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PFA in Brevard County

Thu, 20 Mar 2025 15:24:50 GMT

Parrish Medical Center First in Brevard to Pioneer Pulsed Field Ablation

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Understanding GLP-1 Agonists and Their Role in Heart Failure Management

Sat, 31 Aug 2024 20:44:12 GMT

Understanding GLP-1 Agonists and Their Role in Heart Failure Management

Heart failure is a chronic condition where the heart struggles to pump blood efficiently, leading to symptoms like fatigue, shortness of breath, and fluid retention. While traditional treatments focus on improving heart function directly, newer medications, such as GLP-1 agonists, have shown potential benefits for heart failure patients. This article will explain how GLP-1 agonists work, why they might be beneficial for heart failure, and provide examples of GLP-1 agonists.

What are GLP-1 Agonists?

GLP-1 agonists, or glucagon-like peptide-1 receptor agonists, are a class of medications primarily used to manage type 2 diabetes. These medications mimic the action of the naturally occurring hormone GLP-1, which plays a role in regulating blood sugar levels.

Examples of GLP-1 Agonists:

Exenatide (Byetta, Bydureon)
Liraglutide (Victoza, Saxenda)
Dulaglutide (Trulicity)
Semaglutide (Ozempic, Rybelsus)
Lixisenatide (Adlyxin)
Albiglutide (Tanzeum)

How GLP-1 Agonists Work

Increasing Insulin Secretion:
GLP-1 agonists stimulate the pancreas to release more insulin in response to meals, helping to lower blood sugar levels.

Decreasing Glucagon Secretion:
They reduce the release of glucagon, a hormone that raises blood sugar levels by promoting the release of glucose from the liver.

Slowing Gastric Emptying:
GLP-1 agonists slow down the rate at which the stomach empties, leading to a more gradual absorption of glucose into the bloodstream and helping to control post-meal blood sugar spikes.

Promoting Satiety:
These medications increase feelings of fullness, which can help reduce appetite and support weight loss.

Why GLP-1 Agonists Might Be Beneficial for Heart Failure

Weight Loss:
Many heart failure patients struggle with obesity, which can worsen their condition. GLP-1 agonists promote weight loss by increasing feelings of fullness and reducing appetite. Weight loss can alleviate the strain on the heart and improve overall cardiovascular health.

Improved Blood Sugar Control:
Good blood sugar control is essential for heart failure patients, especially those with diabetes. GLP-1 agonists help manage blood sugar levels, reducing the risk of diabetes-related complications that can negatively impact heart function.

Cardioprotective Effects:
Studies have shown that GLP-1 agonists can have direct benefits on the cardiovascular system. They can improve endothelial function (the health of the inner lining of blood vessels), reduce inflammation, and lower blood pressure, all of which contribute to better heart health.

Reduction in Hospitalizations:
Clinical trials have indicated that GLP-1 agonists may reduce the risk of hospitalizations for heart failure. By improving overall cardiovascular health and controlling blood sugar levels, these medications can help stabilize heart failure symptoms.

How GLP-1 Agonists Can Help Heart Function

Enhanced Cardiovascular Health:
By promoting weight loss, lowering blood pressure, and reducing inflammation, GLP-1 agonists contribute to improved cardiovascular health, which can alleviate the burden on the heart and enhance its function.

Better Blood Sugar Management:
Improved blood sugar control helps prevent the complications of diabetes that can exacerbate heart failure, such as poor circulation and damage to blood vessels.

Potential Direct Benefits on Heart Muscle:
Emerging research suggests that GLP-1 agonists may have direct protective effects on the heart muscle, potentially improving its function and resilience in the setting of heart failure.

Overall Health Improvement:
By addressing multiple factors that contribute to heart failure, such as obesity, high blood pressure, and poor blood sugar control, GLP-1 agonists offer a comprehensive approach to improving heart function and patient outcomes.

GLP-1 agonists, such as liraglutide, semaglutide, and dulaglutide, offer promising benefits for patients with heart failure. These medications improve blood sugar control, promote weight loss, and have potential cardioprotective effects. If you have heart failure and think you might benefit from a GLP-1 agonist, discuss it with your healthcare provider to see if this treatment is right for you. With the right management plan, many patients with heart failure can lead more active and fulfilling lives.

Understanding Toprol XL and Its Role in Heart Failure Management

Mon, 24 Jun 2024 18:50:30 GMT

Understanding Toprol XL and Its Role in Heart Failure Management

Heart failure is a condition where the heart struggles to pump blood efficiently, leading to symptoms such as fatigue, shortness of breath, and fluid retention. Managing heart failure typically involves a combination of lifestyle changes and medications designed to improve heart function and reduce symptoms. One commonly prescribed medication for heart failure is Toprol XL (metoprolol succinate). This article will explain how Toprol XL works, why it might be needed for heart failure, and how it can help improve heart function.

What is Toprol XL?

Toprol XL (metoprolol succinate) is a beta-blocker, a type of medication that affects the heart and circulation (blood flow through arteries and veins).

Beta-Blockers: These medications block the effects of the hormone adrenaline (epinephrine) and other stress hormones. They help reduce heart rate, blood pressure, and the heart's workload.

How Toprol XL Works

Blocking Beta Receptors:
Toprol XL blocks beta-adrenergic receptors in the heart. These receptors are normally stimulated by adrenaline, which increases heart rate and force of contraction.
By blocking these receptors, Toprol XL reduces the heart rate and the force of the heart's contractions, leading to a decrease in the heart's overall workload.

Reducing Blood Pressure:
By lowering the heart rate and reducing the force of contractions, Toprol XL also helps to lower blood pressure. Lower blood pressure means less strain on the heart and blood vessels.

Improving Heart Rhythm:
Toprol XL can help regulate abnormal heart rhythms (arrhythmias) by stabilizing the electrical activity in the heart, which is particularly beneficial for patients with heart failure who are prone to arrhythmias.

Why Toprol XL Might Be Needed

Heart Failure Symptoms:
Patients with heart failure often experience symptoms such as fatigue, shortness of breath, and fluid retention. Toprol XL helps alleviate these symptoms by reducing the heart's workload and improving its efficiency.

Risk of Arrhythmias:
Heart failure patients are at higher risk for dangerous arrhythmias, which can lead to sudden cardiac arrest. By stabilizing the heart's rhythm, Toprol XL helps reduce this risk.

Improving Survival:
Clinical studies have shown that beta-blockers like Toprol XL improve survival rates in heart failure patients by reducing the risk of hospitalization and death from heart-related causes.

How Toprol XL Can Help Heart Function

Reduced Heart Rate:
By blocking the effects of adrenaline, Toprol XL slows down the heart rate. A slower heart rate allows the heart to fill more completely between beats, improving blood flow and oxygen delivery to the body.

Lowered Blood Pressure:
Toprol XL helps lower blood pressure, reducing the strain on the heart. Lower blood pressure decreases the workload on the heart and helps prevent further damage to the heart muscle.

Improved Heart Efficiency:
By reducing the heart rate and blood pressure, Toprol XL allows the heart to pump more efficiently. This leads to improved cardiac output and reduced symptoms of heart failure, such as shortness of breath and fatigue.

Decreased Risk of Arrhythmias:
Toprol XL helps stabilize the heart's electrical activity, reducing the risk of arrhythmias. This is particularly important for heart failure patients who are at increased risk for dangerous heart rhythms.

Enhanced Quality of Life:
Many patients taking Toprol XL report an improvement in their symptoms and overall quality of life. By managing symptoms more effectively, patients can engage in daily activities and maintain a more active lifestyle.

Toprol XL (metoprolol succinate) is a key medication in the management of heart failure. By blocking the effects of adrenaline, Toprol XL reduces heart rate, lowers blood pressure, and improves heart efficiency. This helps alleviate symptoms, stabilize heart rhythms, and improve overall quality of life for heart failure patients. If you have heart failure and think you might benefit from Toprol XL, discuss it with your healthcare provider to see if this treatment is right for you. With proper management, many patients with heart failure can lead more active and fulfilling lives.

Understanding Entresto and Its Role in Heart Failure Management

Mon, 17 Jun 2024 19:52:12 GMT

Understanding Entresto and Its Role in Heart Failure Management

Heart failure is a condition where the heart cannot pump blood as efficiently as it should, leading to symptoms like fatigue, shortness of breath, and fluid retention. Managing heart failure often involves a combination of medications that help improve heart function and reduce symptoms. One such medication is Entresto (sacubitril/valsartan). This article will explain how Entresto works, why it might be needed for heart failure, and how it can help improve heart function.

What is Entresto?

Entresto is a combination medication that includes two active ingredients: sacubitril and valsartan.

Sacubitril: This component is a neprilysin inhibitor. Neprilysin is an enzyme that breaks down beneficial peptides in the body that help relax blood vessels, reduce sodium retention, and decrease strain on the heart.

Valsartan: This component is an angiotensin II receptor blocker (ARB). It blocks the effects of angiotensin II, a hormone that narrows blood vessels and raises blood pressure. By blocking this hormone, valsartan helps relax blood vessels and lower blood pressure.

How Entresto Works

Enhancing Beneficial Peptides:
Sacubitril inhibits neprilysin, which increases the levels of natriuretic peptides. These peptides help dilate blood vessels, reduce sodium retention, and decrease blood pressure, easing the workload on the heart.
By preventing the breakdown of these peptides, sacubitril helps enhance their beneficial effects, leading to improved heart function and reduced symptoms of heart failure.

Blocking Harmful Hormones:
Valsartan blocks the effects of angiotensin II, a hormone that causes blood vessels to constrict and raises blood pressure. By blocking this hormone, valsartan helps relax blood vessels, lower blood pressure, and reduce the strain on the heart.
This combination of blocking harmful effects while enhancing beneficial ones provides a comprehensive approach to managing heart failure.

Why Entresto Might Be Needed

Persistent Symptoms Despite Standard Therapy:
Some patients continue to experience significant symptoms of heart failure despite taking other medications, such as ACE inhibitors or ARBs alone. Entresto offers an alternative that combines the benefits of neprilysin inhibition and angiotensin II blockade, providing more effective symptom relief.

Improving Outcomes:
Clinical studies have shown that Entresto significantly reduces the risk of hospitalization for heart failure and cardiovascular death compared to traditional therapies. For patients with a high risk of these outcomes, Entresto can provide crucial benefits.

Comprehensive Treatment:
Heart failure often involves complex interactions between various hormones and signaling pathways. Entresto's dual action addresses multiple aspects of heart failure pathophysiology, offering a more comprehensive treatment option.

How Entresto Can Help Heart Function

Improved Heart Efficiency:
By enhancing beneficial peptides and blocking harmful hormones, Entresto helps the heart pump blood more effectively. This improves cardiac output and reduces the symptoms of heart failure, such as shortness of breath and fatigue.

Reduced Fluid Retention:
Entresto helps reduce sodium retention and fluid buildup, alleviating swelling in the legs, ankles, and abdomen, and reducing the sensation of breathlessness.

