Norwegian studies indicate that people with osteoporosis have a greater risk of developing cardiovascular disease, and vice versa. Now researchers believe they have found a biological system that may influence both disease processes.
Today over 400 000 Norwegians have some form of cardiovascular disease, according to figures from the Norwegian Society of Public Health. These diseases are the most frequent cause of death of both men and women in Norway.
Osteoporosis is another common, widespread disease. One-half of all Norwegian women and one-fourth of all Norwegian men will experience at least one bone fracture after they have turned 50.
Now it appears that in some cases the same mechanism is at work in both disease processes, making us more vulnerable to osteoporosis and heart attack and stroke.
Greater risk of stroke
Osteoporosis is a disease in which a reduction of the mineral content of the bones results in low bone density. In 2001, Professor Lone J??rgensen and her colleagues at the University of Troms?? published a study showing that women who had suffered a stroke had much lower bone density than other women of the same age.
"This finding piqued our interest in looking for potential connections between osteoporosis and atherosclerosis ('hardening of the arteries'). Atherosclerosis is a disease in which fatty material, calcium and connective tissue collect along the walls of arteries. It is a common cause of stroke and other cardiovascular diseases," Dr J??rgensen explains.
The researchers carried out a project to study some of the possible connections between osteoporosis and the risk of developing cardiovascular disease using data from about 6 000 men and women who participated in a special survey in 1994-1995 and 2001-2002, which was part of the comprehensive Troms?? study of cardiovascular diseases. The project ran from 2006 to 2009, and was funded by the Research Council's allocations earmarked for women's health research.
A possible connection found
"It appears there is a connection between low bone density and the type of atherosclerotic changes that are rich in connective tissue and calcium. Women who exhibit these changes also have a higher risk of bone fracture," Dr J??rgensen says.
In many cases, a person may develop osteoporosis and suffer a heart attack for completely different reasons. But there may be a causal relationship between the diseases. Data from several research groups now indicate that a biological system involving osteoprotegerin (OPG), among other things, may be a common denominator.
"We have found that bone loss is linked to a high level of OPG in post-menopausal women. In addition, we see that a high level of OPG also predicts the development of atherosclerosis in women," she continues.
Prevention
The researchers want to learn more about the role played by the system of which OPG is a part.
"Our contribution will be to find out as much as possible about the connections between these One-half of all Norwegian women and one-fourth of all Norwegian men will experience at least one bone fracture after they have turned 50.diseases in the population in general and the factors that influence them. We hope that our findings will help to develop methods of preventing these serious diseases," Dr J??rgensen concludes.
Sources: Research Council of Norway, AlphaGalileo Foundation.
понедельник, 6 июня 2011 г.
воскресенье, 5 июня 2011 г.
Osteoporosis Drugs Increase Risk For Heart Problems
People who take bisphosphonates
for osteoporosis may be at risk for serious atrial fibrillation (AF), or
irregular heartbeats, according to a new study. The research, presented at
CHEST 2008, the 74th annual international scientific assembly of the
American College of Chest Physicians (ACCP), shows that people taking
alendronate or zoledronic acid, two common medications to prevent or slow
the occurrence of osteoporosis, were significantly more likely to
experience serious AF, including hospitalization or death, compared with
placebo.
"Atrial fibrillation can be serious if it is persistent or occurs in
people with preexisting heart disease or hypertension," said Jennifer
Miranda, MD, Jackson Memorial Hospital, Miami, FL. "If left untreated, it
can lead to pulmonary edema, congestive heart failure, or the formation of
a blood clot that can cause a brain embolism and stroke."
In a metaanalysis, Dr. Miranda and colleagues from the University of
Miami evaluated the relationship between the use of bisphosphonates and AF,
a condition that can produce a wide range of symptoms, including
light-headedness, palpitations, chest pain, and shortness of breath, or no
symptoms at all. Three studies met eligibility criteria and included a
total of 16,322 patients, of whom 76 to 100 percent were women using
bisphosphonates for osteoporosis with a mean age range 69 to 75 years.
Patients in the study were taking alendronate or zoledronic acid. The
analysis showed that 2.5 to 3 percent of patients taking bisphosphonates
experienced atrial fibrillation and 1 to 2 percent experienced serious AF,
including hospitalization or death. Patients taking bisphosphonates were
more likely to experience AF than patients receiving placebo and up to two
times more likely to experience serious AF than patients receiving placebo.
"In patients with increased risk factors for atrial fibrillation,
clinicians should be more cautious when choosing treatment for osteoporosis
and weigh the risks against the benefit of decreased fracture risk," said
Dr. Miranda.
"Bisphosphonates are widely used to treat millions of women and men who
suffer from osteoporosis or low bone density," said James A. L. Mathers,
Jr., MD, FCCP, President of the American College of Chest Physicians. "A
potential link between bisphosphonates and atrial fibrillation warrants
additional research in this area."
CHEST 2008 is the 74th annual international scientific assembly of the
American College of Chest Physicians, held October 25-30 in Philadelphia,
PA. ACCP represents 17,000 members who provide patient care in the areas of
pulmonary, critical care, and sleep medicine in the United States and
throughout the world. The ACCP's mission is to promote the prevention and
treatment of diseases of the chest through leadership, education, research,
and communication. For more information about the ACCP, please visit the
ACCP Web site at chestnet.
American College of Chest Physicians
chestnet
for osteoporosis may be at risk for serious atrial fibrillation (AF), or
irregular heartbeats, according to a new study. The research, presented at
CHEST 2008, the 74th annual international scientific assembly of the
American College of Chest Physicians (ACCP), shows that people taking
alendronate or zoledronic acid, two common medications to prevent or slow
the occurrence of osteoporosis, were significantly more likely to
experience serious AF, including hospitalization or death, compared with
placebo.
"Atrial fibrillation can be serious if it is persistent or occurs in
people with preexisting heart disease or hypertension," said Jennifer
Miranda, MD, Jackson Memorial Hospital, Miami, FL. "If left untreated, it
can lead to pulmonary edema, congestive heart failure, or the formation of
a blood clot that can cause a brain embolism and stroke."
In a metaanalysis, Dr. Miranda and colleagues from the University of
Miami evaluated the relationship between the use of bisphosphonates and AF,
a condition that can produce a wide range of symptoms, including
light-headedness, palpitations, chest pain, and shortness of breath, or no
symptoms at all. Three studies met eligibility criteria and included a
total of 16,322 patients, of whom 76 to 100 percent were women using
bisphosphonates for osteoporosis with a mean age range 69 to 75 years.
Patients in the study were taking alendronate or zoledronic acid. The
analysis showed that 2.5 to 3 percent of patients taking bisphosphonates
experienced atrial fibrillation and 1 to 2 percent experienced serious AF,
including hospitalization or death. Patients taking bisphosphonates were
more likely to experience AF than patients receiving placebo and up to two
times more likely to experience serious AF than patients receiving placebo.
