Working in the Cath Lab Causes Heart Disease

Posted on by Kurt Jensen

Radiation Safety (Still) Matters

In February, ACVP blog reported on a survey that showed non-physician Cath Lab employees, ACVP members, reporting higher levels of musculoskeletal pain due to radiation exposure and lead apron use.

In April, SCAI released a membership survey with almost 50 percent of responders reporting orthopedic injuries, and there has been "no discernible improvement" since a similar survey was collected in 2004.

There's more bad news. A new study published this week links radiation in the Cath Lab to subclinical atherosclerosis. That's right, working in the Cath Lab can cause cardiovascular disease.

The study calculated a radiological risk score based on proximity to radiation source, caseload, and the length of employment, and there was a significant correlation between this measure and carotid intima-media thickness on the left side, not on the right, which provides "further support for a causal connection."

What's being done?

Continue reading Working in the Cath Lab Causes Heart Disease

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Cardiac News Round-Up April 17

Posted on by Kurt Jensen

Stroke

Thrombolysis Safe in Mild Stroke

Jose G. Romano, MD and colleagues reported in the April issue of JAMA Neurology that few treatment complications were seen when treating patients who experienced mild strokes with tissue plasminogen activator (tPA). Mild strokes are defined by an NIHSS score of 5 or less. The study did not address long-term outcomes in the mild-stroke population.

Monitoring Improves NOAC Adherence

Mintu P. Turakhia, MD reported in April issue of JAMA that adherence to new oral anticoagulant (NOAC) dabigatran was highest when pharmacists assisted in monitoring compliance. Dabigatran is one of four fixed-dose NOACs that have been approved as alternatives to warfarin for reducing stroke risk in patients with Afib.

Heart Failure

Ivabradine for Heart Failure Gets FDA Nod

The FDA approved the first new drug for heart failure since 2005---invabradine---approved to "reduce hospitalization from worsening heart failure."

Acute MI

New Strategy can Help Determine Heart Attack in Patients Within One Hour

Results are in from a larger-scale clinical trial for an high-sensitivity cardiac troponin T algorithm (hs-cTnT) which accelerates treatment for patients suspected of having acute MI. The test allows for safe rule-out and 75 percent accurate rule-in. ACVP blog discussed a similar, gender-specific test in January, which found that high-sensitivity is necessary for more accurate diagnosis of heart attacks in women.

One simple procedural change reduces mortality in the cath lab

Posted on by Kurt Jensen

An international study published mid-March in the Lancet showed that using the wrist as an access point for heart catheterization reduced bleeding and lowered mortality rates as opposed to using the groin as an access point.

While previous studies have demonstrated that wrist access reduces incidents of bleeding, this is the first to demonstrate the connection with incidents of mortality.

The change lowers mortality at no additional cost beyond necessary additional training and expertise---insertion through the wrist is more technically demanding than insertion through the groin, as the artery is smaller.

Special Report (3): Mitigating Work-Related Musculoskeletal Pain

Posted on by Kurt Jensen

Most references to musculoskeletal pain suggest they are best treated by identifying and treating the cause of the pain. But what if the cause of pain is work-as-usual for cardiovascular professionals in the Cath Lab?

In our special report series we've already discussed the recent research that showed non-physician Cath Lab personnel reporting more musculoskeletal pain due to interventional procedures involving radiation. We also shared pieces from Dr. James Goldstein's editorial on the subject, discussing the importance of the issue and suggesting ways to advocate and educate. We're also planning on discussing new technological applications that allow cardiovascular professionals to avoid radiation during procedures.

But in this piece, we'll take a lighter look at ways to mitigate musculoskeletal pain including stress reduction techniques and some alternative approaches.

Continue reading Special Report (3): Mitigating Work-Related Musculoskeletal Pain