Lower Blood Pressure:
By relaxing blood vessels and lowering blood pressure, Entresto reduces the workload on the heart. This allows the heart to function more efficiently and prevents further damage to the heart muscle.

Decreased Hospitalizations:
Patients taking Entresto often experience fewer hospitalizations for heart failure exacerbations. This is because the medication helps maintain a more stable heart condition, reducing the frequency and severity of heart failure episodes.

Improved Survival Rates:
Clinical trials have shown that Entresto significantly improves survival rates in heart failure patients. By addressing both the mechanical and hormonal aspects of heart failure, Entresto provides comprehensive protection and support for the heart.

Entresto (sacubitril/valsartan) is a powerful medication for managing heart failure. By enhancing beneficial peptides and blocking harmful hormones, Entresto improves heart function, reduces symptoms, and lowers the risk of hospitalization and death. If you have heart failure and think you might benefit from Entresto, discuss it with your healthcare provider to see if this treatment is right for you. With the right management plan, many patients with heart failure can lead more active and fulfilling lives.

Understanding the Role of SGLT2 Inhibitors in Heart Failure

Mon, 10 Jun 2024 17:10:01 GMT

Understanding the Role of SGLT2 Inhibitors in Heart Failure

Heart failure is a condition where the heart is unable to pump blood effectively, leading to symptoms like fatigue, shortness of breath, and fluid retention. While medications traditionally used for heart failure have focused on improving heart function directly, a newer class of drugs called SGLT2 inhibitors, such as Jardiance (empagliflozin) and Farxiga (dapagliflozin), has emerged as an important treatment option. Originally developed for diabetes management, these medications have shown significant benefits in heart failure. This article will explain why SGLT2 inhibitors might be needed for heart failure and how they can help improve heart function.

Why an SGLT2 Inhibitor Might Be Needed

Persistent Symptoms Despite Standard Therapy:
Some patients with heart failure continue to experience symptoms such as fatigue and shortness of breath despite taking standard heart failure medications (e.g., ACE inhibitors, beta-blockers, diuretics).
SGLT2 inhibitors can provide additional relief and improve overall heart function and quality of life.

High Risk of Hospitalization and Mortality:
Heart failure patients face a high risk of hospitalization and mortality due to the progressive nature of the disease and potential complications.
SGLT2 inhibitors have been shown to reduce the risk of hospitalization and death in heart failure patients, making them a valuable addition to treatment regimens.

Need for Comprehensive Management:
Heart failure is often accompanied by other conditions, such as diabetes, obesity, and kidney disease. SGLT2 inhibitors offer benefits for multiple aspects of health, providing a more comprehensive approach to managing heart failure.

How an SGLT2 Inhibitor Can Help

Improvement of Heart Function:
SGLT2 inhibitors help improve heart function by reducing the workload on the heart. They promote the excretion of excess glucose and sodium through the urine, which leads to a mild diuretic effect.
This diuretic effect reduces fluid volume in the body, decreasing the strain on the heart and lowering blood pressure.

Reduction of Inflammation and Oxidative Stress:
SGLT2 inhibitors have been found to reduce inflammation and oxidative stress in the heart and blood vessels. This can help improve heart muscle function and slow the progression of heart failure.

Protection Against Kidney Damage:
Heart failure and kidney disease often coexist and exacerbate each other. SGLT2 inhibitors have protective effects on the kidneys, helping to preserve kidney function and reduce the risk of worsening kidney disease.
By improving kidney function, these medications indirectly support better heart health.

Improved Blood Sugar Control:
For patients with both heart failure and diabetes, SGLT2 inhibitors provide the added benefit of better blood sugar control. Lowering blood glucose levels helps reduce the risk of diabetes-related complications that can further strain the heart.

Reduced Risk of Hospitalization and Mortality:
Clinical studies have demonstrated that SGLT2 inhibitors significantly reduce the risk of hospitalization for heart failure and cardiovascular death.
These benefits extend to patients with and without diabetes, highlighting the broad applicability of these medications in heart failure management.

Benefits of SGLT2 Inhibitors in Heart Failure

Improved Exercise Capacity: Many patients experience improved exercise tolerance and reduced symptoms, allowing for a more active lifestyle.
Enhanced Quality of Life: By reducing symptoms and preventing hospitalizations, SGLT2 inhibitors contribute to a better quality of life for heart failure patients.
Comprehensive Health Benefits: Beyond heart failure, these medications offer benefits for kidney health and blood sugar control, making them valuable for patients with multiple health concerns.

SGLT2 inhibitors, such as Jardiance and Farxiga, have become important tools in the management of heart failure. By improving heart function, reducing inflammation, protecting kidney health, and lowering the risk of hospitalization and death, these medications offer significant benefits to heart failure patients. If you have heart failure and think you might benefit from an SGLT2 inhibitor, discuss it with your healthcare provider to see if this treatment is right for you.

Understanding the Need for a BiV ICD in Heart Failure

Mon, 03 Jun 2024 19:52:33 GMT

Understanding the Need for a BiV ICD in Heart Failure

Heart failure is a chronic condition where the heart can't pump blood as efficiently as it should. This can lead to symptoms like fatigue, shortness of breath, and fluid retention. For some patients with heart failure, a device called a Biventricular Implantable Cardioverter Defibrillator (BiV ICD) can be crucial in managing their condition. This article will explain why a BiV ICD might be needed for heart failure and how it can help improve heart function.

Why a BiV ICD Might Be Needed

Dyssynchrony in Heart Contractions:
In heart failure, the heart's ventricles (the two lower chambers) may not contract in a coordinated way. This lack of synchronization, known as dyssynchrony, reduces the heart's efficiency in pumping blood.
Dyssynchrony often occurs in patients with a wide QRS complex on an electrocardiogram (ECG), indicating delayed electrical activation of the ventricles.

Risk of Dangerous Arrhythmias:
Patients with heart failure are at a higher risk of developing life-threatening arrhythmias, such as ventricular tachycardia or ventricular fibrillation. These conditions can lead to sudden cardiac arrest if not treated promptly.

Persistent Symptoms Despite Medication:
Some patients continue to experience significant symptoms of heart failure, such as severe fatigue and shortness of breath, despite taking optimal medications. For these patients, additional treatment options are needed to improve their quality of life and heart function.

How a BiV ICD Can Help

Cardiac Resynchronization Therapy (CRT):
The biventricular pacemaker component of a BiV ICD helps to resynchronize the contractions of the left and right ventricles. It sends electrical impulses to both ventricles, making them contract simultaneously.
This resynchronization improves the efficiency of the heart's pumping action, leading to better blood flow throughout the body.

Arrhythmia Detection and Correction:
The implantable cardioverter defibrillator (ICD) component monitors the heart's rhythm continuously. If it detects a dangerous arrhythmia, it can deliver a shock to restore a normal heartbeat.
This feature is critical in preventing sudden cardiac arrest, a major risk for heart failure patients.

Improved Heart Function and Symptoms:
By improving the synchronization of heart contractions, a BiV ICD can enhance overall heart function. This often leads to a reduction in heart failure symptoms, such as shortness of breath and fatigue.
Patients may experience an improved ability to perform daily activities and engage in physical exercise.

Reduced Hospitalizations:
With better-managed heart failure symptoms and a reduced risk of arrhythmias, patients with a BiV ICD often experience fewer hospitalizations for heart failure exacerbations. This contributes to a more stable and manageable condition.

Increased Survival Rates:
The combination of resynchronization therapy and arrhythmia prevention provided by a BiV ICD significantly improves survival rates in heart failure patients. It addresses both the mechanical and electrical dysfunctions of the heart, offering comprehensive protection and support.

Who Should Consider a BiV ICD?

A BiV ICD is typically recommended for heart failure patients who:
Have moderate to severe symptoms despite optimal medical therapy.
Have a reduced ejection fraction (a measure of how much blood the left ventricle pumps out with each contraction).
Show evidence of dyssynchrony on an ECG, particularly a wide QRS complex.
Are at high risk for or have experienced life-threatening arrhythmias.

Your cardiologist will evaluate your specific condition, symptoms, and test results to determine if a BiV ICD is appropriate for you.

A Biventricular Implantable Cardioverter Defibrillator (BiV ICD) can be a lifesaving device for many heart failure patients. By improving the coordination of heart contractions and providing protection against dangerous arrhythmias, a BiV ICD can enhance heart function, reduce symptoms, and improve overall quality of life. If you have heart failure and think you might benefit from this device, discuss it with your healthcare provider to see if a BiV ICD is right for you.

Understanding Medications for Heart Failure

Wed, 29 May 2024 19:00:07 GMT

Medications used in patients with heart failure

Heart failure is a chronic condition where the heart cannot pump blood efficiently, leading to symptoms such as fatigue, shortness of breath, and fluid retention. Managing heart failure often involves lifestyle changes and a combination of medications designed to help the heart work better and reduce symptoms. Here’s an overview of the types of medications commonly recommended for heart failure, along with explanations of how and why they work.

ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors)
Examples of ACE inhibitors: Lisinopril, Enalapril, Ramipril

How do ACE inhibitors Work: ACE inhibitors block the production of angiotensin II, a substance in your body that narrows blood vessels. By preventing this, the blood vessels relax and widen, making it easier for the heart to pump blood.

Why Are ACE inhibitors Used: These medications lower blood pressure, reduce the strain on the heart, and can help prevent further damage to the heart muscle. They also have been shown to improve survival in people with heart failure.

ARBs (Angiotensin II Receptor Blockers)
Examples of ARBs: Losartan, Valsartan, Candesartan

How ARBs Work: ARBs block the action of angiotensin II by preventing it from binding to its receptors on blood vessels. This also leads to the relaxation and widening of blood vessels.

Why Are ARBs Used: ARBs are often used in people who cannot tolerate ACE inhibitors due to side effects like cough. They provide similar benefits in reducing blood pressure and improving heart function.

Beta-Blockers
Examples of beta blockers: Metoprolol, Carvedilol, Bisoprolol

How do beta blockers Work: Beta-blockers slow down the heart rate and reduce the force of contraction, decreasing the heart's demand for oxygen and reducing blood pressure.

Why Are beta blockers Used: By reducing the workload on the heart, beta-blockers help improve heart function over time. They are particularly beneficial in reducing the risk of death and hospitalization in heart failure patients.

Diuretics (Water Pills)
Examples of diuretics: Furosemide, Bumetanide, Torsemide, Hydrochlorothiazide

How do diuretics Work: Diuretics help the kidneys remove excess salt and water from the body, reducing fluid buildup in the lungs, legs, and abdomen.

Why Are diuretics Used: Diuretics alleviate symptoms of fluid overload, such as swelling and shortness of breath, making it easier for patients to breathe and move around.

Aldosterone Antagonists
Examples of aldosterone antagonists: Spironolactone, Eplerenone

How do aldosterone antagonists Work: These medications block the effects of aldosterone, a hormone that causes the body to retain salt and water. They also help remove excess fluid and reduce blood pressure.

