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1.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(6): 658-663, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32684208

RESUMO

Out-of-hospital cardiac arrest (OHCA) is a global medical challenge. Early case recognition and initiating the chain of survival is associated with good prognosis of these patients. On the basis of former research, American Heart Association (AHA) published a policy statement related to telecommunicator cardiopulmonary resuscitation (T-CPR) in March 2020, and introduced its specific procedures, standards and precautions. To assist Chinese doctors in better understanding of the T-CPR, and give a reference for the emergency curing of OHCA, the guideline was translated and interpreted in this paper.


Assuntos
Reanimação Cardiopulmonar , Parada Cardíaca Extra-Hospitalar , American Heart Association , Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Humanos , Estados Unidos
2.
Circ Arrhythm Electrophysiol ; 13(7): e008999, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32530306

RESUMO

Coronavirus disease 2019 (COVID-19) has presented substantial challenges to patient care and impacted healthcare delivery, including cardiac electrophysiology practice throughout the globe. Based upon the undetermined course and regional variability of the pandemic, there is uncertainty as to how and when to resume and deliver electrophysiology services for patients with arrhythmia. This joint document from representatives of the Heart Rhythm Society, American Heart Association, and American College of Cardiology seeks to provide guidance for clinicians and institutions reestablishing safe electrophysiological care. To achieve this aim, we address regional and local COVID-19 disease status, the role of viral screening and serological testing, return-to-work considerations for exposed or infected health care workers, risk stratification and management strategies based on COVID-19 disease burden, institutional preparedness for resumption of elective procedures, patient preparation and communication, prioritization of procedures, and development of outpatient and periprocedural care pathways.


Assuntos
Arritmias Cardíacas/cirurgia , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções/organização & administração , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , American Heart Association , Arritmias Cardíacas/diagnóstico por imagem , Arritmias Cardíacas/epidemiologia , Eletrofisiologia Cardíaca , Técnicas de Imagem Cardíaca , Ablação por Cateter/métodos , Ablação por Cateter/estatística & dados numéricos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Sociedades Médicas , Estados Unidos
8.
Nursing ; 50(6): 58-61, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32453156

RESUMO

Continuous review of current research and practice has resulted in updates to the American Heart Association guidelines for CPR and emergency cardiovascular care. This article examines the recommendations and their implementation into current healthcare practice.


Assuntos
Reanimação Cardiopulmonar/enfermagem , Doenças Cardiovasculares/enfermagem , Enfermagem em Emergência/organização & administração , Primeiros Socorros/enfermagem , Adolescente , Adulto , American Heart Association , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Estados Unidos
11.
Circulation ; 141(21): e823-e831, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32228309

RESUMO

Coronavirus disease 2019 (COVID-19) is a global pandemic that is wreaking havoc on the health and economy of much of human civilization. Electrophysiologists have been impacted personally and professionally by this global catastrophe. In this joint article from representatives of the Heart Rhythm Society, the American College of Cardiology, and the American Heart Association, we identify the potential risks of exposure to patients, allied healthcare staff, industry representatives, and hospital administrators. We also describe the impact of COVID-19 on cardiac arrhythmias and methods of triage based on acuity and patient comorbidities. We provide guidance for managing invasive and noninvasive electrophysiology procedures, clinic visits, and cardiac device interrogations. In addition, we discuss resource conservation and the role of telemedicine in remote patient care along with management strategies for affected patients.


Assuntos
Arritmias Cardíacas/etiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Eletrocardiografia , Pandemias , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , American Heart Association , Arritmias Cardíacas/terapia , Cardiologia , Reanimação Cardiopulmonar , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Sociedades Médicas , Telemedicina , Triagem , Estados Unidos
12.
Ann Rheum Dis ; 79(5): 612-617, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32156706