"In patients with increased risk factors for atrial fibrillation,
clinicians should be more cautious when choosing treatment for osteoporosis
and weigh the risks against the benefit of decreased fracture risk," said
Dr. Miranda.
"Bisphosphonates are widely used to treat millions of women and men who
suffer from osteoporosis or low bone density," said James A. L. Mathers,
Jr., MD, FCCP, President of the American College of Chest Physicians. "A
potential link between bisphosphonates and atrial fibrillation warrants
additional research in this area."
CHEST 2008 is the 74th annual international scientific assembly of the
American College of Chest Physicians, held October 25-30 in Philadelphia,
PA. ACCP represents 17,000 members who provide patient care in the areas of
pulmonary, critical care, and sleep medicine in the United States and
throughout the world. The ACCP's mission is to promote the prevention and
treatment of diseases of the chest through leadership, education, research,
and communication. For more information about the ACCP, please visit the
ACCP Web site at chestnet.
American College of Chest Physicians
chestnet
суббота, 4 июня 2011 г.
VCR - First US implant
Ventracor Limited (ASX: VCR) announced today the first implant in the United States of the VentrAssistTM Left Ventricular Assist System (LVAS).
The procedure was performed by a team led by Professor Bartley P. Griffith, M.D. at the University of Maryland Medical Center in Baltimore. The first US implant of the VentrAssist is part of an FDA-approved feasibility study in 10 patients at up to five hospitals across the United States. The trial is managed in part by the International Center for Health Outcomes and Innovation Research (InCHOIR).
Dr. Griffith said: "We are very pleased to participate in the clinical trial of the VentrAssist, and hope that this new technology will be shown to provide new hope for the thousands of people suffering from end stage heart failure."
Ventracor Limited Chief Executive Officer, Colin Sutton PhD, said: "With each implant, we are adding to the body of clinical evidence and experience. The first VentrAssist implant in the United States was only possible due to the tireless work and dedication of a worldwide team of people in Australia, US and Europe." Dr Sutton noted that to date nearly 30 patients had been implanted with the VentrAssist globally.
Dr. Griffith - is Chief of the Division of Cardiac Surgery and Director of Heart and Lung Transplantation in the Department of Surgery at the University of Maryland Medical Center and is a Professor of Surgery at the University of Maryland School of Medicine. Prior to his arrival at the University of Maryland, Dr. Griffith served as Vice Chair, Department of Surgery at the University of Pittsburgh School of Medicine, where he was also Chief of Cardiothoracic Surgery and the Henry T. Bahnson Professor of Surgery.
Congestive Heart Failure - in the United States, congestive heart failure (CHF) affects about five million people, or two percent of the population. There are an estimated 550,000 new cases diagnosed each year, and around 45,000 deaths from CHF.
Ventracor - is a global medical device company that has developed a blood pump, the VentrAssistTM left ventricular assist system (LVAS) for patients in cardiac failure. The company hopes to bring the VentrAssistTM to the global market in record time, and expects to obtain a significant share of the huge potential market.
Andrew Geddes
infoventracor
61-294-063-086
Research Australia
researchaustralia.au
The procedure was performed by a team led by Professor Bartley P. Griffith, M.D. at the University of Maryland Medical Center in Baltimore. The first US implant of the VentrAssist is part of an FDA-approved feasibility study in 10 patients at up to five hospitals across the United States. The trial is managed in part by the International Center for Health Outcomes and Innovation Research (InCHOIR).
Dr. Griffith said: "We are very pleased to participate in the clinical trial of the VentrAssist, and hope that this new technology will be shown to provide new hope for the thousands of people suffering from end stage heart failure."
Ventracor Limited Chief Executive Officer, Colin Sutton PhD, said: "With each implant, we are adding to the body of clinical evidence and experience. The first VentrAssist implant in the United States was only possible due to the tireless work and dedication of a worldwide team of people in Australia, US and Europe." Dr Sutton noted that to date nearly 30 patients had been implanted with the VentrAssist globally.
Dr. Griffith - is Chief of the Division of Cardiac Surgery and Director of Heart and Lung Transplantation in the Department of Surgery at the University of Maryland Medical Center and is a Professor of Surgery at the University of Maryland School of Medicine. Prior to his arrival at the University of Maryland, Dr. Griffith served as Vice Chair, Department of Surgery at the University of Pittsburgh School of Medicine, where he was also Chief of Cardiothoracic Surgery and the Henry T. Bahnson Professor of Surgery.
Congestive Heart Failure - in the United States, congestive heart failure (CHF) affects about five million people, or two percent of the population. There are an estimated 550,000 new cases diagnosed each year, and around 45,000 deaths from CHF.
Ventracor - is a global medical device company that has developed a blood pump, the VentrAssistTM left ventricular assist system (LVAS) for patients in cardiac failure. The company hopes to bring the VentrAssistTM to the global market in record time, and expects to obtain a significant share of the huge potential market.
Andrew Geddes
infoventracor
61-294-063-086
Research Australia
researchaustralia.au
пятница, 3 июня 2011 г.
What Is A Mini-Stroke? What Is A Transient Ischemic Attack (TIA)?
A mini-stroke, or transient ischemic attack (TIA) occurs when there is a temporary drop in the blood supply to the brain, depriving it of essential oxygen. The patient experiences stroke-like symptoms, although they don't last as long. A mini-stroke only lasts a few minutes and disappears within a day.
In other words, a TIA is like a stroke, produces similar symptoms, but only lasts a few minutes and causes no permanent damage.
Health experts say a TIA may be a warning. Approximately 30% of people who have a TIA eventually go on to have a stroke. Half of that 30% have a stroke within a year of their TIA. Although some may call it a warning, it may also be seen as an opportunity to take steps to prevent a full blown stroke.
According to Medilexicon's medical dictionary, a Transient Ischemic Attack is "a sudden focal loss of neurologic function with complete recovery usually within 24 hours; caused by a brief period of inadequate perfusion in a portion of the territory of the carotid or vertebral basilar arteries."
What are the signs and symptoms of a TIA (mini-stroke)?
A symptom is something the patient experiences or reports, such as a headache, while a sign is something others detect, such as a rash. The signs and symptoms of a TIA are represented by the abbreviation FAST (Face, Arms, Speech, Time):
Face - the face may fall on one side as some of the facial muscles become paralyzed. The patient's eye or mouth may droop, and he/she may be unable to smile properly.
Arms - arm weakness or numbness might make it hard for the patient to either raise both arms, or to keep them raised.
Speech - speech may be slurred and garbled.
Time - when you see at least one of these symptoms it is Time to dial emergency services (911 in USA, 999 in UK).
If signs and symptoms last more than 24 hours or cause lasting brain damage, it's considered a stroke. Do not wait 24 hours to find out!