Why are aldosterone antagonist Used: Aldosterone antagonists can improve survival in patients with severe heart failure and are often used in combination with other medications.

ARNIs (Angiotensin Receptor-Neprilysin Inhibitors)
Example of ARNIs : Sacubitril/Valsartan (Entresto)

How do ARNIs Work: ARNIs combine an ARB (Valsartan) with a neprilysin inhibitor (Sacubitril). Neprilysin is an enzyme that breaks down beneficial peptides that help widen blood vessels and reduce sodium retention.

Why Are ARNIs Used: This combination helps to further reduce strain on the heart and has been shown to improve survival and reduce hospitalizations compared to ACE inhibitors alone.

SGLT2 Inhibitors
Examples of SGLT2 inhibitors: Dapagliflozin, Empagliflozin

How do SGLT2 inhibitors Work: Originally used to treat diabetes, SGLT2 inhibitors help the kidneys remove excess glucose from the blood, which also leads to a slight increase in the removal of sodium and water.

Why Are SGLT2 inhibitors Used: These medications have been found to improve outcomes in heart failure patients, including those without diabetes, by reducing the risk of hospitalization and cardiovascular death.

Digoxin
How digoxin Works: Digoxin increases the force of the heart's contractions and slows the heart rate by affecting the sodium-potassium pump in heart cells.

Why is digoxin Used: Digoxin can help control symptoms and improve exercise tolerance in patients with heart failure, especially those with atrial fibrillation (an irregular heart rhythm).

Managing heart failure effectively often requires a combination of these medications. Each type of medication addresses different aspects of the condition, working together to improve heart function, relieve symptoms, and enhance quality of life. It's important to follow your healthcare provider's instructions and discuss any side effects or concerns you may have about your medications. With the right treatment plan, many people with heart failure can lead active and fulfilling lives.

Understanding the Connection Between Respiratory Syncytial Virus (RSV) and Your Heart

Thu, 11 Apr 2024 18:47:50 GMT

RSV can impact your heart health, exacerbate heart failure, or cause arrhythmias

Understanding the Connection Between Respiratory Syncytial Virus (RSV) and Heart Problems

Respiratory Syncytial Virus (RSV) is a common respiratory virus that typically causes mild, cold-like symptoms in healthy individuals. However, it can lead to more serious health complications in infants, elderly adults, and those with weakened immune systems or chronic heart conditions. Emerging research indicates a concerning link between RSV infections and the exacerbation of heart-related problems, particularly in high-risk groups. This article explores this connection and underscores the importance of RSV vaccination.

The Link Between RSV and Heart Health

RSV can have a significant impact on heart health by exacerbating existing heart conditions or triggering new cardiac issues. Individuals with cardiovascular diseases are at a higher risk of developing severe complications from RSV, including:

1. Heart Failure Exacerbation: RSV can increase the workload on the heart, potentially leading to the worsening of existing heart failure.

2. Arrhythmias: The stress and inflammation caused by an RSV infection may disrupt the normal electrical function of the heart, leading to irregular heart rhythms.

3. Increased Risk of Myocardial Infarction: Some studies suggest that severe respiratory infections like RSV can temporarily increase the risk of a heart attack.

Mechanisms of Impact

RSV leads to increased inflammation and stress on the cardiovascular system. The virus can trigger an immune response that, while fighting the infection, also causes inflammation throughout the body, including the heart. This can exacerbate symptoms in people with pre-existing heart conditions and increase the risk for cardiovascular events.

Vaccination: A Critical Defense

Vaccination against RSV is emerging as a crucial preventive measure, especially for those at higher risk of severe illness. The following points highlight the importance of RSV vaccination:

- Prevention of Severe RSV Infections: Vaccines reduce the likelihood of contracting severe RSV, thus minimizing the stress on the cardiovascular system.

- Reduction in Hospitalizations : By preventing severe disease, vaccines can reduce the number of hospitalizations due to RSV, especially in those with pre-existing heart conditions.

- Protection for Vulnerable Population s: Elderly adults, infants, and individuals with chronic illnesses or compromised immune systems stand to benefit significantly from vaccination.

Conclusion

The connection between RSV and heart problems is an area of active research and concern, particularly for individuals with existing cardiovascular conditions. Vaccination offers a promising avenue to mitigate these risks. As RSV vaccines become more widely available, it is crucial for at-risk populations and their caregivers to discuss vaccination options with healthcare providers.

Atrial Fibrillation Rates in Daytona Beach, Florida: Unveiling a Growing Health Concern

Tue, 29 Aug 2023 18:37:49 GMT

Atrial Fibrillation Rates in Daytona Beach, Florida: Unveiling a Growing Health Concern

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Revolutionizing Heart Failure Treatment: How Jardiance Offers Hope and Health

Tue, 29 Aug 2023 18:34:50 GMT

Jardiance and Heart Failure

Heart failure is a chronic medical condition that affects millions of people around the world, causing a significant impact on their quality of life and overall well-being. The quest to find innovative treatments has led to groundbreaking discoveries, and one such remarkable development is the use of Jardiance (empagliflozin) in the management of heart failure patients. Originally designed as an antidiabetic medication, Jardiance has demonstrated its potential to transform the lives of individuals grappling with heart failure. This article delves into the science behind Jardiance's efficacy, its mechanism of action, and its promising benefits for patients battling heart failure.

Understanding Heart Failure

Heart failure is a complex cardiovascular condition characterized by the heart's inability to pump blood effectively, resulting in insufficient oxygen and nutrients reaching various organs and tissues. This often leads to symptoms such as shortness of breath, fatigue, fluid retention, and reduced exercise tolerance. The condition can stem from various underlying causes, including coronary artery disease, hypertension, and certain heart valve disorders.

Jardiance: A Diabetes Drug with Unexpected Benefits

Jardiance is a medication initially developed to manage type 2 diabetes by inhibiting sodium-glucose cotransporter 2 (SGLT2), a protein responsible for reabsorbing glucose in the kidneys. By blocking SGLT2, Jardiance promotes the excretion of excess glucose in the urine, thereby reducing blood glucose levels in diabetic patients. However, researchers soon discovered that Jardiance's benefits extended beyond glycemic control.

The Mechanism of Jardiance in Heart Failure

The pivotal discovery that reshaped Jardiance's medical application was its impact on heart failure. The medication's mechanism of action involves inhibiting SGLT2 not only in the kidneys but also in the heart. This unique property sets the stage for its profound effects on heart failure patients.

By inhibiting SGLT2 in the heart, Jardiance leads to several interconnected benefits:

Diuretic Effect: Jardiance encourages the excretion of excess sodium from the body, which reduces fluid retention and eases the workload on the heart.
Cardiac Remodeling: The medication appears to promote positive structural changes in the heart, reducing its enlargement and enhancing its pumping efficiency.
Improved Energy Utilization: Jardiance triggers the utilization of alternative energy sources within heart muscle cells, potentially enhancing their function and resilience.
Reduction in Blood Pressure: Jardiance can lower blood pressure, thereby alleviating stress on the heart and blood vessels.

Clinical Evidence and Patient Benefits

Numerous clinical trials have demonstrated the effectiveness of Jardiance in treating heart failure patients, regardless of whether they have diabetes. The EMPEROR-Reduced and EMPEROR-Preserved trials, for instance, showcased significant reductions in heart failure-related hospitalizations and cardiovascular death rates among patients receiving Jardiance.

Patients have reported remarkable improvements in their quality of life, exercise tolerance, and symptom management. The medication's ability to address both the functional and structural aspects of heart failure has ignited hope for individuals who previously had limited options.

Considerations and Future Directions

While Jardiance has exhibited remarkable potential in the treatment of heart failure, it's important to note that like any medication, it may not be suitable for everyone. Consultation with a healthcare professional is vital to determine the appropriateness of Jardiance based on an individual's medical history, current medications, and overall health.

The journey of Jardiance from a diabetes drug to a heart failure treatment exemplifies the serendipitous nature of medical discoveries. Ongoing research aims to delve even deeper into the mechanisms behind Jardiance's benefits and explore its potential in other cardiovascular conditions.

Conclusion

Jardiance's transformation from an antidiabetic drug to a groundbreaking heart failure treatment showcases the incredible potential for repurposing medications to address unmet medical needs. Its ability to simultaneously address multiple facets of heart failure sets a promising precedent for the future of cardiovascular care. As science and innovation continue to evolve, Jardiance stands as a beacon of hope, offering a new lease on life for countless individuals battling the challenges of heart failure.

Alcohol Consumption and Its' Link to Atrial Fibrillation (AFib)

Mon, 19 Jun 2023 19:48:06 GMT

How alcohol is slowly damaging your heart

Atrial fibrillation (AFib) is a common heart rhythm disorder characterized by irregular and often rapid heartbeats. It occurs when the upper chambers of the heart (atria) experience chaotic electrical signals, leading to an irregular heartbeat. Alcohol consumption has been identified as a potential trigger for AFib and can exacerbate the condition. This patient education guide aims to explain how alcohol consumption can lead to AFib and provide recommendations for managing alcohol intake.

How Alcohol Affects the Heart:

Electrical Disturbances: Alcohol interferes with the electrical signaling in the heart, disrupting the normal rhythm. This disturbance can trigger AFib episodes or make existing AFib worse.
Increased Heart Rate: Alcohol consumption can elevate heart rate. For individuals with AFib, this can lead to a rapid and irregular heartbeat, increasing the risk of complications.
Dehydration: Alcohol is a diuretic, which means it increases urine production and can cause dehydration. Dehydration can further contribute to irregular heart rhythms and increase the likelihood of AFib episodes.
Heart Muscle Damage: Heavy and prolonged alcohol consumption can damage heart muscle cells, leading to cardiomyopathy. This condition weakens the heart and increases the risk of developing AFib.

Tips for Managing Alcohol Consumption:

Limit Intake: It is advisable to limit or avoid alcohol consumption if you have been diagnosed with AFib or have a history of heart rhythm disorders. Even moderate alcohol intake can trigger episodes or worsen existing AFib. Speak with your healthcare provider to determine the appropriate level of alcohol consumption for your specific condition.
Know Your Triggers: If alcohol has previously triggered AFib episodes for you, it is essential to recognize this trigger and avoid consuming alcohol altogether. Identifying and avoiding individual triggers can help prevent AFib episodes and reduce the risk of complications.
Stay Hydrated: If you choose to consume alcohol, ensure you drink plenty of water to maintain adequate hydration. This can help counteract the dehydrating effects of alcohol and reduce the impact on your heart rhythm.
Monitor Symptoms: Pay attention to any changes or symptoms you experience after consuming alcohol. If you notice an increase in heart palpitations, dizziness, or shortness of breath, consult your healthcare provider for further evaluation and guidance.
Seek Support: If you find it challenging to limit your alcohol intake, consider seeking support from healthcare professionals, support groups, or counseling services. They can provide guidance, resources, and strategies to help you reduce or quit alcohol consumption.

