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https://www.readbyqxmd.com/read/29300970/patients-knowledge-and-attitudes-regarding-living-with-implantable-electronic-devices-results-of-a-multicentre-multinational-patient-survey-conducted-by-the-european-heart-rhythm-association
#1
Kristina Hermann Haugaa, Tatjana S Potpara, Serge Boveda, Jean-Calude Deharo, Jian Chen, Dan Dobreanu, Stefano Fumagalli, Radoslaw Lenarczyk, Antonio Hernandez Madrid, Torben Bjerregaard Larsen, Elena Sciarrafia, Milos Taborsky, Roland Richard Tilz, Paolo Pieragnoli, Andrzej Przybylski, Nikolaos Dagres
The purpose of this patient survey was to analyse the knowledge, experiences, and attitudes regarding cardiac implantable electronic devices (CIED) in patients with pacemakers, implantable cardioverter-defibrillators (ICDs), or cardiac resynchronization devices. Of the 1644 patients with CIEDs from seven European countries, 88% were over 50 years of age. Most patients (90%) knew what device they were implanted with and felt sufficiently informed about the indications for therapy. As many as 42% of patients needed additional information on the battery replacement and limitations in physical activity...
December 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29191724/moral-distress-at-the-end-of-a-life-when-family-and-clinicians-do-not-agree-on-implantable-cardioverter-defibrillator-deactivation
#2
Jill M Steiner, Kristen K Patton, Jordan M Prutkin, James N Kirkpatrick
A 63-year-old man with end-stage ischemic cardiomyopathy presented with incessant ventricular tachycardia. He had been hospitalized multiple times in the past year for severe heart failure. As he approached end of life and was regularly receiving defibrillator shocks, his care team recommended deactivation of his implantable cardioverter-defibrillator. However, his family did not wish to allow deactivation, reporting a religious obligation to prolong his life, regardless of the risk of suffering. The patient was unable to adequately participate in the decision-making process...
November 28, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29169359/evaluation-of-a-practical-expert-defined-approach-to-patient-population-segmentation-a-case-study-in-singapore
#3
Lian Leng Low, Yu Heng Kwan, Nan Liu, Xuan Jing, Edwin Cheng Tee Low, Julian Thumboo
BACKGROUND: Segmenting the population into groups that are relatively homogeneous in healthcare characteristics or needs is crucial to facilitate integrated care and resource planning. We aimed to evaluate the feasibility of segmenting the population into discrete, non-overlapping groups using a practical expert and literature driven approach. We hypothesized that this approach is feasible utilizing the electronic health record (EHR) in SingHealth. METHODS: In addition to well-defined segments of "Mostly healthy", "Serious acute illness but curable" and "End of life" segments that are also present in the Ministry of Health Singapore framework, patients with chronic diseases were segmented into "Stable chronic disease", "Complex chronic diseases without frequent hospital admissions", and "Complex chronic diseases with frequent hospital admissions"...
November 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29151496/cost-effectiveness-analysis-of-cardiovascular-disease-treatment-in-japan
#4
Satoshi Kodera, Arihiro Kiyosue, Jiro Ando, Hiroshi Akazawa, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#5
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28985839/peritoneal-drainage-is-associated-with-higher-survival-rates-for-necrotizing-enterocolitis-in-premature-extremely-low-birth-weight-infants
#6
COMPARATIVE STUDY
Jun Tashiro, Amy E Wagenaar, Eduardo A Perez, Juan E Sola
BACKGROUND: To evaluate peritoneal drainage (PD) and laparotomy ± resection/ostomy (LAP) as initial approaches to the surgical management of necrotizing enterocolitis (NEC) in premature, extremely low birth weight (ELBW) infants. METHODS: Kids' Inpatient Database (2003-2012) was searched for cases of NEC (International Classification of Diseases, ninth revision, Clinical Modification [ICD-9-CM] 777.5x) in premature (<37 weeks), extremely low birth weight (<1000 g) infants...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28941964/unmet-palliative-care-needs-among-patients-with-end-stage-kidney-disease-a-national-registry-study-about-the-last-week-of-life
#7
Lena Axelsson, Anette Alvariza, Jenny Lindberg, Joakim Öhlén, Cecilia Håkanson, Helene Reimertz, Carl-Johan Fürst, Kristofer Årestedt
CONTEXT: End-stage kidney disease (ESKD) is characterized by high physical and psychological burden, and therefore, more knowledge about the palliative care provided close to death is needed. OBJECTIVES: To describe symptom prevalence, relief, and management during the last week of life, as well as end-of-life communication, in patients with ESKD. METHODS: This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (International Classification of Diseases, Tenth Revision, Sweden; N18...