Being able to identify the signs and symptoms present in FAST is especially important if you live with somebody in a high risk group, such as an elderly person, or an individual with hypertension (high blood pressure) or diabetes.
Other signs and symptoms include:
Dizziness
Difficulty talking
Difficulty understand what others are talking about
Swallowing difficulties
Very bad headache
Paralysis, numbness or weakness on one side of the body
In severe cases, loss of consciousness
If you or somebody else has at least three of these signs and symptoms medical attention should be sought immediately.
TIA symptoms are temporary and should disappear within 24 hours. They may last from a couple of minutes to 15 minutes. TIA sufferers experience varying symptoms, depending on which part of the brain is affected.
In some cases a TIA may be a prelude to a full stroke, in which case permanent and possibly serious damage occurs. Prompt medical attention and treatment significantly reduces the risk of experiencing another TIA or stroke.
In other words - if think that you, or somebody else, is having a TIA, get medical attention immediately.
What are the causes of a TIA?
Disruption of blood supply to the brain
Two main blood vessels - the carotid arteries - supply blood to the brain. These arteries branch off into many smaller blood vessels which provide the whole of the brain with essential nutrients, such as blood, glucose, and oxygen. A TIA can occur if one of the smaller blood vessels becomes blocked, depriving that part of the brain of oxygen-rich blood.
In the case of a TIA, the blocked blood supply is temporary and the affected part of the brain soon returns to normal. When a full stroke occurs the oxygen-rich blood supply is disrupted for much longer, causing brain cells to die.
Blood supply to parts of the brain is usually disrupted because of a narrowing of the arteries (stenosis) or the formation of a blood clot.
Atherosclerosis
Atherosclerosis causes arteries to narrow (stenosis). Fatty deposits (plaque) develop on the inner lining of blood cells, causing them to become hardened, thickened and less flexible - resulting in more difficulties with blood flow.
Blood clots
A blood clot can disrupt the supply of oxygen-rich blood to parts of the brain. Blood clots are usually caused by:
Heart conditions - congestive heart muscle disease or atrial fibrillation are common causes of blood clots.
Blood conditions - leukemia (blood cell cancer), sickle cell anemia, hyperlipidemia (high blood fat levels), polycythemia (very thick blood), or thrombocyemia (overproduction of blood platelets) are common causes of blood clots.
Infections - phlebitis can cause blood clots.
An embolism can cause a TIA, and even a full blown stroke. A blood clot from a blood vessel in another part of the body becomes dislodged and travels into one of the arteries that supplies blood to the brain.
Hemorrhage (internal bleeding)
A minor brain hemorrhage (small amount of bleeding in the brain) can cause a TIA; however, this is rare.
What are the risk factors for TIA?
There are some risk factors we can change, and others we can't.
Risk factors we cannot change:
A family history - people with a family history of TIA or stroke, i.e. people with a close relative who has had a stroke or TIA, have a higher risk of experiencing one themselves.
Age - people aged 55 years or more have a higher risk of TIAs compared to younger people. The older you get, the higher the risk becomes.
Sex - males have a slightly higher risk of stroke and/or TIA than women.
Ethnic origin - people of black African ancestry have a higher risk of stroke and TIA than others.
Risk factors we can change:
Hypertension - people with high blood pressure have a significantly higher risk of developing a TIA, compared to people of normal blood pressure. Hypertension means the patient's systolic blood pressure is 140 mm hg or higher, and diastolic pressure is mm hg or higher.
Cardiovascular disease - people with cardiovascular diseases have a higher risk of stroke and/or TIA. This includes a heart defect, heart failure or arrhythmia (abnormal heart rhythm).
Carotid artery disease - this is when the blood vessels in the neck that lead to the brain are clogged.
PAD (peripheral artery disease) - people whose blood vessels that carry blood to their arms and legs become clogged have a higher risk of stroke and TIA.
Smoking - smoking increases the risk of various diseases and conditions, including TIA, stroke, blood clots, heart attack, cardiovascular disease, cancer, erectile dysfunction, and blindness in old age.
Sedentary lifestyle - people who are physically inactive have a significantly higher risk of stroke or TIA compared to people who do 30 minutes of moderate exercise at least 5 times per week.
Diabetes - patients with diabetes are more likely to suffer from atherosclerosis (narrowing of the arteries due to a build up of fatty deposits), raising the risk of stroke or TIA. This is especially the case if the diabetes is poorly controlled.
Bad diet - people who consume too much bad qualtiy fat and/or salt have a higher risk of stroke and TIA.
Blood cholesterol levels - if your blood cholesterol level is at least 200 mg/dL or 5.2 mmol/L you have a higher risk of TIA or stroke.
Homocysteine levels - homocysteine is an amino acid produced by the body. It is usually a byproduct of consuming meat. It is made from another amino acid, methionine, and then is concerted into other amino acids. Elevated levels of homocysteine in the blood can make the arteries thicken and scar, and more susceptible to clogs, resulting in a higher risk of stroke and TIA.
Bodyweight - obese people have a significantly higher risk of stroke or TIA than people of normal body weight.
Alcohol - people who drink large quantities of alcohol regularly are much more likely to have a stroke or TIA than people who never drink or drink within recommended limits.
Illegal drugs - some illegal drugs, such as cocaine, can raise the risk of stroke or TIA if taken often enough.
How is a TIA diagnosed?
Anybody who has signs and symptoms of a TIA should seek medical attention immediately. As TIAs do not last very long it is most likely the patient will have no symptoms by the time he/she gets to see the doctor.
The GP (general practitioner, primary care physician) or hospital doctor may need to carry out a neurological examination, even if symptoms have gone. This will include some simple tasks to check skills, such as memory and coordination. While being examined the patient will be asked questions regarding symptoms, such as how long they lasted, what they were like, and how they affected the patient. This will help the doctor discard any other conditions which may have similar symptoms.
If the GP, or non-specialized doctor or health care professional believes the patient may have had a TIA he/she will be referred to a neurologist for further testing. A neurologist is a doctor specialized in the diagnosis and treatment of disorders of the nervous system - the brain, spinal cord and the nerves. In the UK and many other countries the patient may be referred to a neurologist who specializes in strokes, or a specialist TIA clinic.
The specialist may order a number of tests designed to identify the underlying factors or conditions which may have caused the TIA.
Blood tests
Blood pressure - the patient's blood pressure will be checked for hypertension.
Blood clotting test - this is to find out how likely the patient's blood is to clot.
Blood cholesterol test - this test determines whether the patient's blood cholesterol level is high.
Electrocardiogram (ECG) - this device records the electrical activity and rhythms of the patient's heart. Electrodes are attached to the patient's skin and impulses are recorded as waves are displayed on a screen (or printed on paper). The test may also reveal any damage to the heart from a heart attack.