Understanding the link between alcohol consumption and AFib is crucial for individuals diagnosed with AFib or those at risk. By limiting alcohol intake, recognizing personal triggers, staying hydrated, monitoring symptoms, and seeking support, you can effectively manage your condition and reduce the risk of AFib-related complications. Remember to consult your healthcare provider for personalized advice and recommendations based on your specific situation.

The Role of Atrial Fibrillation in the Development of Heart Failure

Tue, 13 Jun 2023 16:48:58 GMT

The connection between atrial fibrillation and heart failure.

Atrial fibrillation (AF) is a common cardiac arrhythmia characterized by irregular and rapid electrical impulses originating from the atria. It affects millions of individuals worldwide and is associated with an increased risk of adverse cardiovascular events. One significant complication of AF is its contribution to the development and progression of heart failure. This article explores the intricate relationship between atrial fibrillation and heart failure, highlighting the mechanisms by which AF can lead to heart failure and emphasizing the clinical implications.

Hemodynamic Consequences: Atrial fibrillation disrupts the coordinated contraction of the atria, leading to ineffective atrial contraction and loss of atrial kick. As a result, the ventricles receive an irregular and often rapid ventricular response, compromising the overall cardiac output. The reduced cardiac output can result in decreased systemic perfusion and tissue oxygenation, leading to symptoms such as fatigue, dyspnea, and exercise intolerance.

Structural Remodeling: Prolonged episodes of AF can induce structural remodeling in the atria, promoting fibrosis, dilation, and electrical conduction abnormalities. These changes can further perpetuate and worsen the arrhythmia, creating a self-perpetuating cycle. The structural alterations in the atria may extend to the ventricles, leading to ventricular remodeling, impaired contractile function, and eventually, heart failure.

Ventricular Rate Control: In patients with AF, the irregular ventricular response can be managed through rate control strategies. However, excessively rapid ventricular rates, especially during physical activity, can result in increased myocardial oxygen demand, reduced diastolic filling time, and impaired ventricular relaxation. These factors contribute to ventricular dysfunction and, over time, may contribute to heart failure.
Cardiomyopathy: In some cases, long-standing or uncontrolled AF can lead to the development of atrial cardiomyopathy, characterized by atrial dilation, fibrosis, and impaired mechanical function. This atrial cardiomyopathy can have deleterious effects on the ventricles, leading to a deterioration in ventricular function and the development of heart failure.

Ischemic Events: AF is associated with an increased risk of thromboembolic events, including stroke. When emboli originating from the left atrial appendage occlude arteries supplying the heart, it can result in myocardial infarction, causing damage to the myocardium and potentially leading to heart failure.

Atrial fibrillation significantly contributes to the development and progression of heart failure through various mechanisms. The hemodynamic consequences, structural remodeling, ventricular rate control, cardiomyopathy, and ischemic events associated with AF collectively contribute to the decline in cardiac function and the clinical manifestation of heart failure. Recognizing the relationship between AF and heart failure is crucial for effective management and the implementation of appropriate therapeutic strategies to mitigate the progression of both conditions and improve patient outcomes.

Disclaimer: This article is for informational purposes only and should not be considered as medical advice. It is essential to consult with a qualified healthcare professional for diagnosis, treatment, and guidance regarding atrial fibrillation and heart failure.

January, C. T., et al. (2014). 2014 AHA/ACC/HRS Guideline for the Management of Patients with Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 64(21), e1-e76.
Kotecha, D., et al. (2016). Atrial fibrillation and heart failure: A systematic review and meta-analysis of outcome and treatment effects. European Journal of Heart Failure, 18(5), 592-600.
Santhanakrishnan, R., et al. (2016). Atrial fibrillation begets heart failure and vice versa: Temporal associations and differences in preserved versus reduced ejection fraction. Circulation, 133(5), 484-492.
Savelieva, I., & Camm, A. J. (2008). Atrial fibrillation and heart failure: Natural history and pharmacological treatment. Europace, 10(5), 527-539.
Wijffels, M. C., et al. (1995). Atrial fibrillation begets atrial fibrillation: A study in awake chronically instrumented goats. Circulation, 92(7), 1954-1968.

Heart problem risk increased after covid

Fri, 11 Feb 2022 15:41:53 GMT

Even mild cases of COVID-19 present and increased risk of heart problems

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COVID booster for cardiac patients

Thu, 11 Nov 2021 17:54:59 GMT

What heart and stroke patients should know about COVID-19 vaccine boosters

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CDC Statement on COVID-19 Booster Recommendations

wangepccc@gmail.com (James Wang) — Fri, 01 Oct 2021 16:20:11 GMT

Pfizer Covid Vaccine Booster Recommendations

for Patients with Heart Problems

CDC Director Rochelle P. Walensky, M.D., M.P.H., endorsed the CDC Advisory Committee on Immunization Practices’ (ACIP) recommendation for a booster shot of the Pfizer-BioNTech COVID-19 vaccine in certain populations and also recommended a booster dose for those in high risk occupational and institutional settings. The Food and Drug Administration’s (FDA) authorization and CDC’s guidance for use are important steps forward as we work to stay ahead of the virus and keep Americans safe.

This updated interim guidance from CDC allows for millions of Americans who are at highest risk for COVID-19 to receive a Pfizer-BioNTech COVID-19 booster shot to help increase their protection.

CDC recommends:

people 65 years and older and residents in long-term care settings should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
people aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
people aged 18–49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and
people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

Medical Conditions in Adults that Should get a Booster

This list is presented in alphabetical order and not in order of risk.
CDC completed an evidence review process for each medical condition on this list to ensure they met criteria for inclusion on this webpage.
We are learning more about COVID-19 every day, and this list may be updated as the science evolves.

Cancer

Having cancer can make you more likely to get severely ill from COVID-19. Treatments for many types of cancer can weaken your body’s ability to fight off disease. At this time, based on available studies, having a history of cancer may increase your risk.

Get more information:

Chronic kidney disease

Having chronic kidney disease of any stage can make you more likely to get severely ill from COVID-19.

Get more information:

Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension

Chronic lung diseases can make you more likely to get severely ill from COVID-19. These diseases may include:

Asthma, if it’s moderate to severe
Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis
Having damaged or scarred lung tissue such as interstitial lung disease (including idiopathic pulmonary fibrosis)
Cystic fibrosis, with or without lung or other solid organ transplant
Pulmonary hypertension (high blood pressure in the lungs)

Get more information:

Dementia or other neurological conditions

Having neurological conditions, such as dementia, can make you more likely to get severely ill from COVID-19.

Get more information:

Diabetes (type 1 or type 2)

Having either type 1 or type 2 diabetes can make you more likely to get severely ill from COVID-19.

Get more information:

Diabetes | CDC
American Diabetes Association: How COVID-19 Impacts People with Diabetes
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Down syndrome

Having Down syndrome can make you more likely to get severely ill from COVID-19.

Get more information:

Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)

Having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension) can make you more likely to get severely ill from COVID-19.

Get more information:

HIV infection

Having HIV (Human Immunodeficiency Virus) can make you more likely to get severely ill from COVID-19.

Get more information:

Immunocompromised state (weakened immune system)

Having a weakened immune system can make you more likely to get severely ill from COVID-19. Many conditions and treatments can cause a person to be immunocompromised or have a weakened immune system. Primary immunodeficiency is caused by genetic defects that can be inherited. Prolonged use of corticosteroids or other immune weakening medicines can lead to secondary or acquired immunodeficiency.

People who have a condition or are taking medications that weaken their immune system may not be fully protected even if they are fully vaccinated. They should continue to take all precautions recommended for unvaccinated people, including wearing a well-fitted mask , until advised otherwise by their healthcare provider.

Get more information:

Liver disease

Having chronic liver disease, such as alcohol-related liver disease, nonalcoholic fatty liver disease, and especially cirrhosis, or scarring of the liver, can make you more likely to get severely ill from COVID-19.

Get more information:

Overweight and obesity

Overweight (defined as a body mass index (BMI) > 25 kg/m2 but < 30 kg/m2), obesity (BMI ≥30 kg/m2 but < 40 kg/m2), or severe obesity (BMI of ≥40 kg/m2), can make you more likely to get severely ill from COVID-19. The risk of severe COVID-19 illness increases sharply with elevated BMI.

Get more information:

Pregnancy

Pregnant and recently pregnant people (for at least 42 days following end of pregnancy) are more likely to get severely ill from COVID-19 compared with non-pregnant people.

Get more information:

Sickle cell disease or thalassemia

Having hemoglobin blood disorders like sickle cell disease (SCD) or thalassemia can make you more likely to get severely ill from COVID-19.

Get more information:

Smoking, current or former

Being a current or former cigarette smoker can make you more likely to get severely ill from COVID-19. If you currently smoke, quit. If you used to smoke, don’t start again. If you’ve never smoked, don’t start.

Get more information:

Solid organ or blood stem cell transplant

Having had a solid organ or blood stem cell transplant, which includes bone marrow transplants, can make you more likely to get severely ill from COVID-19.

Get more information:

Stroke or cerebrovascular disease, which affects blood flow to the brain

Having cerebrovascular disease, such as having a stroke, can make you more likely to get severely ill from COVID-19.

Get more information:

Substance use disorders

Having a substance use disorder (such as alcohol, opioid, or cocaine use disorder) can make you more likely to get severely ill from COVID-19.

Get more information:

Many of the people who are now eligible to receive a booster shot received their initial vaccine early in the vaccination program and will benefit from additional protection. With the Delta variant’s dominance as the circulating strain and cases of COVID-19 increasing significantly across the United States, a booster shot will help strengthen protection against severe disease in those populations who are at high-risk for exposure to COVID-19 or the complications from severe disease.

CDC will continue to monitor the safety and effectiveness of COVID-19 vaccines to ensure appropriate recommendations to keep all Americans safe. We will also evaluate with similar urgency available data in the coming weeks to swiftly make additional recommendations for other populations or people who got the Moderna or Johnson & Johnson vaccines.

The following is attributable to Dr. Walensky:

As CDC Director, it is my job to recognize where our actions can have the greatest impact. At CDC, we are tasked with analyzing complex, often imperfect data to make concrete recommendations that optimize health. In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good.

I believe we can best serve the nation’s public health needs by providing booster doses for the elderly, those in long-term care facilities, people with underlying medical conditions, and for adults at high risk of disease from occupational and institutional exposures to COVID-19. This aligns with the FDA’s booster authorization and makes these groups eligible for a booster shot. Today, ACIP only reviewed data for the Pfizer-BioNTech vaccine. We will address, with the same sense of urgency, recommendations for the Moderna and J&J vaccines as soon as those data are available.

While today’s action was an initial step related to booster shots, it will not distract from our most important focus of primary vaccination in the United States and around the world. I want to thank ACIP for their thoughtful discussion and scientific deliberation on the current data which informed my recommendation.

