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3 years ago
Coronary artery disease (CAD), the most common cause of morbidity and mortality in the US, is frequently identified by coronary angiography. Decisions for treatment are often based on angiography alone, absent other clinical indicators for intervention. However, by angiography alone, conventional wisdom has suggested that a coronary stenosis is significant if there is at least a 50 % diameter…
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3 years ago
More than 10 million Americans suffer annually from angina.1 For decades, most of the attention has been focused on epicardial coronary artery disease (CAD). In a European registry of 11,000 stable angina patients, 65% of women and 32% of men had no obstructive CAD (<50% stenosis); however, multiple other studies have demonstrated only 30% of patients have significant obstructive epicardial…
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3 years ago
The highlights of the last decade in interventional cardiology have been the introduction of drug-eluting stents and an overall simplification of percutaneous coronary interventional procedures from a technological standpoint. Indeed, most interventions currently consist of either direct stenting or pre-dilatation followed by stent implantation; the use of rotational atherectomy and other niche…
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3 years ago
Heart failure (HF) affects more than 5 million people, representing 2 % of the population.1,2 At 40 years of age, the lifetime risk of developing HF, regardless of gender, is one in five, with an incidence of 10 per 1,000 population after the age of 65 years.1,3 Despite efforts focused toward primary prevention of HF in the areas of hypertension (HTN), diabetes, obesity, use of cardiotoxic…
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3 years ago
Cardiac output (CO) is a fundamental measure for the assessment of cardiac performance and is applied widely to detect the presence of cardiovascular disease and monitor its progression, as well as to monitor patients in challenging hemodynamic circumstances and to optimize therapy. CO is a key parameter in characterizing a patient’s hemodynamic state. For example, a notable characteristic of…
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3 years ago
In what is often cited as the earliest public reporting of healthcare information, Florence Nightingale published mortality rates at British military hospitals caring for casualties of the Crimean War.1 Dr Ernest Codman, about 50 years later, called for the public release of surgical outcomes at his hospital, but was highly criticized for his effort eventually leading to the loss of his hospital…
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3 years ago
Heart failure (HF), most simply defined as the inability of the heart to meet the demands of the tissue, results in symptoms of fatigue or dyspnea on exertion (progressing to dyspnea at rest), and is a costly and deadly disorder.1 HF is the only cardiovascular disease entity where the incidence is currently increasing. In 1991 there were ‘just’ 3.5 million reported cases of HF in the US; however,…
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3 years ago
Introduction
Coronary artery disease (CAD) is the leading cause of death in the US in both men and women, and in all ethnic groups that have been evaluated.1 The American College of Cardiology estimated the 1998 annual costs (direct and indirect) of CAD in the US to be US$368.4 billion, compared with cumulative cancer costs of US$189 billion.2 The scope of this problem is expanding as the…
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3 years ago
Cardiac resynchronization therapy (CRT) has achieved widespread approval as a safe and efficient therapeutic strategy for medically refractory congestive heart failure (CHF). The standard indications for CRT include patients with advanced heart failure and evidence of systolic dysfunction (ejection fraction [EF] ≤35%), conduction tissue disease (QRS duration ≥120ms), and marked cardiac symptoms …
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The S-ICD: New Insights
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3 years ago
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