A Pilot Study of Implantable Cardiac Device Interrogation by Emergency Department Personnel

2014 ◽  
Vol 13 (1) ◽  
pp. 6-8 ◽  
Author(s):  
James F. Neuenschwander ◽  
Brian C. Hiestand ◽  
W. Frank Peacock ◽  
John M. Billings ◽  
Cole Sondrup ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Cardiac Device ◽  
Implantable Cardiac Device

The HEAR‐VA Pilot Study: Hearing Assistance Provided to Older Adults in the Emergency Department

2021 ◽  
Vol 69 (4) ◽  
pp. 1071-1078
Author(s):  
Joshua Chodosh ◽  
Keith Goldfeld ◽  
Barbara E. Weinstein ◽  
Kate Radcliffe ◽  
Madeleine Burlingame ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Pilot Study

Abstract 23: Detection of Atrial Fibrillation by Implantable Cardiac Monitoring After Acute Central Retinal Artery Occlusion

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Brian C Mac Grory ◽  
Paul D Ziegler ◽  
Sean Landman ◽  
Amador Delamerced ◽  
Anusha Boyanpally ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Cardiac Device ◽  
History Of ◽  
Implantable Cardiac Device ◽  
Retinal Artery

Introduction: Central retinal artery occlusion (CRAO) is a form of ischemic stroke and necessitates a comprehensive workup, including for cardioembolic sources such as atrial fibrillation (AF). However, the incidence of new AF diagnosed after CRAO is unknown. We aimed to examine the incidence of new, cardiac device-detected AF after CRAO in a large population-based cohort. Methods: Using patient-level data from the Optum® de-identified EHR dataset (2007-2017) linked with Medtronic implantable cardiac device data, we identified patients that had a diagnosis-code corresponding to CRAO and no known history of AF, and who also had either a device in-situ at the time of CRAO or implanted ≤1 year post-CRAO with continuous AF monitoring data available. AF incidence was defined as ≥2 minutes of device-detected AF in a day. Results: Of 467,167 patients screened, 246/433 (56.8%) with CRAO had no history of AF, of whom 39 had an eligible implantable cardiac device (mean age 66.7±14.8, 41.0% female). Prevalence of vascular risk factors was high (hypertension, 71.8%; hyperlipidemia, 61.5%; coronary artery disease, 46.2%). Within 3 months, 7.7% of these patients (n=3) had device-detected AF. At 36 months, 33.3% of patients (n=13). The maximum daily AF burden post CRAO ranged from 2 minutes to 24 hours with a mean of 390±530 minutes. Of the patients with device-detected AF, 9 were found by an implantable cardiac monitor and 4 by pacemaker or defibrillator. Discussion: The rate of long-term AF detection after CRAO was high in patients with implanted cardiac devices, and appears comparable with rates seen after cryptogenic ischemic stroke and in other high-risk populations. Our findings warrant future prospective studies not limited by selection bias.

scholarly journals Cost-minimisation analysis alongside a pilot study of early Tissue Doppler Evaluation of Diastolic Dysfunction in Emergency Department Non-ST Elevation Acute Coronary Syndromes (TEDDy-NSTEACS)

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e023920 ◽  
Author(s):  
Vijay S Gc ◽  
Mohamad Alshurafa ◽  
David J Sturgess ◽  
Joseph Ting ◽  
Kye Gregory ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
High Risk ◽  
Length Of Stay ◽  
Cost Saving ◽  
Risk Stratification ◽  
Diagnostic Tool ◽  
Tissue Doppler ◽  
Conventional Care ◽  
St Elevation

ObjectiveTo estimate the cost implications of early angiography for patients with suspected non-ST elevation acute coronary syndrome (NSTEACS) using tissue Doppler imaging (TDI).DesignA decision tree model was used to synthesise data from the pilot study and literature sources. Sensitivity analyses tested the impact of assumptions incorporated into the analysis.SettingEmergency department (ED), Brisbane, Australia.ParticipantsPatients with suspected NSTEACS.InterventionsTDI as a diagnostic tool for triaging patients within 4 hours of presentation in addition to conventional risk stratification, compared with conventional risk stratification alone.Data sourcesResource used for diagnosis and management were recorded prospectively and costed for 51 adults who had echocardiography within 24 hours of admission. Costs for conventional care were based on observed data. Cost estimates for the TDI intervention assumed patients classified as high risk at TDI (E/e’>14) progressed early to angiography with an associated 1-day reduction in length of stay.Primary outcome measuresCosts until discharge from the Australian healthcare perspective in 2016–2017 prices.ResultsFindings suggest that using TDI as a diagnostic tool for triaging patients with suspected NSTEACS is likely to be cost saving by $A1090 (95% credible interval: $A573 to $A1703) per patient compared with conventional care. The results are mainly driven by the assumed reduction in length of stay due to the inclusion of early TDI in clinical decision-making.ConclusionsThis pilot study indicates that compared with conventional risk stratification, triaging patients presenting with suspected NSTEACS with TDI within 4 hours of ED presentation has potential cost savings. Findings assume a reduction in hospital stay is achieved for patients considered to be high risk at TDI. Larger, comparative studies with longer follow-up are needed to confirm the clinical effectiveness of TDI as a diagnostic strategy for NSTEACS, the assumed reduction in hospital stay and any cost saving.

scholarly journals Lactate levels as a marker of tissue hypoperfusion in acute heart failure patients seen in the emergency department: a pilot study

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Kori Sauser ◽  
Lora Alkhawam ◽  
Linda Pierchala ◽  
Peter S. Pang
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Pilot Study ◽  
Acute Heart Failure ◽  
Tissue Ischemia ◽  
Tissue Hypoperfusion ◽  
Baseline Characteristics ◽  
Lactate Levels ◽  
Elevated Lactate ◽  
Mean Heart Rate

Acute heart failure (AHF) may lead to subclinical tissue ischemia due to hypoperfusion from inadequate forward flow or congestion. The aim of the present study is to test whether lactate levels are elevated in emergency department (ED) patients with AHF. A prospective pilot study of ED AHF patients was conducted. Venous lactate level was measured at baseline and 6-12 hours after initial draw. Of the 50 patients enrolled, mean age was 65.3 years, 68% were male. Only 7 (14%) had an elevated lactate on either draw, with no differences in baseline characteristics between patients with and without elevated lactate. Patients with an elevated lactate had a higher mean heart rate (99 <em>vs</em> 81, P=0.03) and trended toward an increased rate of abnormal initial temperature (57 <em>vs</em> 23%, P=0.06). In this pilot study, only a minority of acute HF patients had an elevated lactate on presentation.

scholarly journals Tablet-Based Patient-Centered Decision Support for Minor Head Injury in the Emergency Department: Pilot Study

2017 ◽  
Vol 5 (9) ◽  
pp. e144 ◽  
Author(s):  
Navdeep Singh ◽  
Erik Hess ◽  
George Guo ◽  
Adam Sharp ◽  
Brian Huang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Decision Support ◽  
Pilot Study ◽  
Head Injury ◽  
Minor Head Injury ◽  
Patient Centered
Sign in / Sign up

Export Citation Format

Share Document