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Percutaneous Transluminal Balloon Venoplasty: A Less Invasive Technique For Implantation Of Cardiac Leads In Patients With Limited Venous Access To The Heart, Waiel Abusnina, Zachary O. Curtis, Emilia C. Leigh, Eric Y. Auyoung, Dr. Mehiar El-Hamdani, Esam Baryun 2019 Marshall University

Percutaneous Transluminal Balloon Venoplasty: A Less Invasive Technique For Implantation Of Cardiac Leads In Patients With Limited Venous Access To The Heart, Waiel Abusnina, Zachary O. Curtis, Emilia C. Leigh, Eric Y. Auyoung, Dr. Mehiar El-Hamdani, Esam Baryun

Marshall Journal of Medicine

Since its inception, cardiac pacing has made a significant advancement in cardiology. As new therapies and devices emerge, the number of implantations is steadily increasing which requires up-to-date clinical guidelines for management. Although advanced, these mechanical devices often require maintenance and revisions to achieve optimal performance. One of the most common deteriorations is the lead failure.

In the case of lead failure requiring revision, new lead implant, or upgrading to a more advanced pacing system, venous stenosis resulting in partial or complete obstruction of the vessel can pose a real problem. This case series report introduces the technique of percutaneous ...


Hemodynamic, Therapeutic, And Clinical Outcomes Of Ambulatory Pressure-Guided Heart Failure Management, Jacob Abraham, Lian Wang, Rebecca Lewis, Katherine Callis, Joshua Remick, Kateri J. Spinelli 2019 Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart Institute, Providence St. Joseph Health

Hemodynamic, Therapeutic, And Clinical Outcomes Of Ambulatory Pressure-Guided Heart Failure Management, Jacob Abraham, Lian Wang, Rebecca Lewis, Katherine Callis, Joshua Remick, Kateri J. Spinelli

The VAD Journal

Background: Heart failure (HF) management guided by CardioMEMS™ pulmonary artery pressure (PAP) monitoring reduces PAP and HF hospitalizations. The objective of this project was to characterize the relationship between medication adjustments, PAP change, and outcomes for all patients at an advanced HF center.

Methods: We retrospectively analyzed medication changes and hospitalizations for 32 consecutive patients implanted with the CardioMEMS™ sensor at a single HF center and related these outcomes to PAP data from the Merlin.net (Abbott) database. Absolute change in PAP from baseline was estimated using area under the curve normalized to days monitored.

Results: Patients had an average ...


Temporal Trends And Inequalities In Coronary Angiography Utilization In The Management Of Non-St-Elevation Acute Coronary Syndromes In The U.S., Muhammad Rashid, David L. Fischman, Martha Gulati, Khalid Tamman, Jessica Potts, Chun Shing Kwok, Joie Ensor, Ahmad Shoaib, Hossam Mansour, Azfar Zaman, Michael P. Savage, Mamas A. Mamas 2019 Keele University; Royal Stoke Hospital, University Hospital North Midlands

Temporal Trends And Inequalities In Coronary Angiography Utilization In The Management Of Non-St-Elevation Acute Coronary Syndromes In The U.S., Muhammad Rashid, David L. Fischman, Martha Gulati, Khalid Tamman, Jessica Potts, Chun Shing Kwok, Joie Ensor, Ahmad Shoaib, Hossam Mansour, Azfar Zaman, Michael P. Savage, Mamas A. Mamas

Division of Cardiology Faculty Papers

Coronary angiography (CA) is the basis of an invasive management strategy in non-ST elevation acute coronary syndromes (NSTEACS). There are limited contemporary data on national temporal trends in utilization of CA in different patient subgroups. We sought to investigate temporal trends, predictors and clinical outcomes associated with the use of CA in the US. Using the Nationwide Inpatient Sample (NIS) from 2004–2014, we identified all inpatient admissions, age ≥18, with a primary diagnosis of NSTEACS. Descriptive statistics and multivariable logistic regression models were used to investigate temporal trends, predictors and clinical outcomes associated with CA. From a total of ...