September 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28940060/psychosocial-implications-of-living-with-catecholaminergic-polymorphic-ventricular-tachycardia-in-adulthood
#8
Ebony Richardson, Catherine Spinks, Andrew Davis, Christian Turner, John Atherton, Julie McGaughran, Christopher Semsarian, Jodie Ingles
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmogenic disease with a high risk of sudden cardiac death. The impact on health-related quality of life (HR-QoL) and psychosocial outcomes is not known. We sought to provide the first description of HR-QoL and psychosocial wellbeing of adults with CPVT, parents of affected children and at-risk relatives. Participants were recruited through the Australian Genetic Heart Disease Registry and invited to complete a cross-sectional survey comprising a number of validated scales and open-ended questions...
September 23, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/28939708/the-decisions-interventions-and-goals-in-implantable-cardioverter-defibrillator-therapy-dignity-pilot-study
#9
Daniel B Kramer, Daniel Habtemariam, Yaw Adjei-Poku, Michelle Samuel, Diane Engorn, Matthew R Reynolds, Susan L Mitchell
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are commonly implanted in older patients, including those with multiple comorbidities. There are few prospective studies assessing the clinical course and end-of-life circumstances for these patients. METHODS AND RESULTS: We prospectively followed 51 patients with ICDs for up to 18 months to longitudinally assess in terms of (1) advance care planning, (2) health status, (3) healthcare utilization, and (4) end-of-life circumstances through quarterly phone interviews and electronic medical record review...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28916294/characteristics-of-older-adults-in-primary-care-who-may-benefit-from-primary-palliative-care-in-the-united-states
#10
Nancy Dudley, Christine S Ritchie, Margaret I Wallhagen, Kenneth E Covinsky, Bruce A Cooper, Kanan Patel, Irena Stijacic-Cenzer, Susan A Chapman
CONTEXT: Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care. OBJECTIVES: To describe U.S. primary care visits among adults 65 years and older with advanced illness. METHODS: Cross-sectional analysis of the National Ambulatory and Hospital Ambulatory Medical Care Surveys (2009-2011) was conducted using chi-square tests to compare visits without and with advanced illness to U...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28872268/risk-of-suicide-attempts-among-adolescents-and-young-adults-with-autism-spectrum-disorder-a-nationwide-longitudinal-follow-up-study
#11
Mu-Hong Chen, Tai-Long Pan, Wen-Hsuan Lan, Ju-Wei Hsu, Kai-Lin Huang, Tung-Ping Su, Cheng-Ta Li, Wei-Chen Lin, Han-Ting Wei, Tzeng-Ji Chen, Ya-Mei Bai
BACKGROUND: Previous studies reported a high prevalence of depression among patients with autism spectrum disorder (ASD) and suggested a relationship between ASD and suicidality. However, whether ASD independently increases the risk of attempted suicide regardless of depression has not been determined. METHODS: Using the Taiwan National Health Insurance Research Database, 5,618 adolescents aged 12-17 years and young adults aged 18-29 years with ASD (ICD-9-CM code: 299) and 22,472 age- and sex-matched controls were enrolled between 2001 and 2009 and followed to the end of 2011...
August 29, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28747313/long-term-complications-reoperations-and-survival-following-cardioverter-defibrillator-implant
#12
Nathaniel Mark Hawkins, Maja Grubisic, Jason G Andrade, Flora Huang, Lillian Ding, Min Gao, Jamil Bashir
OBJECTIVE: Implantable cardioverter-defibrillators (ICDs) reduce risk of death in select populations, but are also associated with harms. We aimed to characterise long-term complications and reoperation rate. METHODS: We assessed the rate, cumulative incidence and predictors of long-term reoperation and survival using a prospective, multicentre registry serving British Columbia in Canada, a universal single payer healthcare system with 4.5 million residents. 3410 patients (mean 63...
July 26, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28699936/clinician-attitudes-regarding-icd-deactivation-in-dnr-dni-patients
#13
Andrew Bradley, Adam Marks
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) offer lifesaving therapies but can become burdensome at the end of life. Many ICD patients choose to implement a do-not-resuscitate/do-not-intubate (DNR/DNI) order. When hospitalized, patients are seen by a range of clinicians whose beliefs about ICD management in DNR/DNI patients may vary. OBJECTIVE: To assess clinician opinions on managing ICDs in DNR/DNI patients and stratify it by specialty and training level...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28678000/implantable-cardioverter-defibrillator-knowledge-and-end-of-life-device-deactivation-a-cross-sectional-survey
#14
Samantha M McEvedy, Jan Cameron, Eugene Lugg, Jennifer Miller, Chris Haedtke, Muna Hammash, Martha J Biddle, Kyoung Suk Lee, Justin A Mariani, Chantal F Ski, David R Thompson, Misook Lee Chung, Debra K Moser
BACKGROUND: End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days. AIM: To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation. DESIGN: Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28502872/subcutaneous-implantable-cardioverter-defibrillator-post-approval-study-clinical-characteristics-and-perioperative-results
#15
Michael R Gold, Johan D Aasbo, Mikhael F El-Chami, Mark Niebauer, John Herre, Jordan M Prutkin, Bradley P Knight, Steven Kutalek, Kevin Hsu, Raul Weiss, Eric Bass, Michael Husby, Timothy M Stivland, Martin C Burke
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to reduce short- and long-term complications associated with transvenous ICD leads. Early multicenter studies included younger patients with less left ventricular systolic dysfunction and fewer comorbidities than cohorts with traditional ICD. OBJECTIVE: The purpose of this study was to characterize patient selection and the acute performance of the S-ICD in a contemporary real-world setting...
