Assessing the Effectiveness of Ambulatory Cardiac Monitoring for Specific Clinical Indications: Introduction

1993 ◽  
Vol 9 (1) ◽  
pp. 97-101 ◽  
Author(s):  
Miriam E. Adams ◽  
Alexia Antczak-Bouckoms ◽  
Howard S. Frazier ◽  
Joseph Lau ◽  
Thomas C. Chalmers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Decision Analysis ◽  
Ventricular Arrhythmias ◽  
Antiarrhythmic Drugs ◽  
The Elderly ◽  
Cardiac Monitoring ◽  
Silent Ischemia ◽  
Appropriate Use ◽  
Clinical Indications ◽  
Selection Of

This introduction and the three essays that follow it examine ambulatory cardiac monitoring for specific clinical indications. They also examine the ways in which evidence from the literature may be synthesized through the framework of decision analysis to guide its appropriate use and identify areas in which more research is needed. The essays discuss ambulatory cardiac monitoring for evaluation of syncope in the elderly; detection of silent ischemia after a myocardial infarction; and selection of antiarrhythmic drugs for malignant ventricular arrhythmias.

Noninvasive Testing of Asymptomatic Patients for the Detection of Silent Ischemia After an Infarction: A Decision Analysis

1993 ◽  
Vol 9 (1) ◽  
pp. 112-123 ◽  
Author(s):  
Joseph Lau ◽  
Miriam E. Adams
Keyword(s):  
Life Expectancy ◽  
Decision Analysis ◽  
Submaximal Exercise ◽  
Cardiac Monitoring ◽  
Noninvasive Testing ◽  
Silent Ischemia ◽  
Left Main ◽  
Asymptomatic Patients ◽  
Artery Disease ◽  
Thallium 201 Scintigraphy

AbstractThis decision analysis estimates the overall gain in life expectancy and the relative efficacy of predischarge submaximal exercise electrocardiography, ambulatory cardiac monitoring, and thallium-201 scintigraphy for the identification of silent ischemia in asymptomatic postinfarct patients. A small, virtually equal increase in life expectancy can be obtained from any of the noninvasive tests (as compared to no testing). Large differences in life expectancy may result only when the prevalence of residual coronary artery disease and the probability of left-main and three-vessel lesions are high.

Clinical Pearls in Using Antiarrhythmic Drugs in the Outpatient Setting

2015 ◽  
Vol 29 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Mary H. Parker ◽  
Cynthia A. Sanoski
Keyword(s):  
Clinical Practice ◽  
Cardiac Arrhythmias ◽  
Ventricular Arrhythmias ◽  
Antiarrhythmic Drugs ◽  
Outpatient Setting ◽  
Vital Role ◽  
Efficacy And Safety ◽  
Appropriate Use ◽  
Nonpharmacologic Therapy ◽  
Key Issues

A role for oral antiarrhythmic drugs (AADs) remains in clinical practice for patients with atrial and ventricular arrhythmias in spite of advances in nonpharmacologic therapy. Pharmacists play a vital role in the appropriate use of AAD dosing, administration, adverse effects, interactions, and monitoring. Pharmacists who are involved in providing care to patients with cardiac arrhythmias must remain updated regarding the efficacy and safety of the most commonly used AADs. This review will address key issues for appropriate initiation and maintenance of commonly selected Vaughan-Williams Class Ic and III agents in the outpatient setting.

RESEARCH THE VALUE OF THE COMBINATION OF T WAVE ALTERNANS AND NT-PROBNT IN PREDICTING SUDDEN CARDIAC DEATH

2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Healthy Person ◽  
Treadmill Test ◽  
T Wave ◽  
T Wave Alternans

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone

Myocardial Infarction in the Elderly

Drug Safety ◽  
2002 ◽  
Vol 25 (11) ◽  
pp. 753-758 ◽  
Author(s):  
Wilbert S. Aronow
Keyword(s):  
Myocardial Infarction ◽  
The Elderly

scholarly journals Fever Unmasked Brugada Syndrome in Pediatric Patient: A Case Report

2020 ◽  
Vol 4 (2) ◽  
pp. 244-246
Author(s):  
Orhay Mirzapolos ◽  
Perry Marshall ◽  
April Brill
Keyword(s):  
Emergency Medicine ◽  
Case Report ◽  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Cardiac Monitoring ◽  
St Segment Elevation ◽  
Cardioverter Defibrillator ◽  
St Segment ◽  
Viral Illness ◽  
Automatic Implantable Cardioverter Defibrillator

Introduction: Brugada syndrome is an arrhythmogenic disorder that is a known cause of sudden cardiac death. It is characterized by a pattern of ST segment elevation in the precordial leads on an electrocardiogram (EKG) due to a sodium channelopathy. Case Report: This case report highlights the case of a five-year-old female who presented to the emergency department with a febrile viral illness and had an EKG consistent with Brugada syndrome. Discussion: Fever is known to accentuate or unmask EKG changes associated with Brugada due to temperature sensitivity of the sodium channels. Conclusion: Febrile patients with Brugada are at particular risk for fatal ventricular arrhythmias and fevers should be treated aggressively by the emergency medicine provider. Emergency medicine providers should also consider admitting febrile patients with Brugada syndrome who do not have an automatic implantable cardioverter-defibrillator for cardiac monitoring.

Sign in / Sign up

Export Citation Format

Share Document