Echocardiogram - this is an ultrasound scan that checks the pumping action of the patient's heart. This test also helps distinguish systolic heart failure from diastolic heart failure (the heart is stiff and does not fill properly). Sound waves are used to create a video image of the patient's heart, which helps the doctor see how well the heart is pumping. The doctor measures the percentage of blood pumped out of the patient's left ventricle (the main pumping chamber) with each heartbeat - this measurement is called the ejection fraction.
Chest X-ray - this test helps the doctor rule out any other illness or health condition.
Computerized tomography (CT) scan - a scanning device that creates a 3-D image that can show aneurysms, bleeding, or abnormal vessels within the brain. It can also reveal whether there is a tumor.
Magnetic resonance imaging (MRI) scan - a magnetic field generates a 3-D view of the brain. An MRI can often give a more detailed view of the brain than a CT scan, and can help the doctor identify any brain damage.
Ultrasound - a wand waved over the carotid arteries in the neck can provide a picture that indicates any narrowing or clotting.
What are the treatment options for TIAs?
When the doctor has identified what caused the TIA his/her aim is to treat it, thus minimizing the risk of a subsequent stroke. The doctor may prescribe medication which lowers the risk of a blood clot, or recommend surgery or an angioplasty; this will depend on the cause of the TIA.
Medications
The type of medication(s) prescribed will depend on what caused the TIA, how severe it was, and what part of the brain was affected.
Anti-platelet drugs
These make the platelets less likely to stick together. When a blood vessel has a lesion platelets start forming clots by initially sticking to each other.
Aspirin and dipyridamole - drugs, such as aspirin make the platelets less sticky and lower the risk of undesirable blood clots. Aspirin is commonly prescribed because it is cheap and has few side-effects. Some doctors may prescribe Aggrenox - this drug contains both aspirin as well as dipyridamole, another anti-platelet medication. Some doctors may recommend ticlopidine (Ticlid).
Side effects of aspirin may include:
Indigestion
Nausea
Stomach irritation
Side effects of dipyridamole may include:
Diarrhea
Dizziness
Headaches
Nausea
Clopidogrel - the doctor may prescribe clopidogrel (Plavix) if the patient experienced severe side effects from taking aspirin, had a further TIA despite taking aspirin, or has arterial disease.
Side effects of clopidogrel may include:
Abdominal pain
Bleeding
Bruising
Diarrhoea
Indigestion
Anticoagulants
Examples of anticoagulants are warfarin (Coumadin) and heparin. Warfarin can be used long-term, while heparin is used short-term. Patients on anticoagulants need to be monitored closely.
Warfarin - this is the most commonly used anticoagulant for the prevention of subsequent TIAs. The doctor has to make sure that warfarin thins the patient's blood enough, but not so much that there is a risk of internal bleeding. Patients will have to undergo regular blood tests (INR - international normalized ratio tests).
The most serious undesirable side effect of warfarin is bleeding. Any patient on warfarin who has any of the following symptoms should tell his/her doctor immediately:
-- Blood in urine
-- Blood in feces (either specs of blood, or feces are black)
-- Severe bruising
-- Nosebleeds that persist for more than ten minutes
-- Blood in vomit
-- Coughing up blood
-- Unexplained headaches
-- Bleeding from the vagina
-- Heavy or increased bleeding during menstruation
Medications for hypertension - hypertension (high blood pressure) needs to be controlled as it is an important risk factor for stroke and TIA. There are many different types of antihypertensive drugs. A doctor may prescribe one, or a combination. If the patient is unfit and overweight hypertension can often be brought down by losing weight, doing exercise, getting at least 7 hours good quality sleep every night, and eating a well balanced healthy diet.
Cholesterol medication - high blood cholesterol levels significantly increase a patient's risk of stroke and TIA. As with hypertension, losing weight, following a well balanced diet, doing regular exercise, and sleeping at least 7 hours every night can help bring cholesterol levels back to normal. Sometimes medications are necessary and the patient may be prescribed a statin, which helps reduce the production of cholesterol.
Surgery - Carotid endarterectomy - this operation involves removing part of the lining of the damaged carotid artery, as well as any blockage that has accumulated in the artery. The carotid arteries deliver blood to the brain. When plaques (fatty deposits) accumulate inside them they become narrow and hard, making it more difficult for blood to flow through them (atherosclerosis).
This operation is not suitable for patients whose arteries are nearly completely blocked. Even some patients with partial blockage may not be suitable for this procedure because of the risk of stroke during the operation.
Prevention of TIAs or mini-strokes
The measures below can help you reduce your risks of having a mini-stroke (TIA), stroke, or a recurrent TIA:
Give up smoking - the moment you stop smoking your risk of stroke, TIA and many other conditions and diseases goes down significantly, and continues dropping each month.
Diet - follow a well balanced diet, with plenty of fruit and vegetables, whole grains, fish, poultry and very lean meat. Avoid all junk foods and foods with bad fats, such as saturated and trans fats.
Salt (sodium) intake - if you have high blood pressure, or tend to have high blood pressure, avoid salty foods and do not add salt to your cooking.
Physical exercise - exercise moderately for at least 30 minutes five times a week. Check with your doctor whether you can do this.
Sensible alcohol consumption - either don't drink alcohol at all, or stay within the daily recommended limits.
Body weight - if you are overweight or obese and can bring your body weight down to normal for your height and age your risk of stroke or TIA will go down dramatically, as will your risk of developing several other diseases and conditions.
Illegal drugs - many illegal drugs, such as cocaine, significantly raise your risk of stroke and TIA. Even illegal drugs which are seen not to be particularly harmful are made without inspectors and quality control guarantees (you really don't know what is in them). Avoiding them may help reduce your risks.
Diabetes - good diabetes control, i.e. following your diabetes treatment properly, greatly reduces your risks of stroke and TIA.
Sleep - make sure you get at least 7 hours good quality, continuous sleep every day.
View drug information on Aggrenox; Plavix; Warfarin Sodium tablets.
In other words, a TIA is like a stroke, produces similar symptoms, but only lasts a few minutes and causes no permanent damage.
Health experts say a TIA may be a warning. Approximately 30% of people who have a TIA eventually go on to have a stroke. Half of that 30% have a stroke within a year of their TIA. Although some may call it a warning, it may also be seen as an opportunity to take steps to prevent a full blown stroke.
According to Medilexicon's medical dictionary, a Transient Ischemic Attack is "a sudden focal loss of neurologic function with complete recovery usually within 24 hours; caused by a brief period of inadequate perfusion in a portion of the territory of the carotid or vertebral basilar arteries."
What are the signs and symptoms of a TIA (mini-stroke)?
A symptom is something the patient experiences or reports, such as a headache, while a sign is something others detect, such as a rash. The signs and symptoms of a TIA are represented by the abbreviation FAST (Face, Arms, Speech, Time):
Face - the face may fall on one side as some of the facial muscles become paralyzed. The patient's eye or mouth may droop, and he/she may be unable to smile properly.
