简介:Cardiologistswhoseepatientsonageneralcardiologyservicearebeginningtoseeanincreasingnumberofpatientswhohavereceivedaprimarypreventionimplantablecardiacdefibrillator(ICD)buthaveneverhaditfire.ThereareadditionallyanumberofpatientswhohaveinappropriatefiringofICDs.Inappropriateshocksoccurinupto40%ofpatientswithanICD.Themaincauseissupraventriculartachyarrhythmia,includingsinustachycardia,atrialfibrillation,andotherrapidsupraventriculararrhythmias.
简介:Introduction:Congestiveheartfailure(CHF)accountsforover$32billioninhealthcarecostsperyearandisattheepicenterofhealthcarereform.CHFremainsamajorcauseofhospitalizations.Itisknownandhasbeenreportedthatmisseddiagnosisofandmissedopportunitiestotreatheartfailureareassociatedwithhighermortalityandmorbidity.CHFdiseasemanagementprogramshaveemergedasapotentialsolutiontotheCHFepidemic.TheparadoxremainsthatCHFdiseasemanagementprogramsstillclusterintertiaryhospitalsystems.Theimpactofheartfailurespecialistsandspecialtyteamsincommunityhealthsystemsislesswellunderstood.CurrentlytherearenotenoughCHF-trainedteamsinthecommunitysettingtoaddressthisunmethealthneed.Methods:WeexploredtheimpactofCHFclinicsinacommunity-basedhospitalsystemonreadmissionrates,mortality,andsymptomaticrelief.Atotalof384patientswereenrolledintheclinicbetween2012and2015.Datacollectedincludedage,sex,typeofheartfailure,NewYorkHeartAssociationclass,ejectionfraction,serumcreatinineandbrainnatriureticpeptidevalues,andreadmissionandmortalityrateswithin30days,3months,6months,and1year.WealsocomparedreadmissionratesbetweenpatientswhowerefollowedupintheCHFclinicversusthosewhowerenotseenintheCHFclinic.Results:AstatisticallysignificantdifferencewasdemonstratedinreadmissionratesbetweenpatientswhowerefollowedupintheCHFclinicversusthosewhodidnotvisittheCHFclinicforupto1yearoffollow-up.Conclusion:CHFcommunityhospitalclinicsthatusearapidandfrequentfollow-upformatwithCHF-trainedteamseffectivelyreducerehospitalizationratesupto1year.