1
|
Rasmussen AN, Guise A, Overgaard C. The role of social support in the experience of life with ischemic heart disease for socially disadvantaged patients: A qualitative study. Chronic Illn 2023; 19:354-367. [PMID: 34870487 DOI: 10.1177/17423953211065005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Ischemic heart disease (IHD) displays wide social inequalities that are often explained with reference to lifestyle factors. However, research indicates that social support may also play an important role in social inequality in IHD. This study aims to explore the role of social support in the experience of life with IHD for socially disadvantaged patients. METHODS The study was conducted as a critical hermeneutic qualitative study in Denmark between October 2018 and August 2019. Data consist of in-depth qualitative interviews with 30 socially disadvantaged patients with IHD. RESULTS The findings showed a notable difference between the participants who were engaged in close and supportive social relationships and those who were not. Life with IHD for those who lacked supportive relationships tended to be marked by feelings of chaos, powerlessness and meaninglessness. Contrarily, those who were engaged in supportive relationships received help to navigate their life with illness, reconcile with what had happened to them, feel empowered, and gain a sense of meaning in their life.Discussion: Social support from close social relationships appears to be crucial for socially disadvantaged ischemic heart patients, and should be encouraged and facilitated in healthcare and interventions targeting this patient group.
Collapse
Affiliation(s)
- Amanda Nikolajew Rasmussen
- Department of Health Science and Technology, 1004Aalborg University, Niels Jernes Vej 14, 9220 Aalborg Øst, Denmark
| | - Andrew Guise
- Population Health Sciences, 4616King's College London, Great Maze Pond, London SE1 1UL, UK
| | - Charlotte Overgaard
- Department of Health Science and Technology, 1004Aalborg University, Niels Jernes Vej 14, 9220 Aalborg Øst, Denmark
| |
Collapse
|
2
|
Addressing Rehabilitation Healthcare Disparities During the COVID-19 Pandemic and Beyond. Phys Med Rehabil Clin N Am 2023. [PMCID: PMC10063577 DOI: 10.1016/j.pmr.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
|
3
|
Whiteson JH, Azola A, Barry JT, Bartels MN, Blitshteyn S, Fleming TK, McCauley MD, Neal JD, Pillarisetti J, Sampsel S, Silver JK, Terzic CM, Tosto J, Verduzco‐Gutierrez M, Putrino D. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of cardiovascular complications in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R 2022; 14:855-878. [PMID: 35657351 PMCID: PMC9347705 DOI: 10.1002/pmrj.12859] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Jonathan H. Whiteson
- Department of Rehabilitation Medicine and Department of MedicineRusk Rehabilitation, NYU Langone HealthNew YorkNew YorkUSA
| | - Alba Azola
- Department of Physical Medicine and RehabilitationJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - John T. Barry
- Good Shepherd Penn Partners, Penn Therapy & Fitness—University CityPhiladelphiaPennsylvaniaUSA
| | - Matthew N. Bartels
- Department of Rehabilitation Medicine, Montefiore Health SystemAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Svetlana Blitshteyn
- Department of NeurologyUniversity at Buffalo Jacobs School of Medicine and Biomedical SciencesBuffaloNew YorkUSA
| | - Talya K. Fleming
- Department of Physcial Medicine and RehabilitationJFK Johnson Rehabilitation Institute at Hackensack Meridian HealthEdisonNew JerseyUSA
| | - Mark D. McCauley
- Department of Medicine, Section of CardiologyUniversity of Illinois at Chicago and Jesse Brown VA Medical CenterChicagoIllinoisUSA
| | - Jacqueline D. Neal
- Physical Medicine and RehabilitationNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA,Physical Medicine and RehabilitationPhysical Medicine and Rehabilitation, Jesse Brown VA Medical CenterChicagoIllinoisUSA
| | - Jayasree Pillarisetti
- Division of Cardiology, Department of MedicineUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | | | - Julie K. Silver
- Department of Physical Medicine and RehabilitationHarvard Medical School, Spaulding Rehabilitation HospitalBostonMassachusettsUSA
| | - Carmen M. Terzic
- Department of Physical Medicine and Rehabilitation and Department of Cardiovascular MedicineMayo ClinicRochesterMinnesotaUSA
| | - Jenna Tosto
- Department of Rehabilitation and Human Performance, Abilities Research CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | | | - David Putrino
- Department of Rehabilitation and Human PerformanceIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| |
