Recent Submissions

  • Effective nurse-led interventions in heart disease

    Thompson, David R.; Quinn, Tom; Stewart, Simon; Quinn, Tom; Cardiology; Nursing and Midwifery Registered; University of York; George Eliot Hospital NHS Trust; South Warwickshire General Hospitals NHS Trust; University of Glasgow (Elsevier, 2002-06)
    Nurses are increasingly being involved in initiatives to improve the co-ordination, delivery and eventual outcomes of health care. Key components of these initiatives include application of evidence-based treatments, ensuring individualised follow-up and the provision of "seamless" care overall. There is evidence in key areas that nurse-led interventions for patients with heart disease are effective, and that they are likely to work in other areas if properly supported and appropriate structures and systems are put in place to promote such practice. Given the promising results to date, it would be disappointing if these issues remain unresolved and the potential value of this type of interventions unfulfilled.
  • Report on the BANCC digital health technology webinar

    SPENCER, CHARLES; Spencer, Charles; Cardiology; Nursing and Midwifery Registered; South Warwickshire University NHS Foundation Trust (MA Healthcare, 2021-02-10)
    After attending the second of a series of webinars held by the BANCC, cardiology advanced clinical practitioner and BANCC member Charles Spencer reports on the discussions and learning points that were raised around the theme of digital health and technology.
  • A look at the impact of the advanced clinical practitioner role in the realm of cardiology

    SPENCER, CHARLES; Spencer, Charles; Cardiology; Nursing and Midwifery Registered; South Warwickshire University NHS Foundation Trust (MA Healthcare, 2022-11)
    As an advanced clinical practitioner, registered nurse, founding member of the cardiology nurse forum Facebook group and podcast, and a recently elected ordinary council member of the BANCC, Charles Spencer explores the impact of the advanced clinical practitioner role in cardiology, expanding on his ‘top topic’ session at the recent British Cardiovascular Society conference in June.
  • Caseload management and outcome of patients with aortic stenosis in primary/secondary versus tertiary care settings-design of the IMPULSE enhanced registry

    Rudolph, Tanja K.; Messika-Zeitoun, David; Frey, Norbert; Lutz, Matthias; Krapf, Laura; Passefort, Stephanie; Fryearson, John; Simpson, Helen; Mortensen, Kai; Rehse, Sebastian; et al. (BMJ Publishing Group, 2019-07)
    Background: Severe aortic stenosis (AS) is one of the most common and most serious valve diseases. Without timely intervention with surgical aortic valve replacement or transcatheter aortic valve replacement, patients have an estimated survival of 2-3 years. Guidelines for the treatment of AS have been developed, but studies suggest that as many as 42% of patients with AS are not treated according to these recommendations.The aims of this registry are to delineate the caseload of patients with AS, outline the management of these patients and determine appropriateness of treatments in participating centres with and without onsite access to surgery and percutaneous treatments. Methods/design: The IMPULSE enhanced registry is an international, multicentre, prospective, observational cohort registry conducted at four central full access centres (tertiary care hospitals) and at least two satellite centres per hub (primary/secondary care hospitals). An estimated 800 patients will be enrolled in the registry and patient follow-up will last for 12 months. Discussion: In addition to the primary aims determining the caseload management and outcome of patients with AS in primary, secondary and tertiary care settings, the registry will also determine a time course for the transition from asymptomatic to symptomatic status and the diagnostic steps, treatment decisions and the identification of decision-makers in tertiary versus primary/secondary care hospitals. The last patient will be enrolled in the registry in 2018 and results of the registry are anticipated in 2019. Registration number: NCT03112629. Keywords: aortic stenosis; facilitated data relay; quality of care; surgical aortic valve replacement; transcatheter aortic valve implantation.
  • Florid aortitis following SARS-CoV-2 infection

    Shergill, Simran; Davies, James; Bloomfield, James; Shergill, Simran; Davies, James; Bloomfield, James; Cardiology; Medical and Dental; South Warwickshire University NHS Foundation Trust (Oxford University Press, 2020-11)
    A case report on a patient with florid aortitis following SARS-CoV-2 infection.
  • Assessing heart disease using a novel magnetocardiography device