Arms - arm weakness or numbness might make it hard for the patient to either raise both arms, or to keep them raised.
Speech - speech may be slurred and garbled.
Time - when you see at least one of these symptoms it is Time to dial emergency services (911 in USA, 999 in UK).
If signs and symptoms last more than 24 hours or cause lasting brain damage, it's considered a stroke. Do not wait 24 hours to find out!
Being able to identify the signs and symptoms present in FAST is especially important if you live with somebody in a high risk group, such as an elderly person, or an individual with hypertension (high blood pressure) or diabetes.
Other signs and symptoms include:
Dizziness
Difficulty talking
Difficulty understand what others are talking about
Swallowing difficulties
Very bad headache
Paralysis, numbness or weakness on one side of the body
In severe cases, loss of consciousness
If you or somebody else has at least three of these signs and symptoms medical attention should be sought immediately.
TIA symptoms are temporary and should disappear within 24 hours. They may last from a couple of minutes to 15 minutes. TIA sufferers experience varying symptoms, depending on which part of the brain is affected.
In some cases a TIA may be a prelude to a full stroke, in which case permanent and possibly serious damage occurs. Prompt medical attention and treatment significantly reduces the risk of experiencing another TIA or stroke.
In other words - if think that you, or somebody else, is having a TIA, get medical attention immediately.
What are the causes of a TIA?
Disruption of blood supply to the brain
Two main blood vessels - the carotid arteries - supply blood to the brain. These arteries branch off into many smaller blood vessels which provide the whole of the brain with essential nutrients, such as blood, glucose, and oxygen. A TIA can occur if one of the smaller blood vessels becomes blocked, depriving that part of the brain of oxygen-rich blood.
In the case of a TIA, the blocked blood supply is temporary and the affected part of the brain soon returns to normal. When a full stroke occurs the oxygen-rich blood supply is disrupted for much longer, causing brain cells to die.
Blood supply to parts of the brain is usually disrupted because of a narrowing of the arteries (stenosis) or the formation of a blood clot.
Atherosclerosis
Atherosclerosis causes arteries to narrow (stenosis). Fatty deposits (plaque) develop on the inner lining of blood cells, causing them to become hardened, thickened and less flexible - resulting in more difficulties with blood flow.
Blood clots
A blood clot can disrupt the supply of oxygen-rich blood to parts of the brain. Blood clots are usually caused by:
Heart conditions - congestive heart muscle disease or atrial fibrillation are common causes of blood clots.
Blood conditions - leukemia (blood cell cancer), sickle cell anemia, hyperlipidemia (high blood fat levels), polycythemia (very thick blood), or thrombocyemia (overproduction of blood platelets) are common causes of blood clots.
Infections - phlebitis can cause blood clots.
An embolism can cause a TIA, and even a full blown stroke. A blood clot from a blood vessel in another part of the body becomes dislodged and travels into one of the arteries that supplies blood to the brain.
Hemorrhage (internal bleeding)
A minor brain hemorrhage (small amount of bleeding in the brain) can cause a TIA; however, this is rare.
What are the risk factors for TIA?
There are some risk factors we can change, and others we can't.
Risk factors we cannot change:
A family history - people with a family history of TIA or stroke, i.e. people with a close relative who has had a stroke or TIA, have a higher risk of experiencing one themselves.
Age - people aged 55 years or more have a higher risk of TIAs compared to younger people. The older you get, the higher the risk becomes.
Sex - males have a slightly higher risk of stroke and/or TIA than women.
Ethnic origin - people of black African ancestry have a higher risk of stroke and TIA than others.
Risk factors we can change:
Hypertension - people with high blood pressure have a significantly higher risk of developing a TIA, compared to people of normal blood pressure. Hypertension means the patient's systolic blood pressure is 140 mm hg or higher, and diastolic pressure is mm hg or higher.
Cardiovascular disease - people with cardiovascular diseases have a higher risk of stroke and/or TIA. This includes a heart defect, heart failure or arrhythmia (abnormal heart rhythm).
Carotid artery disease - this is when the blood vessels in the neck that lead to the brain are clogged.
PAD (peripheral artery disease) - people whose blood vessels that carry blood to their arms and legs become clogged have a higher risk of stroke and TIA.
Smoking - smoking increases the risk of various diseases and conditions, including TIA, stroke, blood clots, heart attack, cardiovascular disease, cancer, erectile dysfunction, and blindness in old age.
Sedentary lifestyle - people who are physically inactive have a significantly higher risk of stroke or TIA compared to people who do 30 minutes of moderate exercise at least 5 times per week.
Diabetes - patients with diabetes are more likely to suffer from atherosclerosis (narrowing of the arteries due to a build up of fatty deposits), raising the risk of stroke or TIA. This is especially the case if the diabetes is poorly controlled.
Bad diet - people who consume too much bad qualtiy fat and/or salt have a higher risk of stroke and TIA.
Blood cholesterol levels - if your blood cholesterol level is at least 200 mg/dL or 5.2 mmol/L you have a higher risk of TIA or stroke.
Homocysteine levels - homocysteine is an amino acid produced by the body. It is usually a byproduct of consuming meat. It is made from another amino acid, methionine, and then is concerted into other amino acids. Elevated levels of homocysteine in the blood can make the arteries thicken and scar, and more susceptible to clogs, resulting in a higher risk of stroke and TIA.
Bodyweight - obese people have a significantly higher risk of stroke or TIA than people of normal body weight.
Alcohol - people who drink large quantities of alcohol regularly are much more likely to have a stroke or TIA than people who never drink or drink within recommended limits.
Illegal drugs - some illegal drugs, such as cocaine, can raise the risk of stroke or TIA if taken often enough.
How is a TIA diagnosed?
Anybody who has signs and symptoms of a TIA should seek medical attention immediately. As TIAs do not last very long it is most likely the patient will have no symptoms by the time he/she gets to see the doctor.
The GP (general practitioner, primary care physician) or hospital doctor may need to carry out a neurological examination, even if symptoms have gone. This will include some simple tasks to check skills, such as memory and coordination. While being examined the patient will be asked questions regarding symptoms, such as how long they lasted, what they were like, and how they affected the patient. This will help the doctor discard any other conditions which may have similar symptoms.
If the GP, or non-specialized doctor or health care professional believes the patient may have had a TIA he/she will be referred to a neurologist for further testing. A neurologist is a doctor specialized in the diagnosis and treatment of disorders of the nervous system - the brain, spinal cord and the nerves. In the UK and many other countries the patient may be referred to a neurologist who specializes in strokes, or a specialist TIA clinic.
The specialist may order a number of tests designed to identify the underlying factors or conditions which may have caused the TIA.
Blood tests
Blood pressure - the patient's blood pressure will be checked for hypertension.