Collapse
|
4
|
Hutchens J, Frawley J, Sullivan EA. The healthcare experiences of women with cardiac disease in pregnancy and postpartum: A qualitative study. Health Expect 2022; 25:1872-1881. [PMID: 35616361 PMCID: PMC9327873 DOI: 10.1111/hex.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Cardiac disease affects an estimated 1%-4% of all pregnancies and is a leading cause of maternal morbidity and mortality. There is a lack of data on the healthcare experiences of affected women to inform health service delivery and person-centred care. This study sought to explore and understand the healthcare experiences of women with cardiac disease in pregnancy and postpartum. METHODS This qualitative study used semi-structured interviews with women who had cardiac disease in pregnancy or the first 12 months postpartum. Data were analysed using thematic analysis. RESULTS Participants were 25 women with pre-existing or newly diagnosed acquired, genetic and congenital cardiac disease. Analysis of the interviews highlighted the discrepancy between care aspirations and experiences. The participants had a wide range of cardiac diseases and timing of diagnoses, but had similar healthcare experiences of being dismissed, not receiving the information they required, lack of continuity of care and clinical guidelines and of feeling out of place within a healthcare system that did not accommodate their combined needs as a mother and a cardiac patient. CONCLUSION This study identified a lack of person-centred care and responsiveness of the healthcare system in providing fit-for-purpose healthcare for women with complex disease who are pregnant or new mothers. In particular, cardiac and maternity care providers have an opportunity to listen to women who are the experts on their emergent healthcare needs, contributing to development of the knowledge base on the healthcare experiences of having cardiac disease in pregnancy and postpartum. PATIENT OR PUBLIC CONTRIBUTION Public and patient input into the value and design of the study was gained through NSW Heart Foundation forums, including the Heart Foundation's women's patient group.
Collapse
Affiliation(s)
- Jane Hutchens
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Jane Frawley
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Elizabeth A Sullivan
- College of Health, Mediicne and Wellbeing, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Justice Health and Forensic Mental Health Network, Newcastle, Australia
| |
Collapse
|
5
|
Austin RR, Mathiason MA, Lu SC, Lindquist RA, McMahon SK, Pieczkiewicz DS, Monsen KA. Toward Clinical Adoption of Standardized mHealth Solutions: The Feasibility of Using MyStrengths+MyHealth Consumer-Generated Health Data for Knowledge Discovery. Comput Inform Nurs 2022; 40:71-79. [PMID: 35115437 DOI: 10.1097/cin.0000000000000862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Robin R Austin
- Author Affiliations: School of Nursing, University of Minnesota (Dr Austin, Ms Mathiason, Dr Lindquist, Dr McMahon, and Dr Monsen), Minneapolis; MD Anderson Cancer Center, University of Texas (Dr Lu), Austin; and Institute for Health Informatics, University of Minnesota (Drs Pieczkiewicz and Monsen), Minneapolis
| | | | | | | | | | | | | |
Collapse
|
6
|
Rasmussen AN, Petersen KS, Overgaard C. An Overwhelming Burden of Psychosocial Stress: Life With Ischemic Heart Disease for Midlife Patients With Low Socioeconomic Status and Lack of Flexible Resources. QUALITATIVE HEALTH RESEARCH 2021; 31:2666-2677. [PMID: 34605705 DOI: 10.1177/10497323211043493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The largest social inequalities in ischemic heart disease are found in the midlife population. These inequalities are often explained by lifestyle factors, while the role of structural factors and psychosocial stress are generally less acknowledged. In this study, we explore the influence of psychosocial stress on life with ischemic heart disease for midlife patients with low socioeconomic status and lack of flexible resources. In-depth interviews were conducted with 18 participants, and a critical hermeneutic approach was used to analyze and interpret data. We found that the participants were exposed to several external psychosocial stressors related to their family relationships, employment conditions, and experiences of stigmatization. These stressors reinforced each other and created an overwhelming burden of psychosocial stress. Our findings call for supportive interventions that target external psychosocial stressors and stressful feelings among this vulnerable group of patients.