New ablation technology on the horizon

Mon, 07 Jun 2021 19:08:20 GMT

This is a subtitle for your new post

A new clinical trial effectively uses pulsed field (PF) energy to treat patients with persistent or paroxysmal atrial fibrillation (AF) and showcases a novel approach to performing point-by-point ablation to provide safe and effective patient outcomes. The first-in-human trial combines the effectiveness of radiofrequency (RF) energy with the safety of pulsed field energy for ablation procedures. The results of the multi-center trial were presented today as late-breaking clinical science as part of Heart Rhythm Society (HRS) 2020 Science and were published simultaneously in Circulation: Arrhythmia and Electrophysiology.

The trial looked at tissue selectivity of pulsed field ablation (PFA), which provides safety advantages over radiofrequency ablation (RFA) in treating AFib. "One-shot" PFA catheters have been shown capable of performing pulmonary vein isolation (PVI), but not flexible lesion sets such as linear lesions. The technology also is called electroporation because it causes temporary pore-like openings in the cell walls. This study tested a novel lattice-tip ablation catheter with a compressible 9 mm nitinol tip is able to deliver either focal RFA or PFA lesions, each in 2-5 seconds. It was used with a custom mapping system to treat paroxysmal or persistent AF

“As we see pulse field ablation take off as an influential technology for treating atrial fibrillation, we look forward to how our study can move adoption of this procedure forward,” said Vivek Y. Reddy, M.D. , director of cardiac arrhythmia services for The Mount Sinai Hospital and the Mount Sinai Health System, and The Leona M. and Harry B. Helmsley Charitable Trust professor of medicine in cardiac electrophysiology at Icahn School of Medicine at Mount Sinai. “The streamlined efficacy and safety benefits of using this new pulse field ablation approach are a true advancement for electrophysiologists everywhere. We hope our findings will play a role in reducing the routine procedure time for this patient population.”

This trial sought to evaluate the use of a catheter capable of both RF and PF ablation to deliver efficient linear lesions and reduce ablation safety concerns, including damage to the esophagus and surrounding nerves. The trial examines the use of a novel lattice-tip ablation catheter able to deliver either focal RF or PF energy to treat PAF. The study took place across 3 centers with 11 operators. Patients included a 76-patient cohort (age 59 ± 9.9 yrs; M / F = 50 / 26; PAF / PerAF = 55 / 21) who underwent either RF/PF (40 patients; 47.4±16.2 lesions/pt) or PF/PF (36 patients; 53.1±14.4 lesions/pt) ablation. An 8Fr lattice with RF and PF generators (Sphere-9, Prism-1, HexaGen and HexaPulse, respectively; Affera Inc.) was used to toggle between energy sources during ablation. Point-by-point PV encirclement was performed using biphasic PFA (2-5 sec; 24-32 Amp) posteriorly, and either temp-controlled irrigated RFA (Tmax 73°C; 5 sec) or PFA anteriorly. PVI was confirmed with bidirectional pacing, and adenosine or after a 20 min wait. Linear lesions were with PFA or RFA.

Results of the trial demonstrate a combined RF/PF energy approach or a PF-only approach during ablations can safely and efficiently perform pulmonary vein isolation (PVI) and linear lesions. Findings show that PVI therapy duration time (transpiring from first to last lesion) was 22.6±8.3 min/pt. Additionally, all lesion sets were acutely successful. Linear lesions included 13 mitral (4 RF / 1 RF+PF / 8 PF), 33 LA roof (12 RF / 21 PF) and 43 CTI (35 RF / 8 PF) lines, with therapy duration times of 5.1±3.6, 1.8±2.4 and 2.4±2.2 min/pt, respectively. The total fluoroscopy time was 4.7±3.5 min. There were no device complications; there were four vascular injuries. Post-procedure EGD revealed minor mucosal thermal injury in two of 36 RF/PF and zero of 24 PF/PF patients. Brain MRI revealed DWI+/FLAIR- and DWI+/FLAIR+ asymptomatic lesions in four and three of 52 patients, respectively; the initial ACT was lower in MRI positive (255±26 sec) vs MRI negative (349±84 sec) patients (p<0.00001). Only one patient (of 29; 3.4%) with ACT >300 had an MRI-positive lesion (DWI+/FLAIR-).

The authors of this study look to build upon their findings to determine the durability of the lesions created, and evaluate the one year outcomes of the patients in the study. As a next step, they are planning a large, multicenter U.S. FDA clinical trial in the U.S.

AF is the most common heart rhythm condition, impacting more than 33.5 million individuals around the world.[2] Ablation is a known treatment for patients with persistent AF symptoms and is most commonly performed using a point-by-point approach to make multiple lesions to stop irregular heartbeats. This study looked to test a new point-by-point approach that leverages advancements in technology and attempts to increase patient safety and quality of care for this large arrhythmia patient population.

Read another study on pulsed field technology presented at HRS 2020 — Pulsed AF Trial Shows Pulsed Field Ablation May be Safer Than Tranditional RF Ablations .

Find links to all the Heart Rhythm Society 2020 Late-Breaking Clinical Trials in Electrophysiology

Article Courtesy of - https://www.dicardiology.com/article/pulsed-field-ablation-successfully-treats-atrial-fibrillation

References:

1. Vivek Y. Reddy, Elad Anter, Gediminas Rackauskas, et al. A Lattice-Tip Focal Ablation Catheter that Toggles Between Radiofrequency and Pulsed Field Energy to Treat Atrial Fibrillation: A First-in-Human Trial. Circulation: Arrhythmia and Electrophysiology. Originally published online 8 May 2020, https://doi.org/10.1161/CIRCEP.120.008718.

2. Sumeet S. Chugh et al., “Worldwide Epidemiology of Atrial Fibrillation”, Circulation. 2014;129:837–847.

How is the Johnson and Johnson Vaccine Different?

Wed, 17 Mar 2021 02:51:22 GMT

Johnson and Johnson Covid Vaccine - How it works

What is the difference between how the Johnson & Johnson vaccine works and how the Pfizer and Moderna vaccines work?

The ultimate difference is the way the instructions are delivered. The Moderna and Pfizer vaccines use mRNA technology, and the Johnson & Johnson vaccine uses the more traditional virus-based technology.

mRNA is essentially a little piece of code that the vaccine delivers to your cells. The code serves as an instruction manual for your immune system, teaching it to recognize the virus that causes COVID-19 and attack it, should it encounter the real thing.

Instead of using mRNA, the Johnson & Johnson vaccine uses a disabled adenovirus to deliver the instructions. This adenovirus is in no way related to the coronavirus. It is a completely different virus. Although it can deliver the instructions on how to defeat the coronavirus, it can’t replicate in your body and will not give you a viral infection.

Are there benefits to the Johnson & Johnson vaccine, based on its technology?

Absolutely. The huge advantage to the Johnson & Johnson vaccine is that it is a single shot. The mRNA vaccine requires two.

As well, the Johnson & Johnson vaccine can be kept at essentially refrigerator temperatures for months, and it’s stable. The mRNA vaccines aren’t as stable and require super cold storage temperatures. Once they’re out of cold storage, you only have a small window of time to administer them.

The Johnson & Johnson vaccine is much more like a regular vaccine and is much easier to distribute and maintain. That has huge implications for rural areas of the country. Those areas might not have the ability to keep the mRNA vaccines at super cold temperatures.

Aren’t cold storage and stability some of the reasons the rollout of the vaccine has been a challenge?

We have the capacity in a lot of the U.S. to get the cold storage mRNA vaccines out, but it can be a challenge in rural areas. When you start talking about a vaccine that is more stable and only involves a single shot, this is great news. The easier it is to give, the more people we’re going to vaccinate in the U.S. But this is also true internationally, where delivering a tricky mRNA vaccine can be a challenge in some areas due to the cold storage requirements.

I’ve heard the Johnson & Johnson vaccine is less effective than the Pfizer and Moderna vaccines. Your thoughts?

We have really done ourselves a disservice with how wildly effective the Pfizer and Moderna vaccines are. No one is going to say they don’t want a highly effective vaccine. We are all grateful, but at the start of the pandemic if you said you were going to produce a 60% effective vaccine, that would have been beyond most people’s wildest dreams. Compare that to the flu [vaccine], which can be 50% to 60% effective some years.

The Johnson & Johnson vaccine was found to be 72% effective at preventing moderate to severe cases of COVID-19. Across the board, it was around 66%. I think part of the reason is because it was studied later in the pandemic. Now there are more of these variants out there. The Johnson & Johnson vaccine was less effective in South Africa, where one of the variants has appeared. It was 57% in South Africa. I think if you were to test the Moderna and Pfizer vaccines now, they might be less effective because of the variants.

Isn’t a main advantage of the Johnson & Johnson vaccine that you’re less likely to get severely ill from COVID-19?

In the study population of almost 44,000 people, some of whom received a placebo and didn’t get the vaccine, the Johnson & Johnson vaccine was 85% effective in preventing hospitalizations and death. Even if the vaccine wasn’t 100% effective at preventing disease, it looks like it reduces severe disease. That is really what you want from a vaccine.

Can those who’ve gotten the vaccine still transmit the virus?

We don’t know, but you have to figure if someone has less virus, they might not transmit it as effectively. This could slow down the number of additional cases. That is really the idea with a vaccine, but nobody knows that for sure. That is the hope.

There will still be people who get sick, especially since there are so many cases. People are still going to need to wear masks and socially distance. It’s not a passport to go back to normal living. If you are, in theory, one of the 5% who got the Pfizer vaccine and still got COVID-19, you could still transmit the virus to people, and they could get super sick.

When do you think people will start getting vaccinated with the Johnson & Johnson vaccine in the U.S.?

The federal government has a deal with Johnson & Johnson to buy 100 million doses of vaccine. You will likely see people getting the Johnson & Johnson vaccine in March.

Will I be able to choose which vaccine I get?

We aren’t there yet. That won’t be possible in the short term. We would say get what you can get when something becomes available to you. We really don’t think people should wait. If you have access to get any vaccine, you should get it. Even if it doesn’t completely prevent it, you are much less likely to have severe disease and die. Maybe you’re just at home and feel terrible as opposed to having to be admitted to the hospital with low oxygen. Hospitals and clinics are going to be limited in the short term on what they can provide folks.

These vaccines are safe, right?

If it has emergency use authorization from the FDA, it has been held to a very high safety standard. These vaccine trials have had just massive amounts of patients. There have been at least 30,000 patients in each one of these trials, and Johnson & Johnson’s had 43,000 people. There were no harm signals in the Johnson & Johnson trials.

We have a few reports of possible severe adverse effects from the Moderna and Pfizer vaccines. Reports of severe adverse effects are being monitored and investigated closely. We still have to collect long-term safety data. For any immediate issues, those are usually collected in the vaccine trials. We have months of data now that show the vaccines are safe.

Is the COVID-19 Vaccine Safe for Heart Patients?

Mon, 01 Mar 2021 02:57:32 GMT

For patients with heart problems, is the COVID-19 vaccine safe and effective?