Evidence For Minimal Cardiogenic Potential Of Stem Cell Antigen 1-Positive Cells In The Adult Mouse Heart., Lauren E Neidig, Florian Weinberger, Nathan J Palpant, John Mignone, Amy M Martinson, Daniel W Sorensen, Ingrid Bender, Natsumi Nemoto, Hans Reinecke, Lil Pabon, Jeffery D Molkentin, Charles E Murry, Jop H van Berlo 2018 Cardiology Division, Swedish Medical Center, Seattle, WA.

Evidence For Minimal Cardiogenic Potential Of Stem Cell Antigen 1-Positive Cells In The Adult Mouse Heart., Lauren E Neidig, Florian Weinberger, Nathan J Palpant, John Mignone, Amy M Martinson, Daniel W Sorensen, Ingrid Bender, Natsumi Nemoto, Hans Reinecke, Lil Pabon, Jeffery D Molkentin, Charles E Murry, Jop H Van Berlo

Journal Articles and Abstracts

No abstract provided.


Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson 2018 University of San Francisco

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted ...


Are Patients Living With Hiv Infection At Risk For Not Receiving Statin Medications For Cardiovascular Disease Risk Reduction?, Nick Hastain, PharmD Candidate, Roshni S. Patel, PharmD, BCPS, Jason J. Schafer, PharmD, MPH, BCPS, AAHIVP 2018 Thomas Jefferson University

Are Patients Living With Hiv Infection At Risk For Not Receiving Statin Medications For Cardiovascular Disease Risk Reduction?, Nick Hastain, Pharmd Candidate, Roshni S. Patel, Pharmd, Bcps, Jason J. Schafer, Pharmd, Mph, Bcps, Aahivp

College of Pharmacy Posters

Objective

To determine the prevalence of appropriate statin prescribing for ASCVD risk reduction in PLWH


Perioperative Aspirin And Long-Term Survival In Patients Undergoing Coronary Artery Bypass Graft., Qian Ding, Hong Liu, Zugui Zhang, Jordan E. Goldhammer, Eric Yuen, Zhongmin Li, Linong Yao, Nilas Young, Douglas Boyd, William Weintraub, Rohinton Morris, Jianzhong Sun 2018 Thomas Jefferson University; The Fourth Military Medical University

Perioperative Aspirin And Long-Term Survival In Patients Undergoing Coronary Artery Bypass Graft., Qian Ding, Hong Liu, Zugui Zhang, Jordan E. Goldhammer, Eric Yuen, Zhongmin Li, Linong Yao, Nilas Young, Douglas Boyd, William Weintraub, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Faculty Papers

This study aimed to examine association between perioperative uses of aspirin and long-term survival in patients undergoing CABG. A retrospective cohort study was performed in 9,584 consecutive patients receiving cardiac surgery from three tertiary hospitals. Of all the patients, 4,132 patients undergoing CABG met inclusion criteria and were divided into four groups: with or without preoperative or postoperative aspirin respectively. 30-day postoperative and long-term mortality were compared with the use of propensity scores and inverse probability weighting adjustment to reduce the treatment-selection bias. The patients taking preoperative aspirin presented significantly more with comorbidities. However, the results of this ...


Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. McManus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg 2018 University of Massachusetts Medical School

Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. Mcmanus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg

Open Access Articles

BACKGROUND: To examine age-specific differences in the frequency and impact of cardiac and non-cardiac conditions among patients aged 65years and older hospitalized with acute myocardial infarction (AMI).

METHODS: Study population consisted of 3863 adults hospitalized with AMI at 11 medical centers in central Massachusetts on a biennial basis between 2001 and 2011. The presence of 11 chronic conditions (five cardiac and six non-cardiac) was based on the review of hospital medical records.

RESULTS: Participants' median age was 79years, 49% were men, and had an average of three chronic conditions (average of cardiac conditions: 2.6 and average of non-cardiac conditions ...


