The Journal of cardiovascular nursing
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Heart failure (HF) is a complex and costly disease process associated with high morbidity and mortality. Implanted cardiac rhythm management devices are increasingly used in the HF population to provide therapies such as protection from sudden death and cardiac resynchronization therapy. ⋯ This article will review the evidence for using diagnostic information from cardiac rhythm management devices in the management of HF patients. Future advanced monitoring devices will also be discussed.
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Since 1970, pulmonary artery catheters (PACs) have been used in clinical practice to monitor the hemodynamic status of critically ill and injured patients. This technology was introduced and commercialized without considerable testing to determine safety and efficacy. ⋯ This article reviews the historical context of PAC use, findings from recent clinical trials intended to determine safety and efficacy, issues with reliability and validity of PAC use, and complications associated with PAC use. Data from recent clinical trials do not support routine use of PACs, and the authors suggest that PAC-guided therapy should be the focus of study in future trials.
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Cardiovascular disease today remains a formidable foe affecting 1 in 3 Americans. The emergence of cardiac biochemical markers has provided clinicians unique insight into the state of the myocardium. In fact, cardiac biomarkers now represent an essential criterion in the definition of acute myocardial infarction. ⋯ The advantages and disadvantages of biomarkers will also be presented in the context of their clinical uses. Present markers are highly sensitive and specific to myocardial injury; however they do not specifically identify the method of injury. An exciting potential exists for future biomarkers to demonstrate enhanced specificity and earlier detection of compromised myocardium.