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Sudden cardiac death is a feared complication of hypertrophic cardiomyopathy (HCM). Therapies to reduce the incidence of sudden cardiac death have included implantable defibrillators and surgical- and catheter-based approaches to reduce obstruction by septal reduction.
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Atrial septal defects (ASD) are among the most common congenital heart defect found in the adult population. Although they are often diagnosed and treated in childhood or infancy, some patients survive into adulthood with unrepaired ASDs.
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The ACC/AHA guidelines give a class ii b recommendation for surgery in asymptomatic patients if aortic stenosis is very severe (area < 0.6 cm2) and operation risk is low. However, the outcome of this approach vs. following patients until symptoms or left ventricular dysfunction occurs has not been tested.
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The value of restoring and maintaining sinus rhythm in patients with atrial fibrillation remains controversial.
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Compassion & Choices, an advocacy group for "aid in dying" at the end of life, reports that Idaho Gov. Butch Otter, in a letter to the Idaho Senate, encouraged the legislature to revisit a particular bill.
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Although most patient care scenarios can be worked out through careful communication with all those involved, there are certain situations where even greater diplomacy may be required on the part of ethics consultants.
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The policy for deactivation of an implantable cardioverter-defibrillator (ICD) at Hospice of the Western Reserve in Cleveland, OH, clearly spells out the steps and responsibilities of deactivating an ICD's shocking program.
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The patient was dying of lung cancer and planned to die at home with his family nearby. Instead, he was raced to the emergency department as he died because his implantable cardioverter-defibrillator (ICD) kept firing an electrical impulse to restore his heart rhythm.
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In a memorandum, President Obama has asked Kathleen Sebelius, secretary of the Department of Health and Human Services, to develop guidance for hospitals participating in Medicare or Medicaid to ensure that patients' advance directives are respected.