Restoration Of Left Ventricular Function Following Lvad Implantation – Remission Or Recovery? A Case Series., Shiksha Joshi, Mariah Barlow, Maya Guglin 2018 University of Kentucky

Restoration Of Left Ventricular Function Following Lvad Implantation – Remission Or Recovery? A Case Series., Shiksha Joshi, Mariah Barlow, Maya Guglin

The VAD Journal

Background

A wide range of left ventricular (LV) recovery rates on left ventricular assist device (LVAD) support have been reported. In this case series, we summarize our experience with LVAD explantation for presumed LV recovery.

Case series

Out of 240 patients who received an LVAD implant in our program since its inception, we explanted/inactivated the pump for presumed LV recovery in only three patients. All three of these patients had relapse of cardiomyopathy within 6 months of explantation.

Conclusion

Our experience does not support the existence of LV recovery following LVAD implantation as a common phenomenon. Improvement in LV ...


Designing Tailored Patient Education On Atrial Fibrillation, Tammy Toscos, R Ahmed, Romisa Rohani Ghahari, Elizabeth Martin, Shauna Wagner, Michelle Drouin, Michael J. Mirro 2018 Parkview Health

Designing Tailored Patient Education On Atrial Fibrillation, Tammy Toscos, R Ahmed, Romisa Rohani Ghahari, Elizabeth Martin, Shauna Wagner, Michelle Drouin, Michael J. Mirro

Presentations and Events

Background & Hypothesis: Research has revealed a high prevalence of depression, anxiety, and burnout among medical students accompanied by widespread lack of treatment. We hypothesize that by leveraging our study findings examining the use of telemental health(TMH) among youth (ages 14-24) alongside results from existing research focused on the mental health needs of medical students (median age at start 22-24 years old), we will gain valuable insight into the potential for TMH to address the needs of this high-risk population.

Methods: Using the Delphi method, a sample of 25 experts were surveyed anonymously, thus avoiding group pressure for conformity while ...


Examining Symptom Trajectories That Predict Worse Outcomes In Post-Cabg Patients, Ming-Fen Tsai, Shiow-Luan Tsay, Debra K. Moser, Tsuey-Yuan Huang, Feng-Chun Tsai 2018 Chang Gung University of Science and Technology, Taiwan

Examining Symptom Trajectories That Predict Worse Outcomes In Post-Cabg Patients, Ming-Fen Tsai, Shiow-Luan Tsay, Debra K. Moser, Tsuey-Yuan Huang, Feng-Chun Tsai

Nursing Faculty Publications

Background: Coronary artery bypass grafting is one of the most common interventional revascularisation procedures used to treat coronary artery disease worldwide. With a wide variability in postoperative cardiac symptoms, identification of symptom trajectories during the 3-month postoperative recovery period may improve clinicians’ abilities to support symptom recovery.

Aims: To identify distinct trajectories of cardiac symptoms seen over time in a cohort of patients during the 3-month post-coronary artery bypass grafting period, and determine clinical characteristics associated with different symptom trajectories postoperatively.

Methods: A prospective trial used the cardiac symptom survey to determine patient symptoms at baseline prior to surgery, and ...


Outcomes Of Transcutaneous Aortic Valve Replacement Among High Risk Wv Sample Population., George M. Yousef, Julia Poe, Cameron Killmer, Basel Edris, Jason Mader, Ellen A. Thompson, Daniel Snavely, Silvestre Cansino, Joseph I. Shapiro, Mark a. Studeny 2018 Marshall University

Outcomes Of Transcutaneous Aortic Valve Replacement Among High Risk Wv Sample Population., George M. Yousef, Julia Poe, Cameron Killmer, Basel Edris, Jason Mader, Ellen A. Thompson, Daniel Snavely, Silvestre Cansino, Joseph I. Shapiro, Mark A. Studeny

Marshall Journal of Medicine

Introduction:Transcatheter aortic valve replacement (TAVR) is a relatively new strategy for replacing the aortic valve. We elected to review our early experience to see if we could identify clinical characteristics at baseline or immediately following the procedure that would predict death within one year.

Methods:Charts for all patients assigned to receive TAVR procedure at St Mary’s medical center, Huntington, West Virginia between April, 2013 till November, 2016 were identified and reviewed. A total of seventy-two (72) cases were included.

