I know what you’re thinking. “Did he fire six shots or only five?” Well, to tell you the truth, in all this excitement I kind of lost track myself. But being as this is a .44 Magnum, the most powerful handgun in the world, and would blow your head clean off, you’ve got to ask yourself one question: Do I feel lucky?
Well, do ya, punk?
Harry Callihan, from the movie Dirty Harry
It was a small article in the Wall Street Journal on 8 August 2011: “Zoll Medical Falls As LifeVest May Face Reimbursement Revisions.” No doubt most doctors missed this, but the implications of this article for our patients discovered to have weak heart muscles and considered at high risk for sudden cardiac death could be profound.
That’s because Medicare (CMS) is considering the requirement for the same waiting period after diagnosis of a cardiomyopathy or myocardial infarction as that for permanent implantable cardiac defibrillators (ICDs). To this end, they issued a draft document that contains the new proposal for their use. Read more »
*This blog post was originally published at Dr. Wes*
I’ve been working for a couple of months on an in-depth article on personal defibrillators that are implanted beneath the skin of a person’s chest to shock a heart that starts shaking, thereby restoring its normal beating and preventing sudden death. Discussing these defibrillators is extremely complex, which is why I am spending so much time on researching and writing the article intended to help patients and their families make an informed decision by learning the truth about the devices known as implantable cardioverter defibrillators (ICDs) — the good and the bad, your life saved vs nothing happening or the accompanying risks and harm you may receive. So when I heard that a new study would be presented at the annual scientific meeting this week of the Heart Rhythm Society, a professional organization of cardiologists and electrophysiologists who use cardiac devices in their patients, I made sure to get an advance copy of what would be presented and interview the lead author.
Potentially such a study would be of interest to physicians and to patients considering getting an ICD because it looked at all shocks the defibrillators gave the heart in patients who took part in the clinical trial, including those sent for life-threatening rhythms and in error. For several reasons, I felt the study is not ready to report to the public. It is only an abstract. The full study has not yet been written, let alone published in a peer-reviewed journal or even accepted for publication. Patients with defibrillators who received shocks were matched to only one other patient who was not shocked, but the two patients were not matched for what other illnesses or poor quality of health they had. Yet they were matched to see who lived the longest and the study looked at death for all causes, not just heart-related. One critical question the study sought to answer was this: Do the shocks themselves cause a shortened life (even if they temporarily save it) or is a shortened life the result of the types of heart rhythms a person experiences? Read more »
*This blog post was originally published at HeartSense*
The end of the year marks a time for list-intensive posts. Recently Larry Husten from CardioExchange and CardioBrief asked for my opinion on the three most important cardiology-related news stories of 2010. Additionally, he wanted three predictions for 2011. Here goes:
Top Cardiology Stories Of 2010:
1. By far, the #1 heart story of 2010 was the release of the novel blood-thinning drug dabigatran (Pradaxa) for the prevention of stroke in atrial fibrillation. Until this October, the only way to reduce stroke risk in AF was warfarin, the active ingredient in rat poison. Assuming that there aren’t any post-market surprises, Pradaxa figures to be a true blockbuster. Doctors and patients have waited a long time to say goodbye to warfarin.
2. The Dr. Mark Midei stent story: Whether Dr. Midei is guilty or innocent of implanting hundreds of unnecessary stents isn’t really the big story. The real impact of this well-chronicled saga is the attention that it brings to the therapeutic misconceptions of coronary stenting. The problem with squishing and stenting is that although they improve the physics (of bloodflow), they do not change the biology of arterial disease — a hard concept to grasp when staring at a picture of a partial blockage. The vast press coverage of Dr. Midei’s alleged transgressions has served to educate many about heart disease, the nation’s #1 killer. Read more »
*This blog post was originally published at Dr John M*