Blood clotting test - this is to find out how likely the patient's blood is to clot.
Blood cholesterol test - this test determines whether the patient's blood cholesterol level is high.
Electrocardiogram (ECG) - this device records the electrical activity and rhythms of the patient's heart. Electrodes are attached to the patient's skin and impulses are recorded as waves are displayed on a screen (or printed on paper). The test may also reveal any damage to the heart from a heart attack.
Echocardiogram - this is an ultrasound scan that checks the pumping action of the patient's heart. This test also helps distinguish systolic heart failure from diastolic heart failure (the heart is stiff and does not fill properly). Sound waves are used to create a video image of the patient's heart, which helps the doctor see how well the heart is pumping. The doctor measures the percentage of blood pumped out of the patient's left ventricle (the main pumping chamber) with each heartbeat - this measurement is called the ejection fraction.
Chest X-ray - this test helps the doctor rule out any other illness or health condition.
Computerized tomography (CT) scan - a scanning device that creates a 3-D image that can show aneurysms, bleeding, or abnormal vessels within the brain. It can also reveal whether there is a tumor.
Magnetic resonance imaging (MRI) scan - a magnetic field generates a 3-D view of the brain. An MRI can often give a more detailed view of the brain than a CT scan, and can help the doctor identify any brain damage.
Ultrasound - a wand waved over the carotid arteries in the neck can provide a picture that indicates any narrowing or clotting.
What are the treatment options for TIAs?
When the doctor has identified what caused the TIA his/her aim is to treat it, thus minimizing the risk of a subsequent stroke. The doctor may prescribe medication which lowers the risk of a blood clot, or recommend surgery or an angioplasty; this will depend on the cause of the TIA.
Medications
The type of medication(s) prescribed will depend on what caused the TIA, how severe it was, and what part of the brain was affected.
Anti-platelet drugs
These make the platelets less likely to stick together. When a blood vessel has a lesion platelets start forming clots by initially sticking to each other.
Aspirin and dipyridamole - drugs, such as aspirin make the platelets less sticky and lower the risk of undesirable blood clots. Aspirin is commonly prescribed because it is cheap and has few side-effects. Some doctors may prescribe Aggrenox - this drug contains both aspirin as well as dipyridamole, another anti-platelet medication. Some doctors may recommend ticlopidine (Ticlid).
Side effects of aspirin may include:
Indigestion
Nausea
Stomach irritation
Side effects of dipyridamole may include:
Diarrhea
Dizziness
Headaches
Nausea
Clopidogrel - the doctor may prescribe clopidogrel (Plavix) if the patient experienced severe side effects from taking aspirin, had a further TIA despite taking aspirin, or has arterial disease.
Side effects of clopidogrel may include:
Abdominal pain
Bleeding
Bruising
Diarrhoea
Indigestion
Anticoagulants
Examples of anticoagulants are warfarin (Coumadin) and heparin. Warfarin can be used long-term, while heparin is used short-term. Patients on anticoagulants need to be monitored closely.
Warfarin - this is the most commonly used anticoagulant for the prevention of subsequent TIAs. The doctor has to make sure that warfarin thins the patient's blood enough, but not so much that there is a risk of internal bleeding. Patients will have to undergo regular blood tests (INR - international normalized ratio tests).
The most serious undesirable side effect of warfarin is bleeding. Any patient on warfarin who has any of the following symptoms should tell his/her doctor immediately:
-- Blood in urine
-- Blood in feces (either specs of blood, or feces are black)
-- Severe bruising
-- Nosebleeds that persist for more than ten minutes
-- Blood in vomit
-- Coughing up blood
-- Unexplained headaches
-- Bleeding from the vagina
-- Heavy or increased bleeding during menstruation
Medications for hypertension - hypertension (high blood pressure) needs to be controlled as it is an important risk factor for stroke and TIA. There are many different types of antihypertensive drugs. A doctor may prescribe one, or a combination. If the patient is unfit and overweight hypertension can often be brought down by losing weight, doing exercise, getting at least 7 hours good quality sleep every night, and eating a well balanced healthy diet.
Cholesterol medication - high blood cholesterol levels significantly increase a patient's risk of stroke and TIA. As with hypertension, losing weight, following a well balanced diet, doing regular exercise, and sleeping at least 7 hours every night can help bring cholesterol levels back to normal. Sometimes medications are necessary and the patient may be prescribed a statin, which helps reduce the production of cholesterol.
Surgery - Carotid endarterectomy - this operation involves removing part of the lining of the damaged carotid artery, as well as any blockage that has accumulated in the artery. The carotid arteries deliver blood to the brain. When plaques (fatty deposits) accumulate inside them they become narrow and hard, making it more difficult for blood to flow through them (atherosclerosis).
This operation is not suitable for patients whose arteries are nearly completely blocked. Even some patients with partial blockage may not be suitable for this procedure because of the risk of stroke during the operation.
Prevention of TIAs or mini-strokes
The measures below can help you reduce your risks of having a mini-stroke (TIA), stroke, or a recurrent TIA:
Give up smoking - the moment you stop smoking your risk of stroke, TIA and many other conditions and diseases goes down significantly, and continues dropping each month.
Diet - follow a well balanced diet, with plenty of fruit and vegetables, whole grains, fish, poultry and very lean meat. Avoid all junk foods and foods with bad fats, such as saturated and trans fats.
Salt (sodium) intake - if you have high blood pressure, or tend to have high blood pressure, avoid salty foods and do not add salt to your cooking.
Physical exercise - exercise moderately for at least 30 minutes five times a week. Check with your doctor whether you can do this.
Sensible alcohol consumption - either don't drink alcohol at all, or stay within the daily recommended limits.
Body weight - if you are overweight or obese and can bring your body weight down to normal for your height and age your risk of stroke or TIA will go down dramatically, as will your risk of developing several other diseases and conditions.
Illegal drugs - many illegal drugs, such as cocaine, significantly raise your risk of stroke and TIA. Even illegal drugs which are seen not to be particularly harmful are made without inspectors and quality control guarantees (you really don't know what is in them). Avoiding them may help reduce your risks.
Diabetes - good diabetes control, i.e. following your diabetes treatment properly, greatly reduces your risks of stroke and TIA.
Sleep - make sure you get at least 7 hours good quality, continuous sleep every day.
View drug information on Aggrenox; Plavix; Warfarin Sodium tablets.
четверг, 2 июня 2011 г.
Toshiba Introduces New X-Ray System With 12" X 12" Flat Panels And Hybrid Catheterization Table At ACC 2010
When working on patients in a hybrid setting, it is critical the imaging system provides outstanding image quality, as well as the flexibility to reach ancillary equipment and the patient quickly and easily. Designed to create a best-in-class hybrid suite, Toshiba America Medical Systems, Inc. will showcase its InfinixTM VF-i biplane system with two identical 12" x 12" flat panel detectors and the CAT 880B hybrid catheterization table at this year's American College of Cardiology (ACC) annual meeting in Atlanta, March 14 - 16, 2010 (Booth # 1944).
