ABSTRACT
Cardiac electrophysiology is an evolving specialty that has seen rapid advances in recent years. Concurrently, there has been much progress in the field of cardiac imaging. Electrophysiologists are increasingly requesting cross-sectional imaging in advance of many procedures. Pulmonary vein isolation and left atrial appendage (LAA) occlusion are now an established treatment options for atrial fibrillation. In patients undergoing pulmonary vein isolation, applications of computed tomography (CT) include evaluating the left atrial and pulmonary venous anatomy, excluding LAA thrombus and assessing for pulmonary vein stenosis. In those undergoing LAA occlusion, CT may be of value in assessing the size, position, and morphology of the LAA as well as for determining correct positioning of the device and evaluating for peri-device leak. Implantable cardiac devices are now commonly used in the management of cardiac failure and cardiac arrhythmias. Applications of CT prior to device implantation include detecting myocardial scar, evaluating for mechanical dyssynchrony as well as visualising the coronary venous anatomy.
Subject(s)
Atrial Appendage/diagnostic imaging , Atrial Fibrillation/diagnostic imaging , Catheter Ablation/methods , Tomography, X-Ray Computed/methods , Atrial Appendage/surgery , Atrial Fibrillation/surgery , Cardiac Imaging Techniques , Electrophysiology , Female , Forecasting , Humans , Male , Pulmonary Veins/surgeryABSTRACT
BACKGROUND: Anaemia is an increasingly recognised entity in patients with diabetes mellitus. AIMS: We aimed to determine the prevalence of anaemia in our population of patients with diabetes, and to examine the factors associated with anaemia. METHODS: The haemoglobin (Hb) levels in a consecutive series of patients attending for annual review of their diabetes over a three-month period were measured. Patients were classified as anaemic as per the WHO criteria. RESULTS: During the period of study, 270 patients attended for review. Eleven per cent of males and 16% of females were anaemic. Seventy four per cent of anaemic patients had a serum creatinine <110micromol/l and 72% of anaemic patients had a calculated creatinine clearance of >60ml/min. CONCLUSIONS: Anaemia was relatively common in patients attending for routine outpatient diabetes clinic review. The high prevalence of anaemia supports the routine screening for anaemia in the diabetes out-patient clinic, including in those without overt nephropathy.
Subject(s)
Anemia/epidemiology , Anemia/etiology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Cluster Analysis , Female , Humans , Ireland/epidemiology , Male , Mass Screening , Middle AgedABSTRACT
BACKGROUND: Patients' awareness of the increased cardiovascular risk associated with their diabetes is poorly documented. AIM: The aim of this study was to assess the awareness of diabetes complications among patients with diabetes in Ireland. METHODS: Patients attending diabetes outpatient clinics in two teaching hospitals in different regions of the country were invited to complete a questionnaire. RESULTS: A total of 258 (59.3% male) patients completed the questionnaire; mean age 57.8 years. On questioning, 53.5% reported cardiovascular disease as a potential complication of diabetes, with awareness rates of 61.2, 17.1, 16.3 and 12% for retinopathy, stroke, peripheral vascular disease and amputation, respectively. Disappointingly, less than half of respondents felt that improvements in diet and exercise could potentially reduce their cardiovascular risk. CONCLUSIONS: Awareness of cardiovascular risk and knowledge of effective measures to reduce this were low in our study and an alternative means of education may need to be considered.