Bed-Based Ballistocardiography: Dataset and Ability to Track Cardiovascular Parameters
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Clinical Excellence in Cardiology
Clinical Excellence in Cardiology Roy C. Ziegelstein, MD* A recent study identified 7 domains of clinical excellence on the basis of interviews with “clinically excellent” physicians at academic institutions in the United States: (1) commu- nication and interpersonal skills, (2) professionalism and humanism, (3) diagnostic acu- men, (4) skillful negotiation of the health care system, (5) knowledge, (6) taking a scholarly approach to clinical practice, and (7) having passion for clinical medicine. What constitutes clinical excellence in cardiology has not previously been defined. The author discusses clinical excellence in cardiology using the framework of these 7 domains and also considers the additional domain of clinical experience. Specific aspects of the domains of clinical excellence that are of greatest relevance to cardiology are highlighted. In conclusion, this discussion characterizes what constitutes clinical excellence in cardiology and should stimulate additional discussion of the topic and an examination of how the domains of clinical excellence in cardiology are related to specific patient outcomes. © 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:607–611) On the basis of interviews with 24 academic physicians and clinical excellence has not been clearly demonstrated. deemed “clinically excellent,” Christmas et al1 identified 7 For example, the compliance of hospitals with performance domains of clinical excellence relevant to all disciplines in measures is not associated with improved heart failure out- medicine: (1) communication and interpersonal skills, (2) comes.10,11 The speed with which an interventional cardi- professionalism and humanism, (3) diagnostic acumen, (4) ologist achieves reperfusion of the culprit vessel, the so- skillful negotiation of the health care system, (5) knowl- called door-to-balloon time, is an important performance edge, (6) taking a scholarly approach to clinical practice, measure in the treatment of patients with acute ST-segment and (7) having passion for clinical medicine. -
Medical Policy
bmchp.org | 888-566-0008 wellsense.org | 877-957-1300 Medical Policy Ambulatory Cardiac Monitors (Excluding Holter Monitors) Policy Number: OCA 3.35 Version Number: 24 Version Effective Date: 03/01/21 + Product Applicability All Plan Products Well Sense Health Plan Boston Medical Center HealthNet Plan Well Sense Health Plan MassHealth Qualified Health Plans/ConnectorCare/Employer Choice Direct Senior Care Options ◊ Notes: + Disclaimer and audit information is located at the end of this document. ◊ The guidelines included in this Plan policy are applicable to members enrolled in Senior Care Options only if there are no criteria established for the specified service in a Centers for Medicare & Medicaid Services (CMS) national coverage determination (NCD) or local coverage determination (LCD) on the date of the prior authorization request. Review the member’s product-specific benefit documents at www.SeniorsGetMore.org to determine coverage guidelines for Senior Care Options. Policy Summary The Plan considers the use of ambulatory cardiac monitors in the outpatient setting to be medically necessary if the type of ambulatory cardiac monitor is covered for the Plan member and ALL applicable Plan criteria are met, as specified in the Medial Policy Statement and Limitations sections of this policy. Plan prior authorization is required. When the device is covered for the member, medically necessary ambulatory cardiac monitors utilized in the outpatient setting may include ambulatory cardiac event monitors, mobile cardiac outpatient telemetry, and/or single-use external ambulatory electrocardiographic monitoring patches available by prescription. Ambulatory Cardiac Monitors (Excluding Holter Monitors) + Plan refers to Boston Medical Center Health Plan, Inc. and its affiliates and subsidiaries offering health coverage plans to enrolled members. -
Arxiv:1811.01044V2 [Physics.Med-Ph] 23 Jan 2019 Potentially Be Extended to Include Variability Among Individuals