Collapse
|
7
|
Austin RR, Mathiason MA, Lindquist RA, McMahon SK, Pieczkiewicz DS, Monsen KA. Understanding Women's Cardiovascular Health Using MyStrengths+MyHealth: A Patient-Generated Data Visualization Study of Strengths, Challenges, and Needs Differences. J Nurs Scholarsh 2021; 53:634-642. [PMID: 33998130 DOI: 10.1111/jnu.12674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this data visualization study was to identify patterns in patient-generated health data (PGHD) of women with and without Circulation signs or symptoms. Specific aims were to (a) visualize and interpret relationships among strengths, challenges, and needs of women with and without Circulation signs or symptoms; (b) generate hypotheses based on these patterns; and (c) test hypotheses generated in Aim 2. DESIGN The design of this visualization study was retrospective, observational, case controlled, and exploratory. METHODS We used existing de-identified PGHD from a mobile health application, MyStrengths+MyHealth (N = 383). From the data, women identified with Circulation signs or symptoms (n = 80) were matched to an equal number of women without Circulation signs or symptoms. Data were analyzed using data visualization techniques and descriptive and inferential statistics. FINDINGS Based on the patterns, we generated nine hypotheses, of which four were supported. Visualization and interpretation of relationships revealed that women without Circulation signs or symptoms compared to women with Circulation signs or symptoms had more strengths, challenges, and needs-specifically, strengths in connecting; challenges in emotions, vision, and health care; and needs related to info and guidance. CONCLUSIONS This study suggests that visualization of whole-person health including strengths, challenges, and needs enabled detection and testing of new health patterns. Some findings were unexpected, and perspectives of the patient would not have been detected without PGHD, which should be valued and sought. Such data may support improved clinical interactions as well as policies for standardization of PGHD as sharable and comparable data across clinical and community settings. CLINICAL RELEVANCE Standardization of patient-generated whole-person health data enabled clinically relevant research that included the patients' perspective.
Collapse
Affiliation(s)
- Robin R Austin
- Assistant Professor, University of Minnesota, School of Nursing, Minneapolis, MN, USA
| | | | - Ruth A Lindquist
- Professor Emeriti, University of Minnesota, School of Nursing, Minneapolis, MN, USA
| | - Siobhan K McMahon
- Associate Professor, University of Minnesota, School of Nursing, Minneapolis, MN, USA
| | - David S Pieczkiewicz
- Clinical Associate Professor, University of Minnesota, Institute for Health Informatics, Minneapolis, MN, USA
| | - Karen A Monsen
- Professor, University of Minnesota, School of Nursing and Institute for Health Informatics, Minneapolis, MN, USA
| |
Collapse
|
8
|
D'Arrigo-Patrick E, Samman SK, Knudson-Martin C. Moving from "I" to "We": A Grounded Theory Analysis of Couple Therapy with Liver Patients and Their Partners. FAMILY PROCESS 2020; 59:1517-1529. [PMID: 32097502 DOI: 10.1111/famp.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Prior research indicates that couples who cope with chronic illness from a relational "we" orientation experience more positive outcomes than couples that cope individually; however, little prior research identifies clinical processes that promote reciprocity or how societal gender processes are involved. This grounded theory analysis of 25 videotaped therapy sessions with six heterosexual couples coping with chronic liver disease (LD) used a feminist-informed relational lens to focus on the clinical processes involved in shifting from an individual to a relational orientation. Findings identified three contextual barriers to attaining a "we orientation": (a) autonomy discourse, (b) illness-related power, and (c) gendered power. Analysis detailed therapist actions that decreased the impact of barriers to reciprocity and fostered relational coping. Clinical implications attend to complex intersections among gender, caregiving, and contextual barriers to reciprocity.
Collapse
|
9
|
Sutantri S, Cuthill F, Holloway A. "I just can't sit around and do nothing!": A qualitative study of Indonesian women's experiences diagnosed with heart disease. Nurs Health Sci 2020; 22:1047-1055. [PMID: 32713133 DOI: 10.1111/nhs.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Abstract
Research into cardiovascular disease and its management in Indonesia, where it currently accounts for 67% of all deaths, has heavily emphasized the biomedical aspects; little is known about the individual's experience of the disease, especially for Indonesian women. This study aimed to understand how gender shapes Indonesian women's experiences of living with heart disease in their daily lives. Twenty-six women aged 30-67 years were interviewed, and the transcriptions analyzed using a qualitative framework informed by intersectional approaches to gender and culture. Three major themes emerged: (i) the effect of cardiovascular disease on women's day-to-day activities, (ii) its effects on women's family relationships, and (iii) the women's coping strategies. The inability to fulfill their required social roles as mother or wife undermined the women's sense of self, a problem particularly acute in a cultural context where responsibility for maintaining harmony in the home and society is ascribed to women. Healthcare professionals should be aware of the ethnic and cultural backgrounds of women with cardiovascular disease, in order to deliver services that meet female patients' social, spiritual, and cultural needs.