Results: All cause mortality rate at index hospitalization, 30 days, and 12 months was 5.6%(N=4 ...


Conference Proceedings: Aurora Scientific Day 2018, 2018 Aurora Health Care

Conference Proceedings: Aurora Scientific Day 2018

Journal of Patient-Centered Research and Reviews

This journal supplement includes selected abstracts from among the more than 50 presented at the 44th annual Aurora Scientific Day research symposium. Held May 25, 2018, in Milwaukee, Wisconsin, Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system with hospitals and clinics in Wisconsin and Illinois.


Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven 2018 University of Alabama at Birmingham School of Nursing

Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven

Journal of Patient-Centered Research and Reviews

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing ...


Hyperglycemia And Risk Of Ventricular Tachycardia Among Patients Hospitalized With Acute Myocardial Infarction, Hoang V. Tran, Joel M. Gore, Chad E. Darling, Arlene S. Ash, Catarina I. Kiefe, Robert J. Goldberg 2018 University of Massachusetts Medical School

Hyperglycemia And Risk Of Ventricular Tachycardia Among Patients Hospitalized With Acute Myocardial Infarction, Hoang V. Tran, Joel M. Gore, Chad E. Darling, Arlene S. Ash, Catarina I. Kiefe, Robert J. Goldberg

Open Access Articles

BACKGROUND: Little is known about the association of hyperglycemia Tranwith the development of ventricular tachycardia (VT) in patients hospitalized with acute myocardial infarction (AMI) which we examined in the present study. The objectives of this community-wide observational study were to examine the relation between elevated serum glucose levels at the time of hospital admission for AMI and occurrence of VT, and time of occurrence of VT, during the patient's acute hospitalization.

METHODS: We used data from a population-based study of patients hospitalized with AMI at all central Massachusetts medical centers between 2001 and 2011. Hyperglycemia was defined as a ...


New Oral Anticoagulants And Their Reversal Agents, Crista L. Laslo, Anca Pantea Stoian, Bogdan Socea, Dan N. Paduraru, Oana Bodean, Laura I. Socea, Tiberiu P. Neagu, Ana Maria Alexandra Stanescu, Dragos Marcu, Camelia C. Diaconu 2018 Clinical Emergency Hospital of Bucharest, Internal Medicine Clinic, Bucharest, Romania

New Oral Anticoagulants And Their Reversal Agents, Crista L. Laslo, Anca Pantea Stoian, Bogdan Socea, Dan N. Paduraru, Oana Bodean, Laura I. Socea, Tiberiu P. Neagu, Ana Maria Alexandra Stanescu, Dragos Marcu, Camelia C. Diaconu

Journal of Mind and Medical Sciences

Atrial fibrillation is a commonly encountered pathology in medical practice, and its prevalence has shown a continuous rise over the past years. Atrial fibrillation has a significant impact on patients' quality of life, not only due to the standard anticoagulant treatment with vitamin K antagonists that require close monitoring and dose adjustment, but also due to the fragile equilibrium between hemorrhagic and thrombotic risks. The introduction of new oral anticoagulants (NOACs) in the treatment guidelines for atrial fibrillation has improved the quality of life, as NOACs do not require close monitoring or dose adjustments. However, even if the safety profile ...


Strategies To Increase Early Discharges To Reduce Avoidable Patient Days And Improve Patient Flow, Cathy Palleschi, Cecilia Inman, Erica Weightman, James B. Powers, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks 2018 Maine Medical Center

Strategies To Increase Early Discharges To Reduce Avoidable Patient Days And Improve Patient Flow, Cathy Palleschi, Cecilia Inman, Erica Weightman, James B. Powers, Stephen Tyzik, Joy Moody, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Excellence

CREATING ALGORITHMS TO INCREASE THE NUMBERS OF HOSPITAL MORNING DISCHARGES RESULTING IN IMPROVED PATIENT FLOW

Discharging a percentage of patients early in the day helps to improve patient flow. This results in a reduction of Emergency Department congestion as well as peaks in patient numbers in the early to late afternoon on patient care units.