Cardiovascular function and ballistocardiogram: a relationship interpreted via mathematical modeling Giovanna Guidoboni1, Lorenzo Sala2, Moein Enayati3, Riccardo Sacco4, Marcela Szopos5, James Keller3, Mihail Popescu6, Laurel Despins7, Virginia H. Huxley8, and Marjorie Skubic3 1 Department of Electrical Engineering and Computer Science and with the Department of Mathematics, University of Missouri, Columbia, MO, 65211 USA email: [email protected]. 2Universit´ede Strasbourg, CNRS, IRMA UMR 7501, Strasbourg, France. 5Universit´eParis Descartes, MAP5, UMR CNRS 8145, Paris, France. 3Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, 65211 USA. 4Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy. 6Department of Health Management and Informatics, University of Missouri, Columbia, MO, 65211 USA. 7Sinclair School of Nursing, University of Missouri, Columbia, MO, 65211 USA. 8Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, 65211 USA. Abstract Objective: to develop quantitative methods for the clinical interpretation of the ballistocardiogram (BCG). Methods: a closed-loop mathematical model of the cardiovascular system is proposed to theoretically simulate the mechanisms generating the BCG signal, which is then compared with the signal acquired via accelerometry on a suspended bed. Results: simulated arterial pressure waveforms and ventricular functions are in good qualitative and quantitative agreement with those reported in the clinical literature. Simulated BCG signals exhibit the typical I, J, K, L, M and N peaks and show good qualitative and quantitative agreement with experimental measurements. Simulated BCG signals associated with reduced contractility and increased stiffness of the left ventricle exhibit different changes that are characteristic of the specific pathological con- dition. -
Anemia in Heart Failure - from Guidelines to Controversies and Challenges
52 Education Anemia in heart failure - from guidelines to controversies and challenges Oana Sîrbu1,*, Mariana Floria1,*, Petru Dascalita*, Alexandra Stoica1,*, Paula Adascalitei, Victorita Sorodoc1,*, Laurentiu Sorodoc1,* *Grigore T. Popa University of Medicine and Pharmacy; Iasi-Romania 1Sf. Spiridon Emergency Hospital; Iasi-Romania ABSTRACT Anemia associated with heart failure is a frequent condition, which may lead to heart function deterioration by the activation of neuro-hormonal mechanisms. Therefore, a vicious circle is present in the relationship of heart failure and anemia. The consequence is reflected upon the pa- tients’ survival, quality of life, and hospital readmissions. Anemia and iron deficiency should be correctly diagnosed and treated in patients with heart failure. The etiology is multifactorial but certainly not fully understood. There is data suggesting that the following factors can cause ane- mia alone or in combination: iron deficiency, inflammation, erythropoietin levels, prescribed medication, hemodilution, and medullar dysfunc- tion. There is data suggesting the association among iron deficiency, inflammation, erythropoietin levels, prescribed medication, hemodilution, and medullar dysfunction. The main pathophysiologic mechanisms, with the strongest evidence-based medicine data, are iron deficiency and inflammation. In clinical practice, the etiology of anemia needs thorough evaluation for determining the best possible therapeutic course. In this context, we must correctly treat the patients’ diseases; according with the current guidelines we have now only one intravenous iron drug. This paper is focused on data about anemia in heart failure, from prevalence to optimal treatment, controversies, and challenges. (Anatol J Cardiol 2018; 20: 52-9) Keywords: anemia, heart failure, intravenous iron, ferric carboxymaltose, quality of life Introduction g/dL in men) (2). -
Training in Nuclear Cardiology
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL.65,NO.17,2015 ª 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 0735-1097/$36.00 PUBLISHED BY ELSEVIER INC. http://dx.doi.org/10.1016/j.jacc.2015.03.019 TRAINING STATEMENT COCATS 4 Task Force 6: Training in Nuclear Cardiology Endorsed by the American Society of Nuclear Cardiology Vasken Dilsizian, MD, FACC, Chair Todd D. Miller, MD, FACC James A. Arrighi, MD, FACC* Allen J. Solomon, MD, FACC Rose S. Cohen, MD, FACC James E. Udelson, MD, FACC, FASNC 1. INTRODUCTION ACC and ASNC, and addressed their comments. The document was revised and posted for public comment 1.1. Document Development Process from December 20, 2014, to January 6, 2015. Authors 1.1.1. Writing Committee Organization addressed additional comments from the public to complete the document. The final document was The Writing Committee was selected to represent the approved by the Task Force, COCATS Steering Com- American College of Cardiology (ACC) and the Amer- mittee, and ACC Competency Management Commit- ican Society of Nuclear Cardiology (ASNC) and