Collapse
Affiliation(s)
- Sutantri Sutantri
- School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Jln. Brawijaya, Tamantirto, Kasihan, Bantul, Yogyakarta, Indonesia.,Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
| | - Fiona Cuthill
- Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
| | - Aisha Holloway
- Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
| |
Collapse
|
10
|
Beedholm K, Andersen LS, Lorentzen V. From Bodily Sensations to Symptoms: Health Care-Seeking Practices Among People Affected by Acute Coronary Syndrome. QUALITATIVE HEALTH RESEARCH 2019; 29:1651-1660. [PMID: 31274049 DOI: 10.1177/1049732319857057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The reduction of prehospital delay for patients with acute coronary syndrome (ACS) is widely discussed within cardiac research. Medically informed literature generally considers patient hesitancy in seeking treatment a significant barrier to accessing timely treatment. With this starting point, we conducted an interview study with people previously hospitalized for ACS and with the bystanders involved in their decision to contact the health care system. The analysis was conducted in two stages: first, a systematic extraction of key information; second, an in-depth analysis informed by medical anthropology. This led us to understand the prehospital period as an interpretation process where bodily sensations appeared as symptoms. Informants vacillated between sensations, knowledge, interpretations, and emotions as they struggled to preserve everyday ordinariness. They were led to contact the health care system by bodily discomfort rather than a rational decision to reduce risk. The paradigmatic implications from medical anthropology proved an important alternative to the medical paradigm.
Collapse
Affiliation(s)
| | | | - Vibeke Lorentzen
- 1 Aarhus University, Aarhus, Denmark
- 3 Center for Research in Clinical Nursing, Viborg, Denmark
- 4 Deakin University, Melbourne, Victoria, Australia
| |
Collapse
|
11
|
Sutantri S, Cuthill F, Holloway A. ‘A bridge to normal’: a qualitative study of Indonesian women’s attendance in a phase two cardiac rehabilitation programme. Eur J Cardiovasc Nurs 2019; 18:744-752. [DOI: 10.1177/1474515119864208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: Cardiac rehabilitation is effective in reducing mortality and morbidity, in improving life expectancy and quality of life for people with cardiovascular disease. Despite these recognised benefits, women’s attendance rates in cardiac rehabilitation programmes remain suboptimal. Aims: This paper details the study that explored factors that influence women’s attendance of a phase two cardiac rehabilitation programme in Indonesia Methods: An exploratory qualitative research design was used in the study. Semi-structured interviews were used as the main method of data collection. Data were collected from June to September 2016. Twenty-three women aged between 30 and 66 years were interviewed. Transcribed interview data were analysed using a qualitative framework analysis. Results: Three major themes were inferred from the analysis: (a) a bridge to normal; (b) connecting with others; and (c) contextual factors. The first theme is illustrated by two subthemes: ‘making my heart work again’ and ‘performing social roles’. The second theme was illustrated by the following subthemes: ‘exchanging knowledge and experience’ and ‘developing a give-and-take relationship’. The third theme was illustrated by three subthemes: ‘recommendations from the staff’, ‘family support’ and ‘availability of health insurance’. Conclusion: Women’s attendance in cardiac rehabilitation in Indonesia is mainly influenced by their expectations and desire to be able to resume their previous social roles in the family and society. The findings of this study can assist healthcare professionals to understand better the needs of women and the fit between women’s needs and existing cardiac rehabilitation programmes. Such understanding could provide direction for more effective approaches to the cardiac rehabilitation programmes that are currently offered in Indonesia.
