Pyrnes area of France. (EP Europace)

Warfarin was associated with fewer thromboembolic events after surgical aortic valve replacement with bioprosthetic valves, albeit at the cost of more major bleeding. (Mayo Clinic Proceedings)

Mitral annular disjunction makes a difference in outcomes after mitral transcatheter edge-to-edge repair, one high-volume center found. (JACC: Cardiovascular Interventions)

A soundwave-sensitive ink was developed to quickly harden into a desired 3D structure in deep tissues with high spatial precision, with potential applications in left atrial appendage occlusion and heart valve repair. (Science)

Harlan Krumholz, MD, SM, of Yale School of Medicine, was named the new editor-in-chief of the Journal of the American College of Cardiology.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Read more from the original source:

Statins and CKD; Farxiga's Limited Symptom Improvement; Stop Wasted TNKase - Medpage Today

Cardiology

5 Holiday Foods a Cardiologist Avoidsand What She Eats Instead – Eat This, Not That

If you make living a heart-healthy lifestyle a priority, listen up. With the holiday season upon us, it's important to know what to eat, but more importantly, what not to eat. You are sure to be surrounded by many holiday delights this merry time of year, but it's essential to stay on a healthy track and make good decisions. Eat This, Not That! is here with some common holiday foods a cardiologist avoids like the plagueand what they eat instead.

Elizabeth Klodas, a board-certified cardiologist, author, speaker, the founder of the Preventative Cardiology Clinic near Minneapolis, Minnesota, and the founder and chief medical officer of Step One Foods, shares five popular holiday foods she stays away from. So before you hit up your next holiday party, take a good look at this list. It's good for your heart and overall health this time of year and beyond!

Here's a beverage that everyone loves to enjoy all season long. But beware; it's a beverage that's high in calories and filled with cholesterol, saturated fat, and added sugars. Dr. Klodas explains, "When it comes to heart health and especially cholesterol management, it's about the worst drink you can have."

Let's be honest: We all love a good dinner rollespecially when it's smothered with butter. We hate to be the bearer of bad news, but hold the bread and the rolls at your next holiday feast. Most of them will give you empty calories, sodium, and more. "Baked goods are the number one source of sodium in the American diet, and excess sodium can push blood pressure up," Dr. Klodas reveals.

'Tis the season for snacking before meals and enjoying festive appetizersalong with your cocktails, of course. Dr. Klodas knows this one can be a challenge for many of us to avoid, because who doesn't arrive to a holiday gathering hungry and ready to eat?

"Pre-dinner snacks tend to be calorie-dense and relatively nutrient-poor," Dr. Klodas shares. "Staying away from these items helps you save your calorie, sodium, and fat budgets for items that have better overall nutrient profiles." So pass on the festive baked brie, and save your appetite for dinner!

Don't be disappointedyou knew this one was coming. Hold the gingerbread martinis and cranberry Aperol spritzes! In any case, lightening up on alcohol is a good idea all year long.

"Mixed drinks especially should be avoided as they deliver a lot of added calories and sugars on top of the other alcohol-related negative cardiovascular effects, including increased risk of heart rhythm abnormalities, worsening cholesterol profiles, and higher blood pressure readings," Dr. Klodas explains.

You heard that rightget your hand out of the cookie jar. Sweets in general are always wise to avoid or eat in moderation. It's a good idea to simply stop eating when you're full after dinner, even though desserts always look amazing.

Dr. Klodas tells us, "Excess weight is a risk factor for a whole host of health conditions ranging from diabetes to sleep apnea and is a major risk factor for developing heart disease. One cookie is around 100 calories. To burn that off, you have to walk a mile."

While you want to be good, you also want to eat, drink, and be merry with your loved ones. Here are some festive choices that allow you to get in the holly-jolly spirit while staying heart-healthy.

Your cheese platter will most likely have crackers and some of your favorite cheese spreads on it, but what about citrus fruits and nuts? "Winter is peak season for citrus fruit, so they're especially delicious around the holidays," Dr. Klodas says. "I load up on navel oranges, clementines, and tangerines as my go-to snacks not just for taste but for the extra vitamin C boost that's helpful during colder months."

Heyit's the holidays, and you're not going to eat like this every single day. There will be plenty of choices on the holiday dinner table that will work. 6254a4d1642c605c54bf1cab17d50f1e

Dr. Klodas shares, "While I do avoid mixed drinks, eggnog, rolls, pre-dinner snacks, and extra cookies, I eat all the foods we make that are traditional to my family's Christmas celebration. At our house, that includes roast beef, various vegetable sides, and an array of desserts. But instead of having roast beef with vegetables, I have vegetables with roast beef. And instead of a full serving of every dessert, I have a half or, more typically, a quarter serving so I can enjoy everything without getting stuffed."

It's all about having the right approach and portions. But if you do happen to overindulge, keep in mind that the following day, you can return to your normal healthy eating routine. Dr. Klodas says, "One over-the-top meal is unlikely to have many long-term consequences, especially when all the other meals are pretty good the rest of the year."

Other treats Dr. Klodas enjoys over the holidays include the Apple Cinnamon Bars fromStep One Foods. She shares, "[These bars offer] a healthy alternative for a sweet treat. This chewy bar tastes like apple strudel with sweet, tangy apples, warm, spicy cinnamon, heart-healthy almonds, walnuts, and white chia seeds for a nourishing touch. They're packed with fiber, omega-3s, and antioxidants that make eating healthy during the holidays easy and convenient."

Sign up for our newsletter!

More:

5 Holiday Foods a Cardiologist Avoidsand What She Eats Instead - Eat This, Not That