tee; ratified by the ACC Board of Trustees in March, included a cardiovascular training program director; a 2015; and endorsed by the ASNC. This document is nuclear cardiology training program director; early- considered current until the ACC Competency Man- career experts; highly experienced specialists in agement Committee revises or withdraws it. both academic and community-based practice set- tings; and physicians experienced in defining and applying training standards according to the 6 general 1.2. Background and Scope competency domains promulgated by the Accredita- Nuclear cardiology provides important diagnostic and tion Council for Graduate Medical Education (ACGME) prognostic information that is an essential part of the and American Board of Medical Specialties (ABMS), knowledge base required of the well-trained cardiol- and endorsed by the American Board of Internal ogist for optimal management of the cardiovascular Medicine (ABIM). -
Influence of Sympathetic Activation on Myocardial Contractility Measured 4 with Ballistocardiography and Seismocardiography During Sustained End- 5 Expiratory Apnea
Ballistocardiography, seismocardiography and sympathetic nerve activity 1 TITLE PAGE 2 3 Influence of sympathetic activation on myocardial contractility measured 4 with ballistocardiography and seismocardiography during sustained end- 5 expiratory apnea. 6 Ballistocardiography, seismocardiography and sympathetic nerve activity 7 8 9 Sofia Morra, MD1, Anais Gauthey MD2, Amin Hossein MSc3, Jérémy Rabineau MSc3, Judith 10 Racape, PhD5, Damien Gorlier MSc3, Pierre-François Migeotte, MSc, PhD3, Jean Benoit le Polain de 11 Waroux, MD, PhD4, Philippe van de Borne MD, PhD1 12 13 14 1Department of Cardiology, Erasme hospital, Université Libre de Bruxelles, Belgium 15 2 Department of Cardiology, Saint-Luc hospital, Université Catholique de Louvain, Belgium 16 3LPHYS, Université Libre de Bruxelles, Belgium 17 4 Department of Cardiology, Sint-Jan, Hospital Bruges, Bruges, Belgium 18 5 Research centre in epidemiology, biostatistics and clinical research. School of Public Health. Université libre 19 de Bruxelles (ULB), Brussels, Belgium 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 1 Downloaded from journals.physiology.org/journal/ajpregu at Cornell Univ (132.174.252.179) on September 7, 2020. Ballistocardiography, seismocardiography and sympathetic nerve activity 41 42 43 44 45 46 47 NOTE AND NOTEWORTHY 48 49 50 Ballistocardiography (BCG) and seismocardiography (SCG) assess vibrations produced by cardiac 51 contraction and blood flow, respectively, through micro-accelerometers and micro-gyroscopes. 52 Kinetic energies (KE), and their temporal integrals (iK) during a single heartbeat are computed 53 from the BCG and SCG waveforms in a linear and a rotational dimension. When compared to 54 normal breathing, during an end-expiratory voluntary apnea, iK increased and was positively 55 related to sympathetic nerve traffic rise assessed by microneurography. -
Essentials of Cardiology Timothy C
Th e Heart SECTION IV Essentials of Cardiology Timothy C. Slesnick, Ralph Gertler, and CHAPTER 14 Wanda C. Miller-Hance Congenital Heart Disease Evaluation of the Patient with a Cardiac Murmur Incidence Basic Interpretation of the Pediatric Segmental Approach to Diagnosis Electrocardiogram Physiologic Classifi cation of Defects Essentials of Cardiac Rhythm Interpretation and Acute Arrhythmia Management in Children Acquired Heart Disease Basic Rhythms Cardiomyopathies Conduction Disorders Myocarditis Cardiac Arrhythmias Rheumatic Fever and Rheumatic Heart Disease Pacemaker Therapy in the Pediatric Age Group Infective Endocarditis Pacemaker Nomenclature Kawasaki Disease Permanent Cardiac Pacing Cardiac Tumors Diagnostic Modalities in Pediatric Cardiology Heart Failure in Children Chest Radiography Defi nition and Pathophysiology Barium Swallow Etiology and Clinical Features Echocardiography Treatment Strategies Magnetic Resonance Imaging Syndromes, Associations, and Systemic Disorders: Cardiovascular Disease and Anesthetic Implications Computed Tomography Chromosomal Syndromes Cardiac Catheterization and Angiography Gene Deletion Syndromes Considerations in the Perioperative Care of Children with Cardiovascular Disease Single-Gene Defects General Issues Associations Clinical Condition and Status of Prior Repair Other Disorders Summary Selected Vascular Anomalies and Their Implications for Anesthetic Care Aberrant Subclavian Arteries Persistent Left Superior Vena Cava to Coronary Sinus Communication Congenital Heart Disease adulthood has become the expectation for most congenital car- diovascular malformations.3 At present it is estimated that there Incidence are more than a million adults with CHD in the United States, Estimates of the incidence of congenital heart disease (CHD) surpassing the number of children similarly aff ected for the fi rst range from 0.3% to 1.2% in live neonates.1 Th is represents the time in history. -