I’m nervous about vaccines. Are the COVID-19 vaccines truly effective? They were developed in less than a year.

As a heart patient, you should have no concerns about the speed with which the vaccines were developed. Both the Pfizer-Biontech and the Moderna vaccines were tested on a very large number of patients and shown to be safe and effective. Heart disease and stroke medical experts urge the public to get the COVID-19 vaccinations.

Are the vaccines safe for people with a history of heart disease, heart attack or cardiovascular risk factors?

Not only are the Pfizer-Biontech and Moderna vaccines safe for people with a history of heart disease, they are essential. People with heart disease are at increased risk of severe complications from COVID-19.

On January 15, 2021, the American Heart Association released a statement urging all eligible individuals to get vaccinated to keep themselves, their family and their community healthy and safe:

“As a science-based organization committed to health equity, we are heartened that COVID-19 vaccines have been approved to protect individuals, their loved ones and their communities from the pandemic. The American Heart Association – which has been carefully tracking COVID-19 and its disproportionately negative effects on older adults; people with underlying medical conditions; and Black, LatinX and American Indian/Alaska Native people – strongly encourages everyone to get vaccinated with any approved COVID-19 vaccine as it is available.

In particular, people with cardiovascular risk factors, heart disease, and heart attack and stroke survivors should get vaccinated as soon as possible because they are at much greater risk from the virus than they are from the vaccine.”

What are the side effects of the vaccine? Will the side effects be any different for people with a heart condition or cardiovascular disease?

The most common side effects of the Pfizer-Biontech and Moderna vaccines are pain and bruising at the site of the injection, and in some cases feeling tired or achy. You may also run a low-grade fever. As a heart patient, your symptoms are no different than those of everyone else. Symptoms generally last less than two days.

I hear some people have an allergic reaction. As a heart patient, will I have an increased risk of an allergic reaction?

People with heart disease are not at increased risk of an allergic reaction. Allergic reactions have been reported in only rare cases.

Does my heart condition make me more vulnerable to COVID-19?

People with heart disease are not at higher risk of being infected by the SARS-CoV2 virus, which causes COVID-19.

Am I at greater risk of severe symptoms, or even death, if I get COVID-19?

Unfortunately, people with heart disease are more likely to have a severe or critical case of COVID-19.

In this recorded webinar, Dr. Abbate and Dr. Keyur Shah discuss the latest research on the risk COVID-19 has had on people with heart conditions, and how the virus has affected heart health.

Can people on blood thinners get the vaccine?

Definitely yes. You may get a bigger bruise on your arm, where you got the injection, due to the blood thinner. But this shouldn’t be a concern. If you notice a large bruise that is painful or continues to enlarge, though, ask your doctor about it.

Does my heart disease qualify as an underlying medical condition, moving me ahead of the general public in terms of getting the vaccine?

The Center for Disease Control recommends that, due to the risk of severe or critical COVID-19, patients with heart disease receive their vaccination sooner than the general population.

How long will the vaccine protect me?

While the length of protection with the Pfizer-Biontech and Moderna vaccines is unknown, protection was seen for the entire duration of the clinical studies — about four months, or 120 days.

When can I get the vaccine?

Depending on your age, medical conditions, and occupation, you may be eligible to receive your vaccination now or in the near future.

Where can I get the vaccine?

There will be several places where you can get the vaccine. Please see the Virginia Department of Health to register for vaccination.

As a heart patient, is there anything I have to look out for after getting the vaccine?

There are no special recommendations for patients with heart disease after receiving the vaccine.

What happens after I get the vaccine? Can I stop wearing my mask and social distancing?

After the first dose of the Pfizer-Biontech or Moderna vaccines, you will need a second dose after three or four weeks, respectively. After the second dose, it is estimated that you will develop an immunity that is at least 95% effective. Wearing a mask and observing social distancing are still recommended because the vaccine may not be fully protective and cannot guarantee complete protection for infection.

As a heart patient, are there any extra precautions I should take to reduce my chances of getting COVID-19?

Everyone should observe the common practices of social distancing, wearing a mask, washing your hands frequently and avoiding gatherings — especially in closed spaces. People with heart disease should be particularly careful, given your increased risk of severe or critical COVID-19.

If I’m sick with COVID-19, will I need to be admitted to the hospital?

Thankfully most people with COVID-19 don’t need hospitalization. If you’re diagnosed with COVID-19, you may be able to monitor your condition at home with the help of your doctor.

What treatments can I take at home for COVID-19 that will not interfere with my heart condition and medications?

Everyone’s condition is different, so it’s best to check with your doctor before taking any medications. In general, acetaminophen, when used as directed, is the safest medication for fever.

Are there any treatments for COVID-19, if I’m admitted to the hospital?

For patients admitted with COVID-19 pneumonia requiring oxygen therapy, several treatments are available. These include remdesivir, convalescent plasma and dexamethasone.

COVID-19 and the Heart: What We Know So Far

wangepccc@gmail.com (James Wang) — Mon, 01 Feb 2021 19:20:52 GMT

What do we know about COVID-19 and the heart?

Early in the pandemic, epidemiologists made a striking observation. Compared to the general population, people with cardiovascular disease (CVD) were more than twice as likely to contract severe forms of COVID-19. In the last six months, death rates from COVID-19 have dropped significantly, but CVD remains a major predictor of poor outcome. What have we learned about heart disease and COVID-19 in that time?

Pre-existing heart conditions and poor metabolic health increase risk of severe COVID-19

Some health conditions, like diabetes, increase risk of severe COVID-19 by suppressing the immune system; others, like asthma, increase risk by weakening the lungs. However, in the early months of the pandemic it was not entirely clear how CVD increased the risk of severe COVID-19. We now have two explanations.

The first is that pre-existing heart conditions, such as damaged heart muscle or blocked heart arteries, weaken the body’s ability to survive the stress of the illness. A person with a vulnerable heart is more likely to succumb to the effects of fever, low oxygen levels, unstable blood pressures, and blood clotting disorders — all possible consequences of COVID-19 — than someone previously healthy.

A second explanation relates to poor underlying metabolic health, which is more common in those with heart disease. Poor metabolic health refers to diseases such as type 2 diabetes or prediabetes and obesity, which themselves cause inflammation and risk of blood clots, compounding the effects of COVID-19 and increasing the likelihood of devastating complications of COVID-19.

How does COVID-19 cause heart damage?

The SARS-CoV-2 virus can damage the heart in several ways. For example, the virus may directly invade or inflame the heart muscle, and it may indirectly harm the heart by disrupting the balance between oxygen supply and demand. Heart injury, which may be measured by elevated levels of the enzyme troponin in the bloodstream, has been detected in about one-quarter of patients hospitalized with severe COVID-19 illness. Of these patients, about one-third have pre-existing CVD.

Inflammation of the heart muscle

The majority of people with COVID-19 will have mild symptoms and recover fully. However, about 20% will develop pneumonia, and about 5% will develop severe disease. In the severe form of COVID-19, the body’s immune system overreacts to the infection, releasing inflammatory molecules called cytokines into the bloodstream. This so-called “cytokine storm” can damage multiple organs, including the heart.

Inflammation of the heart muscle, called myocarditis, typically occurs only in patients with advanced COVID-19 disease. Myocarditis can result from direct heart invasion by the virus itself, or more commonly by inflammation caused by cytokine storm. When this occurs, the heart may become enlarged and weakened, leading to low blood pressure and fluid in the lungs. While this severe form of myocarditis is rare, recent studies have suggested that a milder form of heart muscle inflammation may be much more common than previously recognized. A recent study showed that asymptomatic heart inflammation was seen on magnetic resonance imaging in up to three-quarters of patients who had recovered from severe COVID-19.

Increased oxygen demand and decreased oxygen supply lead to heart damage

Fever and infection cause the heart rate to speed up, increasing the work of the heart in COVID-19 patients who develop pneumonia. Blood pressure may drop or spike, causing further stress on the heart, and the resulting increase in oxygen demand can lead to heart damage, especially if the heart arteries or muscle were unhealthy to begin with.

Heart damage is most often caused by heart attacks, which result from the formation of a blood clot in a vulnerable heart artery, blocking delivery of oxygen to the heart muscle. COVID-19-related inflammation raises the risk of this type of heart attack by activating the body’s clotting system and disrupting the blood vessel lining. When inflamed, this lining loses its ability to resist clot formation. These blood clots in the large and small arteries of the heart cut off its supply of oxygen. The increased clotting tendency can also lead to blood clots in the lungs, which can cause a drop in blood oxygen levels. Severe pneumonia drops blood oxygen further. When the oxygen demand exceeds the supply, the heart muscle is damaged.

Finding a silver lining and lowering risk through healthy lifestyle

People with CVD who adopt healthy behaviors can strengthen their defenses against COVID-19 while also reducing the long-term risk from cardiovascular disease itself. This means plenty of physical activity and following a healthy diet like the Mediterranean diet. Cook at home when you can, and walk outdoors with friends if your gym is temporarily closed. Purchase an inexpensive and easy-to-use monitor to measure your blood pressure at home. And continue to follow the CDC’s safety guidelines to wear masks, physically distance, and avoid large gatherings.

Information courte sy of Harvard Health. Original article can be found at https://www.health.harvard.edu/blog/covid-19-and-the-heart-what-have-we-learned-2021010621603

What's in the COVID-19 Vaccine?

Mon, 25 Jan 2021 17:14:24 GMT

What are the COVID-19 Vaccine ingredients?

S Food and Drug Administration says is in Pfizer’s vaccine:

Active Ingredient
nucleoside-modified messenger RNA (modRNA) encoding the viral spike glycoprotein (S) of SARS-CoV-2
Lipids
(4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis (ALC-3015)
(2- hexyldecanoate),2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide (ALC-0159)
1,2-distearoyl-snglycero-3-phosphocholine (DPSC)
cholesterol
Salts
potassium chloride
monobasic potassium phosphate
sodium chloride
basic sodium phosphate dihydrate
Other
sucrose

Reading the ingredient list is like looking at the side of a cereal box, except that you need a degree in organic chemistry to understand it. We got help from various scientists and biotech entrepreneurs to understand what each of the ingredients does and make some educated guesses about others.

The mRNA

Pfizer’s vaccine is the first on the market that consists of actual genetic information from a virus in the form of messenger RNA, or mRNA, a type of molecule whose usual job is to transport copies of genetic instructions around a cell to guide the assembly of proteins. Imagine an mRNA as a long ticker tape carrying instructions. It's fairly delicate stuff, and that's why Pfizer's vaccine needs to be kept at around -100 °F (-73 °C) until it's used.

The new vaccine, delivered as a shot in the arm muscle, contains an RNA sequence taken from the virus itself; it causes cells to manufacture the big “spike” protein of the coronavirus, which the pathogen uses to glom onto a person’s cells and gain entry. On its own, without the rest of the virus, the spike is pretty harmless. But your body still reacts to it. This is what leaves you immunized and ready to repel the real virus if it turns up.

