Variation among hospitals in coronary-angiography practices and outcomes after myocardial infarction in a large health maintenance organization

Article Abstract:

Patient outcomes may vary substantially among hospitals handling diverse amounts of coronary angiographies after a heart attack. Researchers compared outcomes after heart attack and angiography in 6,851 patients treated in 16 Kaiser Permanente hospitals. The least adverse cardiac consequences including death were found in patients treated in those hospitals performing the highest number of angiographies. On-site angiography services were available in three of the five busiest hospitals. Angiography was performed within three months after the heart attack in 48% of all patients.

Care and treatment, Standards, Heart attack, Hospitals, Coronary care units, Hospital services, Cardiovascular services

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Do patients prefer physiologic pacing?

Article Abstract:

More research is needed before a recommendation can be made for or against dual-chamber pacemakers. These pacemakers stimulate both the atria of the heart as well as the ventricles. A 1998 study compared quality of life in patients who were randomly assigned to receive a dual-chamber pacemaker or one that only stimulated the ventricles. There were no significant differences between the groups, but the researchers did not study long-term complications such as stroke and premature death. Dual-chamber pacemakers are more expensive and do not last as long as ventricular pacemakers.

Editorial, Methods, Evaluation, Pacemaker, Artificial (Heart), Pacemakers, Cardiac pacing

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Evidence-based use of of cardiac procedures and devices

Article Abstract:

A discussion is presented that tries to evaluate whether, there would be a demand for solid evidence for cardiac procedures and devices, after the advent of evidence-based medicine.

United States, Usage, Cardiovascular diseases, Diagnosis, Drug therapy, Evidence-based medicine, Cardiovascular equipment

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