Chapter 2 Ballistocardiography
POLITECNICO DI TORINO Corso di Laurea Magistrale in Ingegneria Biomedica Tesi di Laurea Magistrale Ballistocardiographic heart and breathing rates detection Relatore: Candidato: Prof.ssa Gabriella Olmo Emanuela Stirparo ANNO ACCADEMICO 2018-2019 Acknowledgements A conclusione di questo lavoro di tesi vorrei ringraziare tutte le persone che mi hanno sostenuta ed accompagnata lungo questo percorso. Ringrazio la Professoressa Gabriella Olmo per avermi dato la possibilità di svolgere la tesi nell’azienda STMicroelectronics e per la disponibilità mostratami. Ringrazio l’intero team: Luigi, Stefano e in particolare Marco, Valeria ed Alessandro per avermi aiutato in questo percorso con suggerimenti e consigli. Grazie per essere sempre stati gentili e disponibili, sia in campo professionale che umano. Un ringraziamento lo devo anche a Giorgio, per avermi fornito tutte le informazioni e i dettagli tecnici in merito al sensore utilizzato. Vorrei ringraziare anche tutti i ragazzi che hanno condiviso con me questa esperienza ed hanno contribuito ad alleggerire le giornate lavorative in azienda. Ringrazio i miei amici e compagni di università: Ilaria e Maria, le amiche sulle quali posso sempre contare nonostante la distanza; Rocco, compagno di viaggio, per i consigli e per aver condiviso con me gioie così come l’ansia e le paure per gli esami; Valentina e Beatrice perché ci sono e ci sono sempre state; Rosy, compagna di studi ma anche di svago; Sara, collega diligente e sempre con una parola di supporto, grazie soprattuto per tutte le dritte di questo ultimo periodo. Il più grande ringraziamento va ai miei genitori, il mio punto di riferimento, il mio sostegno di questi anni. -
Clinical Research Protocol
DOCUMENT APPROVAL PAGE Document Number: Rev: Page: 90D0167 C 1 of 32 Title: Ambulatory Remote Patient Monitoring using the µCor Heart Failure and Arrhythmia Management System (PATCH) Feasibility Study: Protocol NCT04512703 Author: Ramu Perumal, PhD Date: 9-February-2018 Approvals ( “ ” indicates approval signature required) Medical Affairs: Date: Marketing: Date: Clinical Operations: Date: Billing/Reimbursement: Date: IE/QE Engineering: Date: Support Service: Date: Service Operations: Date: Technology Applications: Date: OEM Regulatory: Date: OEM Engineering: Date: Documentation Control: Date Archived: Electronic File info: (if applicable) *If multiple files (such as multiple sheets of a drawing) list file info separately File name: Size (in bytes) Time & Date (or Date & Time) 90D0167_revC.docx Transferred File info: (To be completed by Documentation Control) File name: Size (in bytes) Time & Date (or Date & Time) 90d0167_revc.doc 90d0167_revc.pdf ZOLL Services Form Number: 90A0001-A01 Form REV Level: A DOCUMENT REVISION HISTORY PAGE Document Number: Rev: Page: 90D0167 C 2 of 32 Title: Ambulatory Remote Patient Monitoring using the µCor Heart Failure and Arrhythmia Management System (PATCH)Feasibility Study: Protocol Revision History Of Document CO Rev Number Description of Change Author Effective Date FI NA First version RP 7/17/17 A NA Changed the device name from Continuous Mobile Cardiac RP 8/22/17 Telemetry System to uCor Heart Failure and Arrhythmia Management System. B NA The following changes were made: RP 10/16/17 1. Removed CE-mark reference for the device 2. Subjects no longer have to send photographs of the skin and device placement. Instead, they will note their skin condition and device location on the subject diary 3. -
Appropriate Usage of Continuous Cardiac Monitoring in the Inpatient Setting: a Literature Review