The mRNA in the vaccine, to be sure, isn’t quite the same as the stuff in your body. That’s good, because a cell is full of defenses ready to chop up RNA, especially any that doesn’t belong there. To avoid that, what’s known as “modified nucleosides” have been substituted for some of the mRNA building blocks.

But Pfizer is holding back a little. The spike gene sequence can be tweaked in small ways for better performance, by means that include swapping letters. We don’t think Pfizer has said exactly what sequence it is using, or what modified nucleosides. That means the content of the shot may not be 100% public.

The lipids

The Pfizer vaccine, like one from Moderna, uses lipid nanoparticles to encase the RNA. The nanoparticles are, basically, tiny greasy spheres that protect the mRNA and help it slide inside cells.

These particles are probably around 100 nanometers across. Curiously, that’s about the same size as the coronavirus itself.

Pfizer says it uses four different lipids in a “defined ratio.” The lipid ALC-0315 is the primary ingredient in the formulation. That’s because it’s ionizable—it can be given a positive charge, and since the RNA has a negative one, they stick together. It's also a component that can cause side-effects or allergic reactions. The other lipids, one of which is the familiar molecule cholesterol, are “helpers” that give structural integrity to the nanoparticles or stop them from clumping. During manufacturing, the RNA and the lipids are stirred into a bubbly mix to form what the FDA describes as a “white to off-white” frozen liquid.

Salts

The Pfizer vaccine contains four salts, one of which is ordinary table salt. Together, these salts are better known as phosphate-buffered saline, or PBS, a very common ingredient that keeps the pH, or acidity, of the vaccine close to that of a person’s body. You’ll understand how important that is if you’ve ever squeezed lemon juice on a cut. Substances with the wrong acidity can injure cells or get quickly degraded.

Sugar

The vaccine includes plain old sugar, also called sucrose. It’s acting here as a cryoprotectant to safeguard the nanoparticles when they’re frozen and stop them from sticking together.

Saline solution

Before injection, the vaccine is mixed with water containing sodium chloride, or ordinary salt, just as many intravenously delivered drugs are. Again, the idea is that the injection should more or less match the salt content of the blood.

No preservatives

Pfizer makes a point of saying its mixture of lipid nanoparticles and mRNA is “preservative-free.” That’s because a preservative that’s been used in other vaccines, thimerosal (which contains mercury and is there to kill any bacteria that might contaminate a vial), has been at the center of worries around over whether vaccines cause autism. The US Centers for Disease Control says thimerosal is safe; despite that, its use is being phased out. There is no thimerosal—or any other preservative—in the Pfizer vaccine. No microchips, either.

The vaccine is still known by the code name BNT162b, but once it’s authorized, expect Pfizer to give it a new, commercial name that conveys something about what’s in it and what it promises for the world.

We thank the following people for explaining the vaccine ingredients: Jacob Becraft and Aalok Shah, Strand Therapeutics; Yizhou Dong, Ohio State University; Jason Underwood, Pacific Biosciences; Andrey Zarur, Greenlight Biosciences; Charles L. Cooney, MIT; and the communications staffs of Pfizer and Moderna

Accessed January 23, 2021 at: Therapeutics. https://www.technologyreview.com/2020/12/09/1013538/what-are-the-ingredients-of-pfizers-covid-19-vaccine/ material copied from Technology Review.com

COVID Vaccine Fact Check

Tue, 19 Jan 2021 21:23:06 GMT

Facts about COVID-19 Vaccines

Information courtesy of the CDC

Can a COVID-19 vaccine make me sick with COVID-19?

No. None of the authorized and recommended COVID-19 vaccines or COVID-19 vaccines currently in development in the United States contain the live virus that causes COVID-19. This means that a COVID-19 vaccine cannot make you sick with COVID-19.

There are several different types of vaccines in development. All of them teach our immune systems how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building protection against the virus that causes COVID-19. Learn more about how COVID-19 vaccines work .

It typically takes a few weeks for the body to build immunity (protection against the virus that causes COVID-19) after vaccination. That means it’s possible a person could be infected with the virus that causes COVID-19 just before or just after vaccination and still get sick. This is because the vaccine has not had enough time to provide protection.

After getting a COVID-19 vaccine, will I test positive for COVID-19 on a viral test?

No. Neither the recently authorized and recommended vaccines nor the other COVID-19 vaccines currently in clinical trials in the United States can cause you to test positive on viral tests , which are used to see if you have a current infection .

If your body develops an immune response—the goal of vaccination—there is a possibility you may test positive on some antibody tests . Antibody tests indicate you had a previous infection and that you may have some level of protection against the virus. Experts are currently looking at how COVID-19 vaccination may affect antibody testing results.

If I have already had COVID-19 and recovered, do I still need to get vaccinated with a COVID-19 vaccine?

Yes. Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, vaccine should be offered to you regardless of whether you already had COVID-19 infection. CDC is providing recommendations to federal, state, and local governments about who should be vaccinated first.

At this time, experts do not know how long someone is protected from getting sick again after recovering from COVID-19. The immunity someone gains from having an infection, called natural immunity, varies from person to person. Some early evidence suggests natural immunity may not last very long.

We won’t know how long immunity produced by vaccination lasts until we have more data on how well the vaccines work.

Both natural immunity and vaccine-induced immunity are important aspects of COVID-19 that experts are trying to learn more about, and CDC will keep the public informed as new evidence becomes available.

Will a COVID-19 vaccination protect me from getting sick with COVID-19?

Yes. COVID-19 vaccination works by teaching your immune system how to recognize and fight the virus that causes COVID-19, and this protects you from getting sick with COVID-19.

Being protected from getting sick is important because even though many people with COVID-19 have only a mild illness, others may get a severe illness , have long-term health effects , or even die. There is no way to know how COVID-19 will affect you, even if you don’t have an increased risk of developing severe complications . Learn more about how COVID-19 vaccines work .

Will a COVID-19 vaccine alter my DNA?

No. COVID-19 mRNA vaccines do not change or interact with your DNA in any way.

Messenger RNA vaccines—also called mRNA vaccines—are the first COVID-19 vaccines authorized for use in the United States. mRNA vaccines teach our cells how to make a protein that triggers an immune response. The mRNA from a COVID-19 vaccine never enters the nucleus of the cell, which is where our DNA is kept. This means the mRNA cannot affect or interact with our DNA in any way. Instead, COVID-19 mRNA vaccines work with the body’s natural defenses to safely develop immunity to disease. Learn more about how COVID-19 mRNA vaccines work .

At the end of the process, our bodies have learned how to protect against future infection. That immune response and making antibodies is what protects us from getting infected if the real virus enters our bodies.

COVID Vaccine and Heart Problems

Tue, 29 Dec 2020 20:48:34 GMT

Should Adults With Heart Problems Get the COVID-19 Vaccine?

AS ALWAYS, PLEASE CONSULT WITH YOUR PHYSICIAN. SOME MAY NOT BE SAFE CANDIDATES TO RECIEVE THE VACCINE IF YOU HAVE OTHER UNDERLYING CONDITIONS.

Heart Disease, Stroke, or Other Cardiovascular Disease and Adult Vaccination

Each year thousands of adults in the United States get sick from diseases that could be prevented by vaccines — some people are hospitalized, and some even die. People with heart disease and those who have suffered stroke are at higher risk for serious problems from certain diseases. Getting vaccinated is an important step in staying healthy. If you have cardiovascular disease, talk with your doctor about getting your vaccinations up-to-date.

Why Vaccines are Important for You

Heart disease can make it harder for you to fight off certain diseases or make it more likely that you will have serious complications from certain diseases.
Immunization provides the best protection against vaccine-preventable diseases.
Vaccines are one of the safest ways for you to protect your health, even if you are taking prescription medications. Vaccine side effects are usually mild and go away on their own. Severe side effects are very rare.
Some vaccine-preventable diseases, like the flu, can increase the risk of another heart attack.

Is the coronavirus vaccine safe?

Vaccines are only approved for use after being thoroughly tested on tens of thousands of people. In order to approve a vaccine, experts at the MHRA look carefully at all the evidence about the vaccine and make sure have that it meets strict standards of safety, quality and effectiveness.

There have been a very small number of reports of allergic reactions in people who already had a history of serious allergic reactions. As a result, the vaccine is not recommended for people with serious allergies. That doesn't change the fact that this is a safe vaccine for the vast majority of people. Unless you have a history of serious allergies, there is no need for you to worry about these reports. Just to be extra careful, the people receiving the vaccine will be observed by medical staff for 15 minutes afterwards - so any reactions that do rarely happen can be treated right away.

Is the vaccine safe for people with heart conditions?

Any vaccine which is approved will have been tested on people with long-term conditions, including heart and circulatory conditions, and including older people. It is safe for people with heart conditions and other at-risk groups, and that at-risk people should be among those who are prioritized to receive the vaccine.

As part of the testing, experts also looked at whether there are any differences in how well the vaccine works in people with health conditions. In the case of the Pfizer/BioNTech vaccine (the only one which has completed testing) there were no meaningful differences in how well it works in people with health conditions that put them at risk of severe Covid-19 (including diabetes, high blood pressure, asthma and obesity.)

Is the vaccine safe for people taking blood thinners like warfarin or other anticoagulants?

Like most vaccines, the coronavirus vaccine is injected into the muscle of your upper arm. As with any injection, there is some risk of bleeding. Injections into your muscle may bleed a little more than injections that are given under the skin, but less than those that are given into a vein. If you are taking a blood thinner such as warfarin, or a new anticoagulant, the bleeding may take a little longer to stop and you may get more bruising on your upper arm.

Public Health England and the Department of Health have said that you can have the vaccine if your anticoagulant treatment is stable. That generally means that you will have been taking the same dose for a while and that if you are on warfarin, that your INR checks are up to date and that your latest INR level was in the right range.

Is the vaccine safe for people taking blood thinners like clopidogrel or other antiplatelet drugs?

Yes. If you are taking an antiplatelet medication, such as clopidogrel, then the vaccine is safe for you to take. You may experience a little more bruising around the injection site.

Does the vaccine work against the new strain of the virus?

As far as we know, the vaccine will still work against the new strain of the virus.

COVID Vaccine in Volusia

wangepccc@gmail.com (James Wang) — Tue, 29 Dec 2020 20:33:21 GMT

COVID Vaccine rollout in Volusia County for Seniors

On Monday, Jan. 4, the Florida Department of Health in Volusia County (DOH-Volusia) in partnership with the City of Daytona Beach will begin vaccinating people age 65 and older, according to health officials.

The first vaccination clinic will run from 9 a.m. to 4 p.m., Jan. 4-5 at Daytona Stadium, 3917 LPGA Blvd., Daytona Beach.

Drive-thru vaccinations will be offered. Vaccine supply is limited and will be offered first come, first served.

There will be no cost for COVID-19 vaccinations offered by DOH-Volusia.

Photo IDs will be required to receive a vaccination.

Only the Moderna vaccine will be provided at this initial community vaccination event.