    Beadle, Roger; McDonnell, D; Ghasemi-Roudsari, S; Unitt, L; Parker, S J; Varcoe, B T H; Beadle, R; McDonnell, D; Department of Cardiology; Medical and Dental; et al. (IOP Publishing, 2021-02-23)
    The aim of this paper is to present the use of a portable, unshielded magnetocardiograph (MCG) and identify key characteristics of MCG scans that could be used in future studies to identify parameters that are sensitive to cardiac pathology. We recruited 50 patients with confirmed myocardial infarction (MI) within the past 12 weeks and 46 volunteers with no history of cardiac disease. A set of 38 parameters were extracted from MCG features including both signals from the sensor array and from magnetic images obtained from the device and principal component analysis was used to concentrate the information contained in these parameters into uncorrelated predictors. Linear fits of these parameters were then used to examine the ability of MCG to distinguish between sub-groups of patients. In the first instance, the primary aim of this study was to ensure that MCG has a basic ability to separate a highly polarised patient group (young controls from post infarction patients) and to identify parameters that could be used in future studies to build a formal diagnostic tool kit. Parameters that parameterised left ventricular ejection fraction (LVEF) were identified and an example is presented to show differential low and high ejection fractions.
  • Echocardiography in a critical care unit: a contemporary review

    Mohsin, Muhammad; Farooq, Muhammad Umar; Akhtar, Waheed; Mustafa, Waqar; Rehman, Tanzeel Ur; Malik, Jahanzeb; Zahid, Taimoor; Zahid, Taimoor; Rawalpindi Institute of Cardiology, Pakistan; Abbas Institute of Medical Sciences, Pakistan; Benazir Bhutto Hospital, Pakistan; South Warwickshire University NHS Foundation Trust (Taylor and Francis Group, 2022-01)
    Introduction: Echocardiography is a rapid, noninvasive, and complete cardiac assessment tool for patients with hemodynamic instability. Relevant articles were extracted after searching on databases by two reviewers and incorporated in this review in anarrative style. Areas covered: his review provides an overview of the evidence for current practices in critical care units (CCUs), incorporating the use of echocardiography in different etiologies of shock. Expert opinion: In an acute scenario, a basic echocardiographic study yields prompt diagnosis, allowing for the initiation of treatment. The most common pathologies in shocked patients are identified promptly using two-dimensional (2D) and M-mode echocardiography. A more comprehensive assessment can follow after patients have been stabilized. There are four types of shock: (i) cardiogenic shock, (ii) hypovolemic shock, (iii) obstructive shock, and (iv) septic shock. All of them can be readily identified by echocardiography. As echocardiography is increasingly being used in an intensive care setting, its applications and evidence base should be expanded by randomized controlled trials to demonstrate patient outcomes in critical care.
  • Feasibility of novel unshielded portable magnetocardiography: Insights from the prospective multicenter MAGNETO-SCD trial

    Lachlan, Thomas; He, Hejie; Miller, Adam; Chandan, Nakul; Siddiqui, Shoaib; Beadle, Roger; Wilson, David; Petkar, Sanjiv; Randeva, Harpal; Osman, Faizel; et al. (Elsevier, 2023-03)
    A research letter communicating insights into the feasibility of novel unshielded portable magnetocardiography from the prospective multicenter MAGNETO-SCD trial.
  • Tipping the balance: chronic superior vena cava thrombosis resulting in an aberrant and inefficient venous circuit

    Shergill, Simran; Bloomfield, James; Fryearson, John; Shergill, Simran; Bloomfield, James; Fryearson, John; Cardiology; Medical and Dental; South Warwickshire University NHS Foundation Trust (Elsevier, 2022-03)
    Given there was no direct flow into the right atrium from the SVC, we deemed this inefficient venous circuit responsible for her breathlessness, with a small reduction in cardiac function 'tipping the balance' and producing symptoms this late in life. The patient opted for conservative management with the risk of intervention outweighing her currently manageable symptoms.
  • Right ventricular function and long-term clinical outcomes after cardiac resynchronization therapy: A cardiovascular magnetic resonance study

