Heart, lung & circulation
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Heart, lung & circulation · Mar 2015
Comparative StudyShorter ischaemic time and improved survival with pre-hospital STEMI diagnosis and direct transfer for primary PCI.
We sought to determine if our regional program for pre-hospital STEMI diagnosis and direct transfer for primary PCI (PPCI) was associated with shorter ischaemic times and improved survival compared with ED diagnosis. ⋯ Pre-hospital diagnosis of STEMI and direct transfer to the cath lab reduced total ischaemic time by 57 minutes and mortality by >50% following PPCI. Further efforts are needed to increase the proportion of STEMI patients treated using this strategy.
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Heart, lung & circulation · Mar 2015
Radiation exposure during cardiac catheterisation is similar for both femoral and radial approaches.
Radial approach invasive coronary angiography has been shown to be superior to the femoral approach in terms of reducing vascular access complications and improving patient comfort. However, one major limitation has been the perception of higher patient radiation exposure, with guidelines recommending 7mSv as an appropriate average effective dose (E) for routine coronary angiography. Therefore, we sought here to assess differences in radiation exposure between the femoral and radial access routes in patients undergoing diagnostic coronary angiography with or without angioplasty (CA +/- PCI), as performed by two operators, experienced in both techniques. ⋯ In our high volume cardiac catheterisation laboratory, radiation doses for routine angiography were near UNSC targets. Patient radiation exposure was comparable between femoral and radial approaches, for both CA and CA +/- PCI. Thus, our results allay concerns that radial cardiac catheterisation might be associated with greater radiation exposure.
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Heart, lung & circulation · Mar 2015
Observational StudyEffective pre-hospital care for out-of-hospital cardiac arrest caused by respiratory disease.
The relationship between pre-hospital care and the prognosis of out-of-hospital cardiac arrest (OHCA) caused by respiratory disease is unclear. This study aimed to assess the impact of pre-hospital care on the prognosis of OHCA caused by respiratory disease. ⋯ Even in OHCA caused by respiratory disease, not only pre-hospital epinephrine administration but also pre-hospital advanced airway management and rescue breathing in bystander CPR may not be critical.
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Heart, lung & circulation · Mar 2015
The Australian and New Zealand cardiac pacemaker and implantable cardioverter-defibrillator survey: calendar year 2013.
A pacemaker (PM) and implantable cardioverter-defibrillator (ICD) survey was undertaken in Australia and New Zealand for calendar year 2013. ⋯ For 2013, PMs sold as new implants in Australia was 15,203 (12,523 in 2009) and implanted in New Zealand were 1,641 (1,277 in 2009). The number of new PM implants per million population 652 for Australia (565 were in 2009) and 367 for New Zealand (299 in 2009). Although PM replacements rose in New Zealand, there was a fall in Australia as a result of improved power source service life. Pulse generator types sold in Australia were predominantly dual chamber 74% (71% in 2009) and implanted in New Zealand 59% (54% in 2009). There were 661 biventricular PMs implanted in Australia (446 in 2009) and 83 in New Zealand (45 in 2009). Transvenous pacing leads were overwhelmingly bipolar with preferences for active fixation leads, although, since 2009, there has been a minor resurgence in Australia of passive fixation lead usage in the atrium from 20 to ∼24%. There was also a marked increase in the ICD implants with 3904 new implants in Australia (3555 in 2009) and 423 in New Zealand (329 in 2009). The new ICD implants per million population were 167 for Australia (160 in 2009) and 95 for New Zealand (77 in 2009). Biventricular ICD implants increased significantly in both Australia (2211) and New Zealand (118).