Prior to receiving a vaccination, individuals will receive the Moderna Fact Sheet on the Emergency Use Authorization and information on what to expect during and after the injection.

Individuals also will be required to complete a medical screening form and sign an informed consent form before receiving a vaccination.

Individuals are encouraged to contact their primary care provider with questions about whether they should receive the vaccine before presenting to a vaccination site.

Each person will receive a second dose reminder card that lists the date and the manufacturer for the first vaccination. The Moderna booster vaccination should be received 28 days after the initial dose. The second dose must be from the same manufacturer as the first vaccine, according to health officials.

After receiving a vaccination, recipients will be required to remain on-site for 15-30 minutes for medical monitoring.

DOH-Volusia will return to this location in 28 days to offer the second dose to those who are due.

Future vaccination dates in several locations across the county will be based on vaccine availability.

Information also will be posted online at Volusia.org/coronavirus .

For information on specific medical conditions that may affect an individual’s ability to get this vaccine, please visit modernatx.com/covid19vaccine-eua/recipients/ .

Arrhythmias and COVID

Tue, 22 Dec 2020 21:48:17 GMT

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There has been much speculation around the effects of certain medications in relation to the novel coronavirus, as well as the effects that, not just the medications, but certain heart conditions may have on the disease. The topic is particularly worrisome for those with heart disease and, more specifically, for individuals with heart arrhythmias.

What are the cardiac risks of the medications used to treat COVID-19?

There are several therapies being used to treat the virus infection known as COVID-19, including the medications Chloroquine, Hydroxychloroquine and Azithromycin. All these medications can change the potassium currents in the heart, which can cause prolongation of the QT interval. The QT interval is a measurement made on an electrocardiogram used to assess some of the electrical properties of the heart. When the QT interval gets too long, there is a risk for life-threatening arrhythmias.

Some patients can be started on these medications and have minimal changes in their QT interval. However, some patients who start these medications may have very dramatic changes in their QT interval, making them at higher risk of dying suddenly. The treating physicians will properly assess each patient to determine if these medications can be safely administered, particularly if they are not remaining under hospital care. For patients admitted to the hospital, the QT interval is monitored continuously so that dosages can be changed if the QT interval becomes too prolonged.

There are also anti-viral drugs that are currently under clinical trials in the United States. We do not yet know the

cardiac toxicities, if any, in these new medications.

I have a pacemaker, am I at increased risk of contracting coronavirus?

Let’s discuss two separate risks here.

Risk of becoming infected:

Thus far, exposure to other infected individuals, breathing in droplets or aerosols (particles floating in the air), and touching contaminated surfaces and then touching your face are the only routes described of becoming infected.

Risk of more severe disease symptoms requiring hospitalization, ICU-level care and increased risk of death:

With the current available data, patients with hypertension , diabetes, coronary artery disease , heart failure and “heart disease” (a generic term for other cardiac-related problems) have been identified as being at higher risk of requiring hospitalization, ICU-level care and higher risk of passing away, if they become infected.

While the specific presence of a pacemaker has not been identified as posing an increased risk of a more complicated disease course, presence of “heart disease” by some authors would likely include patients with pacemakers . Therefore, at this time I would say yes, there is an increased risk of a more complicated disease course if you have a pacemaker.

Will I have complications with my pacemaker/defibrillator if I get COVID-19?

Pacemakers and defibrillators will continue to work without issues if you would become infected. A small portion of patients with pacemakers might need a device setting change, giving them a faster heart rate if they are critically ill and trying to recover from the infection.

Does having atrial fibrillation (AFib) put me at a higher risk if I become infected with the coronavirus?

The short answer is, possibly. Based on data published in The Lancet (Epidemiological and Clinical Characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study), patients with the following diagnoses were more likely to die from COVID-19:

cancer (5.6% fatality rate)
hypertension (6.0% fatality rate)
chronic respiratory disease (6.3% fatality rate)
diabetes (7.3% fatality rate)
cardiovascular disease (10.5% fatality rate)

The term “cardiovascular disease” is broad and encompasses a wide range of diagnoses from coronary artery disease, valvular heart disease, congenital heart disease and arrhythmias (which would include atrial fibrillation ). Data that was specific to arrhythmias or atrial fibrillation, however, has not yet been published.

Blood Pressure, Atrial Fibrillation, COVID-19

Tue, 22 Dec 2020 21:41:03 GMT

Blood pressure, Afib and COVID - the connection.

Blood pressure medication adherence should continue for patients with novel coronavirus (COVID-19) infection, and atrial fibrillation and atrial flutter can worsen outcomes in hospitalized COVID-19 patients, according to two posters presented at the virtual American Heart Association Scientific Sessions 2020.

In the first poster , investigators from the United States and Japan noted that a hypothesis exists about the ability of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-receptor blockers (ARB) to possibly modify the outcomes of COVID-19. To test this, they conducted two meta-analyses to compare mortality and susceptibility of COVID-19 in patients who were treated with ACEI and/or ARB to those who were not treated with either medication.

They identified 3 eligible studies after searching the Medline and Embase databases through June 2020 that would be able to assist in the first meta-analysis, which examined the testing positive rate of COVID-19. The study authors learned that the testing positive rates for COVID-19 were similar among those treated with ACEI and those not treated with ACEI. The same was true for patients treated and not treated with ARB, they said.

A further 14 studies were identified that would be included in the second analysis, which investigated the in-hospital mortality rate for COVID-19 patients, the authors explained. In-hospital mortality for COVID-19 patients was similar among those who were treated with ACIE and/or ARB and for those who were not treated with ACEI or ARB, the study authors wrote. Once they further analyzed this data and looked at only patients with hypertension, they learned that ACEI and/or ARB use was associated with a significant reduction of in-hospital mortality compared to no ACEI or ARB use, the investigators said.

“Our study results confirm that patients already taking ACE inhibitors and ARBs should not discontinue taking them due to COVID-19 infection,” lead study author Yujiro Yokoyama, MD, said in a statement . “Both medications have proven benefits for heart and kidney disease, and this further confirms previous findings that ACE inhibitors do not pose additional risk with COVID-19.”

Acute SARS-CoV-2 infection may increase the susceptibility to AF and promote the evolution of a prothrombotic state. The potential development of long-term complications including development of cardiac arrhythmias in COVID-19 survivors remains to be established, especially as COVID-19 survivors are unlikely to produce long-lasting protective antibodies against this virus [1] , [2] , hence may be susceptible to reinfection within weeks or months. As in the acute phase of COVID-19 infection, the susceptibility to AF is increased and a worsening of existing AF likely, utilization of personal electrocardiogram devices as well as remote monitoring (teleconsultations) could optimize care of patients with AF and those with a high risk for developing AF.

In the second poster , investigators from the Yale School of Medicine conducted a retrospective cohort study in order to further understand how atrial fibrillation and atrial flutter patients are impacted when hospitalized with COVID-19. Currently, the interactions are not known, the study authors said. They were able to identify 396 patients over the age of 18 that were hospitalized with COVID-19 between March and June 2020 and then calculated the rates of prior and in-hospital atrial fibrillation and atrial flutter.

The mean age of these patients was 68 years and about half were men, the study authors said. Half were Caucasian, about a third were Black and about 20% were Hispanic.

The study authors discovered that 15% of the patients had a prior history of atrial fibrillation and atrial flutter, while 20% of patients had in-hospital atrial fibrillation and atrial flutter and nearly 8% did not have a history of atrial fibrillation and atrial flutter.

The patients who experienced in-hospital atrial fibrillation and atrial flutter had significantly more cardiovascular complications compared to the patients without, including cardiac injury, type 2 myocardial infarction, and heart failure, the study authors said.

In-hospital atrial fibrillation and atrial flutter was linked to significantly worse COVID-19-related outcomes including ICU survival, heart failure, myocardial injury, dialysis, and hospice/death, the study authors wrote.

“Our study suggests that the combination of COVID-19 and atrial arrhythmias may create a pathologic synergy that markedly increases the risk for major adverse cardiac events and death,” the study’s lead author Zaniar Ghazizadeh, MD, added in the statement . “COVID-19 places patients at a high risk for abnormal heart rhythms that are, in turn, associated with markedly worse outcomes including death and multi-organ failure. Patients and physicians need to monitor for these arrhythmias closely and treatments needs to be timely.”

Introducing the LUX-Dx™ Insertable Cardiac Monitor (ICM) System

Tue, 22 Dec 2020 21:35:01 GMT

LUX-Dx™ Insertable Cardiac Monitor (ICM) System

The challenge with today’s ICMs isn’t what they’re missing. It’s what they have too much of: Excessive false positives and unnecessary appointments to adjust programming.

The LUX-Dx ICM System is designed to change all that with a dual-stage algorithm to help reject false positives, remote programming to put you in control and advanced technologies to streamline patient care. It’s more of what you want in an ICM—and less of what you don’t.

It's time for an ICM like no other.

__________________________________

An ICM That Checks its Work

The LUX-Dx ICM features a dual-stage algorithm that automatically detects and then verifies data before sending results, so it can reject false positives, provide actionable insights and get you to an accurate diagnosis faster. It’s time for data you can count on.

Advanced Control, on Your Terms

Combining remote programming and the new LATITUDE Clarity™ Data Management System, the LUX-Dx ICM System helps you accelerate critical decision making and increase efficiency—without having to make another patient appointment. It’s time to put the power in your hands.

Reliable Data for You. Peace of Mind for Patients

The myLUX™ Patient App helps patients feel confident that their heart rhythms are being monitored, while helping improve compliance and educate patients. It’s time for more informed patients.

_________________________________

Boston Scientific has announced winning FDA clearance for its LUX-Dx Insertable Cardiac Monitor (ICM), an implant that can detect hard-to-spot cardiac arrhythmias, such as atrial fibrillation, and help diagnose their origin.

The device’s detection algorithm has two separate components, one of which detects a suspect arrhythmia and the other verifies the finding. Once an arrhythmia is confirmed, the wireless device sends a signal to the patient’s cardiologist via an app installed on the patient’s phone. Having a double-checking component within the implant’s brains helps to prevent false positive alarms.

To help cardiologists get the most out of the monitor, and as a side benefit during the ongoing COVID-19 pandemic, the LUX-Dx can be re-programmed by the physician remotely to adjust its arrhythmia detection settings. Other similar devices involve patients visiting their doctors for a change in programming to happen.

The device can spot atrial fibrillation (AFib), rhythm pause, atrial flutter, bradycardia, and tachycardia within certain parameters that are defined by the physician.

“For physicians, receiving accurate monitoring data and having remote access to programming provides the opportunity to operate with more efficiency and confidence,” said Kenneth Stein, M.D., senior vice president and chief medical officer, Rhythm Management and Global Health Policy, Boston Scientific, in a press release. “The LUX-Dx ICM System is designed to provide physicians the ability to accelerate critical clinical decisions and allow them to spend more time focusing on patient outcomes by reviewing monitoring data and catching false positive detections without compromising sensitivity.”