Improving adherence to medications for heart failure: Medtronic says their CRT does it

Posted on by Kurt Jensen

Despite relatively few strong research studies supporting methodologies for improving adherence to medications for patients with heart failure, Medtronic's recent press release suggests their cardiac resynchronization therapy (CRT) implants might do the trick.

Medtronic accounced results of a retrospective analysis of administrative claims data of more than 4,500 patients with heart failure at the 2016 Heart Failure Society of America Scientific Meeting, Monday.

The analysis found that the number of patients "fully compliant" to a regimen of guideline-recommended medications "nearly doubled" at twelve months following CRT implants compared to those who did not receive implants.

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Future of cardiology: personalized care through genetics?

Posted on by Kurt Jensen

Genetic arrhythmia programs are paving new roads for personalized cardiac care—from preventing unnecessary cautionary testing or treatment to improving screening.

Melvin Scheinman, MD—the first person to perform catheter ablation for arrhythmia in a human patient, now chief of the Comprehensive Genetic Arrhythmia Program at the University of California, San Francisco—believes genetic testing will lead to the "ultimate form of personalized medicine," writes Gregory A. Freeman of HealthLeaders Magazine.

"If you examine the genetic background of a patient, you may be able to identify sensitivity to specific drugs, propensity for developing some very serious heart disorders, and at the same time rule out those same things for other people," said Scheinman to HealthLeaders.

"That is really what personalized medicine is all about—delivering the right care to the patient because you truly understand the patient and don't have to treat him or her as just a member of a group with certain statistical risks."

A proliferation of genetic arrhythmia programs "across the country" have been introducing new, measured responses to a sudden cardiac death in the family—preventive healthcare for some, but not all family members.

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Comparing New Leadless Pacemakers: Micra vs. Nanostim

Posted on by Kurt Jensen

On the back of encouraging Phase III trial results, Medtronic's "Micra" leadless pacemaker was approved by the U.S. Food and Drug Administration in April, beating St. Jude Medical's "Nanostim" to approval—but does it have more limitations?

For leadless pacemakers, size matters.

Despite being small for pacemakers, both devices are rather large for transfemoral catheterization—the access site for both devices.

Sheaths for St. Jude Medical's Nanostim device measure 18 French or 6mm in diameter, to which Dr. Prapa Kanagaratnam of St. Mary's Hospital, Imperial College, London expressed some concern. "An 18-F sheath is a big sheath to put in the leg," he said to heartwire.

"A lot of the patients we're putting these devices into are small, elderly people," said Dr. Kanagaratnam. "So it's still a procedure that we feel anxious about."

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Routine Cardiac Catheterization Expanding to Saturdays?

Posted on by Kurt Jensen

Expanding availability of elective, non-emergent cardiac catheterization services to Saturdays might significantly reduce length of stay, with no effect on clinical quality reports a recent economic impact study.

The study, published online in the American Journal of Managed Care found that reduced length of stay did not result in total cost savings, however.

In January 2009, Mayo Clinic Rochester expanded cardiac catheterization service availability (CSA) to Saturdays with the "goal of timely access with improved efficiency of care," write the authors.

Despite succeeding in greatly reducing length of stay—a statistically significant, adjusted average of 1.73 days—total costs of care were similar prior to CSA expansion.

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