RESUMO

BACKGROUND: The 2017 American College of Cardiology/American Heart Association guidelines defined hypertension at ≥130/80 mm Hg. Studies on patients with connective tissue diseases were not considered. Our aim was to assess the impact of this definition on atherosclerotic vascular events (AVEs) in systemic lupus erythematosus. PATIENTS METHODS: Individuals from the Toronto Lupus Clinic with at least 2 years of follow-up and no prior AVE were divided in three groups according to their mean blood pressure (BP) over that period (≥140/90 mm Hg, 130-139/80-89 mm Hg and <130/80 mm Hg). They were followed until the first occurrence of an AVE (fatal or non-fatal coronary artery disease, cerebrovascular event and peripheral vascular disease) or last visit. Groups were compared as per the baseline atherosclerotic risk factors. A multivariable time-dependent analysis was performed to adjust for the presence of other risk factors. RESULTS: Of 1532 patients satisfying the inclusion criteria, 155 (10.1%) had a BP ≥140/90 mm Hg, 316 (20.6%) 130-139/80-89 mm Hg and 1061 (69.3%) were normotensives. After a mean follow-up of 10.8 years, 124 AVEs were documented. The incidence rates were 18.9, 11.5 and 4.5 per 1000 patient-years for the three groups, respectively (p=0.0007 between the 130-139/80-89 mm Hg group and the normotensives). A mean BP of 130-139/80-89 mm Hg over the first 2 years was independently associated with the occurrence of AVEs (HR 1.73, 95% CI 1.13 to 2.65, p=0.011). CONCLUSION: Patients with lupus with a sustained mean BP of 130-139/80-89 mm Hg over 2 years had a significantly higher incidence of AVEs compared with normotensive individuals. This BP level should be the target for antihypertensive therapy to minimise their cardiovascular risk.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Hipertensão/epidemiologia , Lúpus Eritematoso Sistêmico/epidemiologia , Infarto do Miocárdio/epidemiologia , American Heart Association , Análise de Variância , Anti-Hipertensivos/uso terapêutico , Cardiologia/normas , Estudos de Coortes , Doença da Artéria Coronariana/diagnóstico , Feminino , Hospitais Universitários , Humanos , Hipertensão/classificação , Hipertensão/tratamento farmacológico , Lúpus Eritematoso Sistêmico/diagnóstico , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Infarto do Miocárdio/diagnóstico , Ontário , Prevalência , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Sociedades Médicas , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Análise de Sobrevida , Estados Unidos
14.
Nursing ; 50(4): 63-69, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32195880

RESUMO

Accurate BP measurements are vital for determining appropriate medication and treatment regimens. This article describes a quality improvement project to increase compliance with the American Heart Association's guidelines for BP measurement.


Assuntos
Determinação da Pressão Arterial/enfermagem , Fidelidade a Diretrizes/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Melhoria de Qualidade/organização & administração , American Heart Association , Humanos , Pesquisa em Avaliação de Enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Reprodutibilidade dos Testes , Estados Unidos
16.
Expert Rev Cardiovasc Ther ; 18(2): 117-125, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32066287

RESUMO

Introduction: Hypertension is the leading modifiable risk factor for cardiovascular events and mortality in the world.Areas covered: An extensive literature review of articles and clinical trials on PUBMED on the topic of hypertension in the elderly from 1976 through January 2020 was conducted. This review article discusses clinical trials on treatment of hypertension in the elderly, the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guidelines, the 2018 European Society of Cardiology/European Society of Hypertension guidelines, and the treatment of hypertension and of resistant hypertension in the elderly.Expert opinion: The 2017 ACC/AHA hypertension guidelines recommend treatment of noninstitutionalized ambulatory community-dwelling adults aged 65 years and older with an average systolic blood pressure of 130 mm Hg or higher with lifestyle measures plus antihypertensive drug to lower the blood pressure to less than 130/80 mm Hg. For elderly adults with hypertension and a high burden of comorbidities and limited life expectancy, clinical judgment, patient preference, and a team-based approach to assess risk/benefit is reasonable for decisions about the intensity of SBP lowering and the choice of antihypertensive drugs to use for treatment.


Assuntos
Anti-Hipertensivos/uso terapêutico , Gerenciamento Clínico , Hipertensão/tratamento farmacológico , Estilo de Vida , Idoso , Idoso de 80 Anos ou mais , American Heart Association , Cardiologia , Europa (Continente) , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto , Sociedades Médicas , Estados Unidos
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