The new mid-sized 12" x 12??? flat panel detector expands the versatility of the Infinix-i line, which features a five-axis C-arm positioner and enables unprecedented patient access and coverage. The new mid-sized flat panel detector covers more anatomical area in one view. The ability to see more anatomy in one view reduces C-arm movement or table panning and decreases overall procedure time. The flexible system easily accommodates acquiring all standard views of the heart and is also beneficial when imaging anatomy outside the heart.
Along with the new mid-sized detector, the Infinix-i five-axis systems are now available with the new CAT 880B tilt/cradle hybrid catheterization table. This table is designed to allow greater positioning flexibility and patient access during imaging and surgery. The table functionality with side-to-side cradle and head-to-toe tilt permits clinicians to angle the table in the optimal position to quickly complete procedures. The flexibility and ergonomic design enhance the clinicians' ability to work around the patient and accommodate views that conventional angiographic tables cannot achieve.
The new hybrid catheterization table features a 550-pound table weight limit, making this table ideal for a range of patients, from pediatric to bariatric. It also allows for angulations of up to 16 degrees in all four directions and offers the lowest tabletop height of any catheterization table in the industry. The 75-cm table height is particularly important for open surgical procedures, as it provides ultimate patient access and physician comfort, regardless of the procedure being performed. With the new table, Toshiba's Infinix-i five-axis X-ray systems are designed to accommodate endovascular catheter based techniques, open surgical settings or a combined hybrid approach.
"Toshiba is dedicated to improving patient access and flexibility during procedures to enhance the quality of care," said Robert Micer, director, X-ray Vascular Business Unit. "Our Infinix VF-i vascular X-ray system with 12" x 12" flat panel detectors and CAT 880B hybrid catheterization create the ideal hybrid cath lab unmatched in the industry today."
Source
Toshiba
The new mid-sized 12" x 12??? flat panel detector expands the versatility of the Infinix-i line, which features a five-axis C-arm positioner and enables unprecedented patient access and coverage. The new mid-sized flat panel detector covers more anatomical area in one view. The ability to see more anatomy in one view reduces C-arm movement or table panning and decreases overall procedure time. The flexible system easily accommodates acquiring all standard views of the heart and is also beneficial when imaging anatomy outside the heart.
Along with the new mid-sized detector, the Infinix-i five-axis systems are now available with the new CAT 880B tilt/cradle hybrid catheterization table. This table is designed to allow greater positioning flexibility and patient access during imaging and surgery. The table functionality with side-to-side cradle and head-to-toe tilt permits clinicians to angle the table in the optimal position to quickly complete procedures. The flexibility and ergonomic design enhance the clinicians' ability to work around the patient and accommodate views that conventional angiographic tables cannot achieve.
The new hybrid catheterization table features a 550-pound table weight limit, making this table ideal for a range of patients, from pediatric to bariatric. It also allows for angulations of up to 16 degrees in all four directions and offers the lowest tabletop height of any catheterization table in the industry. The 75-cm table height is particularly important for open surgical procedures, as it provides ultimate patient access and physician comfort, regardless of the procedure being performed. With the new table, Toshiba's Infinix-i five-axis X-ray systems are designed to accommodate endovascular catheter based techniques, open surgical settings or a combined hybrid approach.
"Toshiba is dedicated to improving patient access and flexibility during procedures to enhance the quality of care," said Robert Micer, director, X-ray Vascular Business Unit. "Our Infinix VF-i vascular X-ray system with 12" x 12" flat panel detectors and CAT 880B hybrid catheterization create the ideal hybrid cath lab unmatched in the industry today."
Source
Toshiba
среда, 1 июня 2011 г.
Siemens Highlights Cardiovascular IT Integrated Imaging And Information Solutions
Siemens Healthcare will showcase the latest advancements in cardiovascular information technology (IT) innovations that focus on providing innovative solutions to help enable sounder decisions and enhance operational efficiency in booth 1629 at the 60th Annual Scientific Session and Expo of the American College of Cardiology (ACC) in New Orleans. Highlights include syngo Dynamics and syngo.via1 on one workstation, creating an exciting experience and ease of use - anywhere2.
"At this year's ACC, we are highlighting syngo Dynamics' expanded CVIS functionalities, building upon a solid platform that is already deployed at hundreds of customer sites worldwide," said Kurt Reiff, CEO of the Americas, Center of Competence, SYNGO Business Unit, Siemens Healthcare. "Additionally, syngo Dynamics interfacing with syngo.via allows all images to be available on one workstation, helping the clinician save time and improve their workflow.
syngo.via is Siemens' imaging software for multimodality reading of clinical cases that automatically prepares images and enables timely navigation through a case - in line with disease-specific requirements. When this solution interfaces with syngo Dynamics3, routine and 3D pre-processed multi-modality images are available and integrated with structured reporting.
syngo Dynamics' new Cardiovascular Patient Jacket and Analytics functionality3 provides a holistic, patient-centric view for the clinical team that expands upon the realm of in vivo diagnostics and also includes in vitro diagnostics data. The flexible user interface allows clinical and business analyses through customizable key performance indicators (KPIs).
Additionally, the new Cardiovascular Whiteboard functionality3 brings a new level of efficiency to cardiology departments. The Web-native user interface will allow anywhere, anytime2 access to robust tools to manage the case load among care teams and corresponding resources.
1. syngo.via can be used as a standalone device or together with a variety of syngo.via-based software options, which are medical devices in their own rights.
2. Prerequisites include: Internet connection to clinical network, DICOM compliance, meeting of minimum hardware requirements, and adherence to local data security regulations.
3. The information about this product is preliminary. The product is under development and is not commercially available in the U.S., and its future availability cannot be ensured.
"At this year's ACC, we are highlighting syngo Dynamics' expanded CVIS functionalities, building upon a solid platform that is already deployed at hundreds of customer sites worldwide," said Kurt Reiff, CEO of the Americas, Center of Competence, SYNGO Business Unit, Siemens Healthcare. "Additionally, syngo Dynamics interfacing with syngo.via allows all images to be available on one workstation, helping the clinician save time and improve their workflow.
syngo.via is Siemens' imaging software for multimodality reading of clinical cases that automatically prepares images and enables timely navigation through a case - in line with disease-specific requirements. When this solution interfaces with syngo Dynamics3, routine and 3D pre-processed multi-modality images are available and integrated with structured reporting.
syngo Dynamics' new Cardiovascular Patient Jacket and Analytics functionality3 provides a holistic, patient-centric view for the clinical team that expands upon the realm of in vivo diagnostics and also includes in vitro diagnostics data. The flexible user interface allows clinical and business analyses through customizable key performance indicators (KPIs).
