Aims and Scope
Feasibility of Telephone-Based Cardiology Consultation: Comparison of Resource Use and Outcomes vs In-Person ConsultationMartin E. Matsumura, Kelly Austin, Yasser Khalil, James C. Blankenship, Bryan Martin
The COVID-19 (Coronavirus infectious disease 2019) pandemic has highlighted the need for alternative modalities to connect with outpatients beyond in-person clinic visits. In the present study, we evaluated the feasibility of a telephone-based teleconsultation cardiology service and compared the use of testing and outcomes between teleconsultation and traditional in-office consultations
The study took place prior to the COVID-19 pandemic July 2019 to March 2020. Consult lists were reviewed by a cardiologist for patients appropriate for teleconsultation. Those patients were contacted directly and, if agreeable, a consultation was completed and any required testing was arranged. A series of patients seen in the clinic, matched for a reason for consultation and consulting a cardiologist, were compared in terms of testing frequency and outcomes.
Of 157 patients who felt appropriate for teleconsultation, 100 (63.7%) were successfully contacted and a teleconsultation was completed. Comparing patients undergoing teleconsultation with a matched series of patients seen in person in the clinic, there were no significant differences in testing utilization or outcomes, including emergency room or hospital admission within 30 days of consultation or death or adverse cardiac events at six months following consultation.
Telemedicine can be successfully utilized as an alternative to traditional clinic consultation for selected patients needing cardiology consultation. This consultative modality does not appear to lead to utilization of increased testing or decreased quality or patient outcomes. Larger studies are needed to assess this mode of consultation.
August 24, 2021
- August 20, 2021
- April 19, 2021
- February 15, 2021
- March 22, 2021
- August 20, 2021
- August 24, 2021
The Role of Echocardiography in the Optimization of Cardiac Resynchronization Therapy: Current Evidence and Future PerspectivesMichael Spartalis, Eleni Tzatzaki, Eleftherios Spartalis, Christos Damaskos, Antonios Athanasiou, Efthimios Livanis, Vassilis Voudris
Cardiac resynchronization therapy (CRT) has become a mainstay in the management of heart failure. Up to one-third of patients who received resynchronization devices do not experience the full benefits of CRT. The clinical factors influencing the likelihood to respond to the therapy are wide QRS complex, left bundle branch block, female gender, non-ischaemic cardiomyopathy (highest responders), male gender, ischaemic cardiomyopathy (moderate responders) and narrow QRS complex, non-left bundle branch block (lowest, non-responders).
This review provides a conceptual description of the role of echocardiography in the optimization of CRT.
A literature survey was performed using PubMed database search to gather information regarding CRT and echocardiography.
A total of 70 studies met selection criteria for inclusion in the review. Echocardiography helps in the initial selection of the patients with dyssynchrony, which will benefit the most from optimal biventricular pacing and provides a guide to left ventricular (LV) lead placement during implantation. Different echocardiographic parameters have shown promise and can offer the possibility of patient selection, response prediction, lead placement optimization strategies and optimization of device configurations.
LV ejection fraction along with specific electrocardiographic criteria remains the cornerstone of CRT patient selection. Echocardiography is a non-invasive, cost-effective, highly reproducible method with certain limitations and accuracy that is affected by measurement errors. Echocardiography can assist with the identification of the appropriate electromechanical substrate of CRT response and LV lead placement. The targeted approach can improve the haemodynamic response, as also the patient-specific parameters estimation.
December 19, 2017
- November 17, 2017
- November 16, 2017
- September 30, 2017
- September 30, 2017
- January 24, 2017
- January 15, 2016