A cardiac unit in an academic tertiary medical center created a goal to increase the number of their discharges by 11 AM and to streamline key discharge planning activities. A root cause analysis was initiated and after identifying several barriers, two KPIs were developed using ...


Association Of Arginine Vasopressin With Low Atrial Natriuretic Peptide Levels, Left Ventricular Remodelling, And Outcomes In Adults With And Without Heart Failure, Julio A. Chirinos, Mayank Sardana, Garrett Oldland, Bilal Ansari, Jonathan Lee, Anila Hussain, Anique Mustafa, Scott R. Akers, Wen Wei, Edward G. Lakatta, Olga V. Fedorova 2018 University of Pennsylvania

Association Of Arginine Vasopressin With Low Atrial Natriuretic Peptide Levels, Left Ventricular Remodelling, And Outcomes In Adults With And Without Heart Failure, Julio A. Chirinos, Mayank Sardana, Garrett Oldland, Bilal Ansari, Jonathan Lee, Anila Hussain, Anique Mustafa, Scott R. Akers, Wen Wei, Edward G. Lakatta, Olga V. Fedorova

Open Access Articles

AIMS: The arginine vasopressin (AVP) pathway has been extensively studied in heart failure (HF) with reduced ejection fraction (HFrEF), but less is known about AVP in HF with preserved EF (HFpEF). Furthermore, the association between AVP and atrial natriuretic peptide (ANP, a well-known inhibitor of AVP secretion) in HF is unknown.

METHODS AND RESULTS: We studied subjects with HFpEF (n = 28) and HFrEF (n = 25) and without HF (n = 71). Left ventricular (LV) mass and left atrial (LA) volumes were measured with cardiac magnetic resonance imaging. Arginine vasopressin and ANP were measured with enzyme-linked immunosorbent assay. Arginine vasopressin levels were ...


Outcome Of Radioactive Iodine Therapy In Toxic Nodular Goiter In Pakistan, Tauseef Ahmad, Adeel Khoja, Naveed Rashid, Muhammad Areeb Ashfaq 2018 Aga Khan University

Outcome Of Radioactive Iodine Therapy In Toxic Nodular Goiter In Pakistan, Tauseef Ahmad, Adeel Khoja, Naveed Rashid, Muhammad Areeb Ashfaq

Section of Cardiology

Objective: To determine the outcome of patients receiving radioactive iodine therapy for toxic nodular goiter coming to Aga Khan University Hospital Karachi.

Methods: A total of 89 patients who visited the outpatient department of Aga Khan University Hospital from January 2010 to August 2017 were recruited for the study. Toxic nodular goiter was diagnosed on the basis of having hot nodule on thyroid scan with low TSH and high FT4/T4. Other demographic and laboratory data were also recorded.

Results: Eighty nine patients with toxic nodular goiter received a dose range from 10 to 30mCi RAI. Six months after RAI ...


Effects Of Beta Blockers And Ace Inhibitors After Left Ventricular Assist Device Implantation, Gaurang Vaidya, Emma Birks, Jessica Pillarella, Benjamin Salgado, Rajakrishnan Vijayakrishnan, Andrew Lenneman, Mark Slaughter, Dmitry Abramov 2018 University of Louisville

Effects Of Beta Blockers And Ace Inhibitors After Left Ventricular Assist Device Implantation, Gaurang Vaidya, Emma Birks, Jessica Pillarella, Benjamin Salgado, Rajakrishnan Vijayakrishnan, Andrew Lenneman, Mark Slaughter, Dmitry Abramov

The VAD Journal

Purpose: While Beta blockers(BB) and Angiotensin system blockers(ACEinh/ARB) are important components in advanced heart failure therapy, their use after left ventricular assist device (LVAD) implantation remains controversial. Concern has been raised about possible adverse effects of BB on right ventricular(RV) function while tolerance and efficacy/outcome data for ACEinh are lacking. This study aimed to characterize the use of medical therapy post-LVAD implantation and to evaluate its safety and efficacy. Methods: Demographic, clinical and echocardiographic variables of patients implanted with a continuous-flow LVAD between 2012 and 2015 at a single center were retrospectively reviewed. Mortality and ...


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