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Are guidelines adhered to at first assessment of atrial fibrillation

Nurse led atrial fibrillation (AF) clinics have been reported to improve adherence to guidelines and improve clinical outcome. In order to assess the potential for this approach to improve patient care locally an audit of current AF management was conducted.

I. Melton, L. Lim
Christchurch Hospital, Christchurch
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

Interventional nursing perspective on seting up of a coronary rotational atherectomy service: First-year experiences and lessons learnt

Coronary Rotational Atherectomy (CRA) is a complex intervention to treat heavily calcified coronary atherosclerosis. We began performing CRA at Middlemore Hospital in August 2012. We discuss our experiences in setting up this service.

R. McIntosh, S. Graham, W. Harrison, C. Flynn, A. Escondo, P. Kay
Middlemore Hospital, Auckland
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

Total ambulatory care (TAC) for day-stay coronary angiography patients (Amsterdam protocol): A positive response with suggested enhancements

TAC seeks to deconstruct the traditional approach to diagnostic and interventional procedures: Long periods without food or drink, impersonal and unflattering attire, strong procedural sedation, restriction of movement and boredom. Radial artery access angiography allows us the opportunity to address these issues and provide patient-friendly care.

M. McAleer, S. Madenholt-Titley, S. Savage, T. Gudex, J. White, P. Ruygrok
Auckland District Health Board, Auckland
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

The use of gastrointestinal cocktail for excluding myocardial ischaemia in the emergency setting: A systematic review

Differentiating acute chest pain caused by myocardial ischaemia from other potentially more benign causes of chest pain is a frequent diagnostic challenge faced by Emergency Department clinicians. A systematic review of the literature was conducted to locate and evaluate clinical trials comparing the use of an oral “gastrointestinal (GI) cocktail” (oral viscous lidocaine /antacid ± anticholinergic) to standard diagnostic protocols (serial electrocardiograms (ECGs), serial biomarkers, imaging and/or provocative testing) to differentiate emergency patients presenting with acute chest pain caused by gastro-oesophageal disease from those with other aetiologies.

S. Chan, A. Maurice, S. Davies, D. Walters

Transcatheter aortic valve implantation in patients with percutaneous coronary intervention to the left main coronary artery

Transcatheter Aortic Valve Implantation (TAVI) is increasingly utilised in patients with severe aortic valve stenosis who are deemed unacceptably high risk for surgical valve replacement. There are few studies describing the feasibility, efficacy and safety of TAVI in patients who are also candidates for percutaneous coronary intervention (PCI) for significant left main (LM) coronary artery stenosis.

A. Maurice, S. Chan, D. Murdoch, A. Clarke, D. Walters
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

Audit of the burden of rheumatic heart disease in the Wellington region

Acute rheumatic fever (ARF), with the potential sequelae of rheumatic heart disease (RHD), has a well defined incidence in New Zealand. However the effects of these diseases on the health of young adults is less well described. In this study we examined patients aged between 15 and 25 with a previous presentation with either ARF or RHD.

M. Margetts, A. Aitken, N. Wilson
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

Reduced sedation in patients undergoing coronary angiography of total ambulatory management Online Only

Midazolam and fentanyl are routinely used for coronary angiography via a radial approach to reduce patient anxiety, pain and arterial spasm. This has implications for ambulation, time to discharge and work-flow efficiency. There is little evidence to support the routine use of “up-front” intravenous sedation and analgesia compared to “as required” and using local anaesthesia alone.

S. MadenHolt-Titley, T. Gudex, M. McAleer, S. Savage, J. White, P. Ruygrok
Auckland District Health Board, Auckland
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

Prevalence and predictors of subclinical coronary artery disease in patients with confirmed heterozygous familial hypercholesterolaemia

Familial hypercholesterolaemia (FH) is associated with a marked increase in risk of premature coronary artery disease (CAD). The aim of this study is to describe the prevalence and predictors of subclinical CAD in those with genetically proven heterozygous familial hypercholesterolaemia (HeFH).

J. Lumby, A. Moffat, T. Bates, G. Watts, A. Abraham
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

Does timing of platelet function testing (PFT) contribute to variability in residual on-treatment platelet reactivity in patients with acute coronary syndrome (ACS)?

ACS patients on dual antiplatelet therapy display large variations in residual platelet reactivity. In part, this may reflect the dynamic nature of the ACS process. Understanding the impact of the timing of measurement on this variability is required. This study examined the effect of time from symptom onset to testing and from antiplatelet agent loading to testing on residual platelet reactivity.

C. Legge, A. Al-Sinan, A. Holley, L. Johnston, P. Larsen, S. Harding
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

Warfarin vs Dabigatran for elective direct current cardioversion (DCCV)

In clinical practice, achieving 4 weeks of therapeutic anticoagulation with warfarin is challenging and hinders timely DCCV. Dabigatran is a safe and effective alternative. We evaluated the difference in time to DCCV and success rate between those on dabigatran compared to warfarin.

A. Kueh, D. Judson, K. Reed, R. Gabriel, J. Looi, D. Heaven, N. van Pelt
Counties Manukau District Health, Auckland
Heart, Lung and Circulation – Volume 23, Supplement 1, e1-e48
Abstract & full-text available.

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