October 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28495487/effect-of-psychiatric-illness-on-acute-care-utilization-at-end-of-life-from-serious-medical-illness
#16
Kyle Lavin, Dimitry S Davydow, Lois Downey, Ruth A Engelberg, Ben Dunlap, James Sibley, William B Lober, Kelson Okimoto, Nita Khandelwal, Elizabeth T Loggers, Joan M Teno, J Randall Curtis
CONTEXT: Little is known about psychiatric illness and utilization of end-of-life care. OBJECTIVES: We hypothesized that preexisting psychiatric illness would increase hospital utilization at end of life among patients with chronic medical illness due to increased severity of illness and care fragmentation. METHODS: We reviewed electronic health records to identify decedents with one or more of eight chronic medical conditions based on International Classification of Diseases-9 codes...
May 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28405065/practical-and-ethical-considerations-in-the-management-of-pacemaker-and-implantable-cardiac-defibrillator-devices-in-terminally-ill-patients
#17
REVIEW
Mina M Benjamin, Christine A Sorkness
More than 4.5 million people worldwide live with an implanted pacemaker, including >3 million in the USA alone. Also, >0.8 million people in the USA have an implantable cardioverter defibrillator (ICD). Knowing the principles of managing these devices towards the end of life is important, as the interruption of their function may have serious consequences. This article provides health care providers who are not specialized in cardiac electrophysiology with an introduction to the general principles of management of pacemakers or ICD devices towards the end of life, with a suggested algorithm for approaching this process...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28398367/-implantable-cardioverter-defibrillator-deactivation-at-the-end-of-life-ethical-clinical-and-communication-issues
#18
REVIEW
Massimo Romanò, Maria Antonella Piga, Roberta Bertona, Roberto Negro, Chiara Ruggeri, Federica Zorzoli, Rosvaldo Villani
The number of cardioverter-defibrillator implants is increasing worldwide, with the main indication being primary prevention of sudden cardiac death. During the follow-up, patients may die from progression of their underlying heart disease or from nonarrhythmic causes, such as malignancies, dementia and lung disease, without receiving appropriate shocks until the last few days or weeks of their life. These events occur roughly in 30% of patients, mainly in the last 24 hours before death. In this case, inappropriate and even appropriate shock deliveries can no longer prolong life and may simply lead to pain and reduced quality of life...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28339581/rationale-and-design-of-the-budapest-crt-upgrade-study-a-prospective-randomized-multicentre-clinical-trial
#19
Bela Merkely, Annamaria Kosztin, Attila Roka, Laszlo Geller, Endre Zima, Attila Kovacs, Andras Mihaly Boros, Helmut Klein, Jerzy K Wranicz, Gerhard Hindricks, Marcell Clemens, Gabor Z Duray, Arthur J Moss, Ilan Goldenberg, Valentina Kutyifa
Aims: There is lack of conclusive evidence from randomized clinical trials on the efficacy and safety of upgrade to cardiac resynchronization therapy (CRT) in patients with implanted pacemakers (PM) or defibrillators (ICD) with reduced left ventricular ejection fraction (LVEF) and chronic heart failure (HF). The BUDAPEST-CRT Upgrade Study was designed to compare the efficacy and safety of CRT upgrade from conventional PM or ICD therapy in patients with intermittent or permanent right ventricular (RV) septal/apical pacing, reduced LVEF, and symptomatic HF...
September 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28253884/reflection-of-illness-and-strategies-for-handling-advanced-lung-cancer-a-qualitative-analysis-in-patients-and-their-relatives
#20
Anika Sparla, Sebastian Flach-Vorgang, Matthias Villalobos, Katja Krug, Martina Kamradt, Kadiatou Coulibaly, Joachim Szecsenyi, Michael Thomas, Sinikka Gusset-Bährer, Dominik Ose
BACKGROUND: Lung cancer patients are often diagnosed in an advanced stage of disease. In a situation of palliative treatment, both patients and their relatives experience existential burden. Evidence suggests that multi-professional teams should deal with them as dyads. However, little is known about differences in their individual situation. The purpose of this study is to explore and compare reflections that arise out of the context of diagnosis and to compare how patients and their relatives try to handle advanced lung cancer...
March 2, 2017: BMC Health Services Research
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