    Zegard, Abbasin; Okafor, Osita; Moody, William; Marshall, Howard; Qiu, Tian; Stegemann, Berthold; Beadle, Roger; Leyva, Francisco; Beadle, Roger; Moody, William; et al. (Wiley, 2022-09)
    Background: Right ventricular (RV) dysfunction has been linked to a poor response to cardiac resynchronization therapy (CRT). We sought to determine whether cardiovascular magnetic resonance (CMR)-derived measures of RV function influence clinical outcomes after CRT. Methods: In this retrospective study, we used CMR to assess pre-implant RV volumes and RV ejection fraction (RVEF) in relation to clinical outcomes after CRT implantation. Results: Among 243 patients (age: 70.3 ± 10.8 years [mean ± SD]; 68.7% male; 121 [49.8%]) with ischemic cardiomyopathy and 122 (50.2%) with nonischemic cardiomyopathy, 141 (58%) after CRT-defibrillation (CRT-D) and 102 (42%) after CRT-pacing (CRT-P), 101 (41.6.0%) patients died, 61 (25.1%) from cardiac causes and 24 (9.88%) from noncardiac causes, over 5.87 years (median; interquartile range: 4.35-7.73). Two (0.82%) patients underwent cardiac transplantation and four (1.64%) had a left ventricular assist device (LVAD). A total of 41 (16.9%) met the composite endpoint of sudden cardiac death (SCD), ventricular tachycardia, or ventricular fibrillation. In univariate analyses, no measure of RV function was associated with total mortality or the arrhythmic endpoint. RVEF was associated with cardiac mortality on univariate analyses (HR per 10%: 0.82, 95% CI 0.70-0.96), but not on multivariate analyses that included left ventricular ejection fraction. Conclusions: There is no relationship between measures of RV function, such as RV volumes and RVEF, and the long-term clinical outcome of CRT. These findings indicate that such measures should not be considered in patient selection.
  • Severe aortic stenosis management in heart valve centres compared with primary/secondary care centres

    Rudolph, Tanja K.; Messika-Zeitoun, David; Frey, Norbert; Lutz, Matthias; Krapf, Laura; Passefort, Stephanie; Fryearson, John; Simpson, Helen; Mortensen, Kai; Rehse, Sebastian; et al. (BMJ Publishing Group, 2023-01)
    Objective: Current guidelines recommend use of heart valve centres (HVCs) to deliver optimal quality of care for patients with valve disease but there is no evidence to support this. The hypothesis of this study is that patient care with severe aortic stenosis (AS) will differ in HVCs compared with satellite centres. We aimed to compare the treatment of patients with AS at HVCs (tertiary care hospitals with full access to AS interventions) to satellites (hospitals without such access). Methods: IMPULSE enhanced is a European, observational, prospective registry enrolling consecutive patients with newly diagnosed severe AS at four HVCs and 10 satellites. Clinical characteristics, interventions performed and outcomes up to 1 year by site-type were examined. Results: Among 790 patients, 594 were recruited in HVCs and 196 in satellites. At baseline, patients in HVCs had more severe valve disease (higher peak aortic velocity (4.3 vs 4.1 m/s; p=0.008)) and greater comorbidity (coronary artery disease (CAD) (44% vs 27%; p<0.001) prior myocardial infarction (MI) (11% vs 5.1%; p=0.011) and chronic pulmonary disease (17% vs 8.9%; p=0.007)) than those presenting in satellites. An aortic valve replacement was performed more often by month 3 in HVCs than satellites in the overall population (52.6% of vs 31.3%; p<0.001) and in symptomatic patients (66.7% vs 43.2%, p<0.001). One-year survival rate was higher for patients in HVCs than satellites (HR2.19; 95% CI 1.28 to 3.73 total population and 2.89 (95%CI 1.64 to 5.11) for symptomatic patients. Conclusions: Our data support the implementation of referral pathways that direct patients to HVCs performing both surgery and transcatheter interventions. Trial registration number: NCT03112629.