- Contemporary understanding of ventricular mechanics with identification of the structure and function of the ventricular myocardial band
- Detailed description of the anatomic proximity of cardiac structures and how knowledge of this proximity helps prevent intraoperative complications and damage to critical cardiac structures
- Comprehensive description of aortic root anatomy and mechanics and application of how this anatomy dictates performance of transcatheter aortic valve replacement
Latest Updates
- CT of the chest has taken a greater role in determining injury severity in inhalation injury.
- Airway control and ventilator management remain the mainstays of treatment in those with severe injury.
- Volumetric diffusive respiration is a mode specifically developed for inhalation injury that has been shown to decrease use of other rescue modes of ventilation.
- The number of permanent pacemakers implanted per year increased by 55.6% between 1993 and 2009, and is continuing to rise. Accordingly, the number of patients treated in the emergency department who have permanent pacemakers is increasing, and it is important for physicians in the emergency department to be familiar with the operation and potential complications of these devices.
- Genetic testing of first-degree relatives is recommended according to 2018 ACC/AHA/HRS guidelines on evaluation of bradycardia and conduction delay.
- Permanent pacing is reasonable intervention for patients with tachy-brady syndrome and symptoms attributable to bradycardia.
- 2018 ACC/AHA/HRS specific guideline considerations for genetic disorders, neuromuscular disorders, and infiltrative disorders (e.g., cardiac sarcoidosis and amyloidosis).
- Radiofrequency ablation as a treatment modality has revolutionized therapy for many SVTs; acts as a first-line alternative to drug therapy in some circumstances, with a high acute success rate and relatively low complication rate.
- Cryoablation therapy emerging as an alternative in ablative therapies. Investigation of this modality for SVTs is ongoing.
- Detailed drug regimens optimized for acute and chronic management of specific SVTs; detailed in the 2015 ACC/AHA/HRS practice guidelines.
- The REVERT trial concluded that a modified valsalva maneuver has a higher rate of cardioversion than historical vagal maneuvers.
- In a patient with stable SVT where vagal maneuvers have failed, IV adenosine remains the first-line pharmacologic agent.
- Combining adenosine and saline in a single syringe, rather than administration of adenosine followed by a saline flush, has been proven to be an effective form of administration.
- Latest available ACC/AHA guidelines and ongoing controversy around optimal heart rate targets
- Updated classification for patients with valvular and nonvalvular AF algorithm for maintenance of sinus rhythm
- 2019 AHA/ACC/HRS and 2020 ESC/EACTS practice guidelines delineated new and modified anticoagulation recommendations pertaining to NOACs.
- BTAI is now the gold standard n treating patients with these problems
- The grade of injury with these lesions has been defined and there is controversy on which lesion should be treated and how emergently
- Recently in the US a device changed its IFU because of complications after TEVAR for BTAI. It was being used outside its IFU.
- Recent advancement on sizing and device differences between BTAI and other pathologies treated with TEVAR
- BTAI is now the gold standard n treating patients with these problems
- The grade of injury with these lesions has been defined and there is controversy on which lesion should be treated and how emergently
- Recently in the US a device changed its IFU because of complications after TEVAR for BTAI. It was being used outside its IFU.
- Recent advancement on sizing and device differences between BTAI and other pathologies treated with TEVAR
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