Archive - Jul 30, 2012 - SCA Article

Archive - Jul 30, 2012 - SCA Article


Scarred Heart May Indicate Need for ICD

Left ventricular scarring may be a better determinant for implantable cardioverter defibrillator (ICD) candidacy than a low ejection fraction. 

ICD Outcomes Tied to Cardiac Muscle Scarring

A significant amount of MRI-detected scarring in the myocardium is predictive of a poor prognosis in patients with an implantable cardioverter defibrillator (ICD) no matter the left ventricular ejection fraction (LVEF), according to a study in the July 31 issue of the Journal of the American College of Cardiology.

Of the 137 patients in the study, those with a LVEF greater than 30% had a six-fold increased risk of adverse events following ICD placement when they had more than 5% scarring compared with those with minimal or no scarring, reported Igor Klem, MD, from Duke University Medical Center in Durham, N.C., and colleagues.

U.S. Preventative Services Task Force Issues New Guidelines on ECG Screening for Adults

New guidelines from the U.S. Preventive Services Task Force (USPSTF), comprised of 16 volunteer members, recommend against screening with electrocardiography (ECG) during rest or exercise to predict coronary heart disease (CHD) events in asymptomatic adults at low risk for CHD events.

An ECG is a simple, non-invasive test that measures electrical activity from the heart. Information picked up from an ECG may determine how fast a heart beat is, or whether it has a steady or problematic rhythm. An irregular ECG could detect a major heart problem, including heart attacks, arrhythmias and heart failure.

While the panel recommends against giving ECGs to healthy adults, some physicians believe they're important in order to establish baseline measures when people are healthy in case things later go awry, in order to compare the results.

Post-Cardiac Arrest Care System Improved Survivors' Neurological Status

DALLAS -- Fewer sudden cardiac arrest survivors had neurologic impairment after a novel regional system of care was implemented, according to research published in Circulation, an American Heart Association journal.

In 2009, the Aizu region of Japan established an advanced post-cardiac arrest care system that included emergency medical services (EMS) taking survivors directly to hospitals specializing in advanced care or from an outlying hospital to the specialty hospital after an effective heartbeat was restored.

Advanced care includes therapeutic hypothermia, appropriate fluids, cardiovascular medications, respiratory management and procedures like percutaneous coronary intervention (PCI) to open blocked arteries.

The American Heart Association refers to these treatments as the "fifth link" in the Chain of Survival for sudden cardiac arrest.

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