Additionally, the new Cardiovascular Whiteboard functionality3 brings a new level of efficiency to cardiology departments. The Web-native user interface will allow anywhere, anytime2 access to robust tools to manage the case load among care teams and corresponding resources.
1. syngo.via can be used as a standalone device or together with a variety of syngo.via-based software options, which are medical devices in their own rights.
2. Prerequisites include: Internet connection to clinical network, DICOM compliance, meeting of minimum hardware requirements, and adherence to local data security regulations.
3. The information about this product is preliminary. The product is under development and is not commercially available in the U.S., and its future availability cannot be ensured.
вторник, 31 мая 2011 г.
Endosense Completes Enrollment In EFFICAS I Clinical Study
Endosense, a Swiss medical technology company focused on improving the efficacy, safety and accessibility of catheter ablation for the treatment of cardiac arrhythmias, has announced enrollment completion in the EFFICAS I clinical study. EFFICAS is a study series intended to demonstrate that, in patients with paroxysmal atrial fibrillation (AF), the use of contact force control during cardiac ablation utilizing the company's TactiCath® force-sensing catheter1 results in superior outcomes as compared to ablations performed with a standard catheter.
EFFICAS I is a 45-patient, single-arm, prospective, multi-center European clinical trial designed to demonstrate the correlation between contact forces applied during pulmonary vein isolation (PVI) and AF treatment efficacy at three months. The endpoint for the study is the occurrence of reconduction (or "gap") areas in the PVI lines, relative to the contact forces applied during lesion formation. While investigators perform the procedure with the TactiCath, they are blinded to contact force measurements; however, the contact forces applied are recorded. Patients are re-assessed with a mapping catheter at three months to identify potential gaps in the PVI lines. Contact force parameters from initial procedures are then analyzed to determine the relationship with lesion formation.
"We believe that the data from EFFICAS I will greatly advance the scientific understanding of contact force and the role it plays in the catheter ablation treatment of AF, as the data will allow us to better identify those force parameters that will deliver optimal patient outcomes," said Eric Le Royer, president and chief executive officer of Endosense. "This study is yet one more proof point illustrating Endosense's leadership and commitment to clinical research of contact force in catheter ablation."
The next study in the EFFICAS series is EFFICAS II, in which investigators will take full advantage of the real-time, objective TactiCath contact force control features to improve their ablation technique during lesion creation. Endpoints for EFFICAS II will include reduction in PVI gaps as compared to EFFICAS I. Outcomes data from EFFICAS I and II will help in the design of future, larger EFFICAS randomized studies with clinical endpoints. EFFICAS II enrollment is currently underway.
"The EFFICAS studies represent a scientifically rigorous approach to quantifying the importance of contact force in catheter ablation," said Karl-Heinz Kuck, M.D., Asklepios Klinik St. Georg, Hamburg. "Never before have we looked at each ablation point with such level of detail. A preliminary analysis of the 24 patients who have completed their three-month follow-up indicates some truly groundbreaking findings. We look forward to communicating the results to our fellow electrophysiologists, as we believe these studies will result in actionable recommendations that will have a meaningful impact on catheter ablation effectiveness."
The TactiCath force-sensing ablation catheter and the TactiSys™ system are indicated for the treatment of AF and supraventricular tachycardia (SVT). BIOTRONIK is the exclusive distributor of the TactiCath in Europe, Latin America, Canada, Africa and the Middle East. The TactiCath is not yet available in the United States.
About the TactiCath
Endosense's TactiCath is the first and only force-sensing ablation catheter to give physicians a real-time, objective measure of contact force during the catheter ablation procedure. It has undergone considerable pre-clinical and clinical testing, the results of which have created a solid foundation of evidence supporting the feasibility, safety and value of contact force sensing during catheter ablation. The TactiCath has the potential to improve the effectiveness, safety and reproducibility of catheter ablation treatment of cardiac rhythm disorders, including AF.
1. Caution: TactiCath is an investigational device. Limited by Federal (or United States) law to investigational use.
EFFICAS I is a 45-patient, single-arm, prospective, multi-center European clinical trial designed to demonstrate the correlation between contact forces applied during pulmonary vein isolation (PVI) and AF treatment efficacy at three months. The endpoint for the study is the occurrence of reconduction (or "gap") areas in the PVI lines, relative to the contact forces applied during lesion formation. While investigators perform the procedure with the TactiCath, they are blinded to contact force measurements; however, the contact forces applied are recorded. Patients are re-assessed with a mapping catheter at three months to identify potential gaps in the PVI lines. Contact force parameters from initial procedures are then analyzed to determine the relationship with lesion formation.
"We believe that the data from EFFICAS I will greatly advance the scientific understanding of contact force and the role it plays in the catheter ablation treatment of AF, as the data will allow us to better identify those force parameters that will deliver optimal patient outcomes," said Eric Le Royer, president and chief executive officer of Endosense. "This study is yet one more proof point illustrating Endosense's leadership and commitment to clinical research of contact force in catheter ablation."
The next study in the EFFICAS series is EFFICAS II, in which investigators will take full advantage of the real-time, objective TactiCath contact force control features to improve their ablation technique during lesion creation. Endpoints for EFFICAS II will include reduction in PVI gaps as compared to EFFICAS I. Outcomes data from EFFICAS I and II will help in the design of future, larger EFFICAS randomized studies with clinical endpoints. EFFICAS II enrollment is currently underway.
"The EFFICAS studies represent a scientifically rigorous approach to quantifying the importance of contact force in catheter ablation," said Karl-Heinz Kuck, M.D., Asklepios Klinik St. Georg, Hamburg. "Never before have we looked at each ablation point with such level of detail. A preliminary analysis of the 24 patients who have completed their three-month follow-up indicates some truly groundbreaking findings. We look forward to communicating the results to our fellow electrophysiologists, as we believe these studies will result in actionable recommendations that will have a meaningful impact on catheter ablation effectiveness."
The TactiCath force-sensing ablation catheter and the TactiSys™ system are indicated for the treatment of AF and supraventricular tachycardia (SVT). BIOTRONIK is the exclusive distributor of the TactiCath in Europe, Latin America, Canada, Africa and the Middle East. The TactiCath is not yet available in the United States.
About the TactiCath
Endosense's TactiCath is the first and only force-sensing ablation catheter to give physicians a real-time, objective measure of contact force during the catheter ablation procedure. It has undergone considerable pre-clinical and clinical testing, the results of which have created a solid foundation of evidence supporting the feasibility, safety and value of contact force sensing during catheter ablation. The TactiCath has the potential to improve the effectiveness, safety and reproducibility of catheter ablation treatment of cardiac rhythm disorders, including AF.
1. Caution: TactiCath is an investigational device. Limited by Federal (or United States) law to investigational use.
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