Arch Intern Med Res 2021; 4 (2): 062-065 DOI: 10.26502/aimr.0057 Review Article Appropriate Usage of Continuous Cardiac Monitoring in the Inpatient Setting: A Literature Review Sara Whyte1, Krishna Vedala1*, Philip T Sobash1, Raghuveer Vedala2, Kalyan Gonugunta1 Review Article 1Department of Internal Medicine, White River Health System, Arkansas, USA 2Department of Family Medicine, University of Oklahoma Health Sciences Center, Oklahoma, USA *Corresponding author: Krishna Vedala, Department of Internal Medicine, White River Health System, Batesville, Arkansas, USA Received: 31 March 2021; Accepted: 08 April 2021; Published: 21 April 2021 Citation: Sara Whyte, Krishna Vedala, Philip T Sobash, Raghuveer Vedala, Kalyan Gonugunta. Appropriate Usage of Continuous Cardiac Monitoring in the Inpatient Setting: A Literature Review. Archives of Internal Medicine Research 4 (2021): 062-065. Keywords: Telemetry ed, life-threatening arrhythmias [5, 6]. Electrocardiographic monitoring (telemetry) in the In patients presenting with chest pain and indications for inpatient setting has significant utility, but is constrained acute coronary syndrome (ACS), telemetry is warranted by rising healthcare costs, rare detection of significant in the early phases (<24 hours) for intermediate- or events and potential for great alert fatigue [1, 2]. In high-risk non-ST elevated-ACS or ST-segment- 2017, the American Heart Association (AHA) published elevation of myocardial infarction (STEMI), until ruled updated practice standards for telemetry monitoring that out [3]. Cardiac arrest is the leading cause of death addressed overuse, appropriate use, alarm management among adults in the United States, and most common and documentation in electronic medical records [3, 4]. cause of death after MI [7]. In patients with myocardial Here, we review their recommendations for indication infarction (MI), after cardiac arrest, during temperature for telemetry utilization on the hospital floor. -
Cardiac Monitoring Infographic
Cardiac monitors have been used for years to help physicians determine if patients are experiencing EVOLUTION OF THE irregular heartbeats (arrhythmias) that are causing recurrent fainting, palpitations, unexplained stroke, or atrial fibrillation. Over time, these devices have grown smaller—and smarter—and the latest devices ™ are revolutionizing the world of cardiac monitoring. Reveal LINQ CARDIAC MONITOR Insertable Cardiac Monitor Cardiac monitors have evolved from large, wired, external devices to small and simple, yet powerful, systems that monitor a patient’s MCT Wire-free Wearable Miniaturized Insertable 1 Holter Monitor Event Monitor heartbeat for up to three years, (Mobile Cardiac Telemetry) MCT Monitor Cardiac Monitor without the bulk and inconvenience of traditional devices. KEY External, adhesive-backed = Duration of use monitor improves patient Nearly invisible on most comfort and convenience patients; approximately = Not water resistant with “peel and stick” 1/3 the size of an AAA battery and safe for use simplicity and remote in an MRI setting. = Water resistant monitoring capabilities. 24–48 hours Up to 30 days Up to 30 days Up to 30 days Up to 3 years = Worn externally = Worn internally = Device automatically transmits data to physicians via wireless connectivity 1. Reference the Reveal LINQ ICM Clinician Manual for usage parameters. Brief Statement: REVEAL LINQ™ LNQ11 Insertable Cardiac Monitor and Patient Assistant Patient Assistant Operation of the Patient Assistant near sources of electromagnetic interference, such as -
MEDICAL COVERAGE POLICY SERVICE: Cardiac Monitoring
MEDICAL COVERAGE POLICY SERVICE: Cardiac Monitoring - Outpatient Policy Number: 065 Effective Date: 03/01/2021 Last Review: 01/28/2021 Next Review Date: 01/28/2022 Important note Unless otherwise indicated, this policy will apply to all lines of business. Even though this policy may indicate that a particular service or supply may be considered medically necessary and thus covered, this conclusion is not based upon the terms of your particular benefit plan. Each benefit plan contains its own specific provisions for coverage and exclusions. Not all benefits that are determined to be medically necessary will be covered benefits under the terms of your benefit plan. You need to consult the Evidence of Coverage (EOC) or Summary Plan Description (SPD) to determine if there are any exclusions or other benefit limitations applicable to this service or supply. If there is a discrepancy between this policy and your plan of benefits, the provisions of your benefits plan will govern. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Unless otherwise specifically excluded, Federal mandates will apply to all plans. With respect to Medicare-linked plan members, this policy will apply unless there are Medicare policies that provide differing coverage rules, in which case Medicare coverage rules supersede guidelines in this policy. Medicare-linked plan policies will only apply to benefits paid for under Medicare rules, and not to any other health benefit plan benefits. CMS's Coverage Issues Manual can be found on the CMS website.