Collapse
Affiliation(s)
- Sutantri Sutantri
- Department of Nursing Studies, The University of Edinburgh, UK
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Indonesia
| | - Fiona Cuthill
- Department of Nursing Studies, The University of Edinburgh, UK
| | - Aisha Holloway
- Department of Nursing Studies, The University of Edinburgh, UK
| |
Collapse
|
12
|
Telephone-based mindfulness training to reduce stress in women with myocardial infarction: Rationale and design of a multicenter randomized controlled trial. Am Heart J 2018; 202:61-67. [PMID: 29864732 PMCID: PMC7432959 DOI: 10.1016/j.ahj.2018.03.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/13/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Elevated stress is associated with adverse cardiovascular disease outcomes and accounts in part for the poorer recovery experienced by women compared with men after myocardial infarction (MI). Psychosocial interventions improve outcomes overall but are less effective for women than for men with MI, suggesting the need for different approaches. Mindfulness-based cognitive therapy (MBCT) is an evidence-based intervention that targets key psychosocial vulnerabilities in women including rumination (i.e., repetitive negative thinking) and low social support. This article describes the rationale and design of a multicenter randomized controlled trial to test the effects of telephone-delivered MBCT (MBCT-T) in women with MI. METHODS We plan to randomize 144 women reporting elevated perceived stress at least two months after MI to MBCT-T or enhanced usual care (EUC), which each involve eight weekly telephone sessions. Perceived stress and a set of patient-centered health outcomes and potential mediators will be assessed before and after the 8-week telephone programs and at 6-month follow-up. We will test the hypothesis that MBCT-T will be associated with greater 6-month improvements in perceived stress (primary outcome), disease-specific health status, quality of life, depression and anxiety symptoms, and actigraphy-based sleep quality (secondary outcomes) compared with EUC. Changes in mindfulness, rumination and perceived social support will be evaluated as potential mediators in exploratory analyses. CONCLUSIONS If found to be effective, this innovative, scalable intervention may be a promising secondary prevention strategy for women with MI experiencing elevated perceived stress.
Collapse
|
13
|
Dechaine CL, Merighi JR, O’Keefe TC. Healing the Heart: A Qualitative Study of Challenges and Motivations to Cardiac Rehabilitation Attendance and Completion among Women and Men. SEX ROLES 2017. [DOI: 10.1007/s11199-017-0873-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
14
|
Langdridge D. Recovery From Heart Attack, Biomedicalization, and the Production of a Contingent Health Citizenship. QUALITATIVE HEALTH RESEARCH 2017; 27:1391-1401. [PMID: 27634296 DOI: 10.1177/1049732316668818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this article, I explore the experience of recovery from a heart attack through an analytic autoethnography. I discuss the tensions inherent in biomedical subjectivities of health and ill-health during cardiac recovery through three key themes: (a) the transfer of responsibility and becoming a subject "at risk," (b) technologies of biomedicine and the disciplining of subjectivities, and (c) the transformation of a body toward a new pharmaceuticalized bodily normal. Through an analysis driven by the biomedicalization thesis of Clarke, alongside work on biopower and the governmentality of health by Foucault, Rose, and Rabinow, I seek to provide new insights into the process of cardiac recovery and the relationship between individual experience and broader socio-political processes. Key to this analysis is a focus on the contingent subjectivities brought into being through biomedicalization that constitute a new form of health citizenship that is otherwise not accounted for in narratives of recovery.
Collapse
|
15
|
Padeletti L, Curnis A, Tondo C, Lunati M, Porcellini S, Verlato R, Sciarra L, Senatore G, Catanzariti D, Leoni L, Landolina M, Delise P, Iacopino S, Pieragnoli P, Arena G. Pulmonary Vein Isolation with the Cryoballoon Technique: Feasibility, Procedural Outcomes, and Adoption in the Real World: Data from One Shot Technologies TO Pulmonary Vein Isolation (1STOP) Project. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 40:46-56. [PMID: 27862043 DOI: 10.1111/pace.12975] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/20/2016] [Accepted: 10/25/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Catheter ablation (CA) is recommended for patients with drug refractory symptomatic atrial fibrillation (AF). "One Shot" catheters have been introduced to simplify CA and cryoballoon ablation (CBA) is spreading rapidly. Few real-world data are available on standard clinical practice, mainly from single-center experience. We aimed to evaluate clinical settings, demographics, and acute procedural outcomes in a large cohort of patients treated with CBA. METHODS A total of 903 patients (73% male, mean age 59 ± 11) underwent pulmonary vein CBA. Correlations between the patient's inclusion time and clinical characteristics, procedure duration, acute success rate, and intraprocedural complications were evaluated. RESULTS Seventy-seven percent of patients were affected by paroxysmal AF and 23% by persistent AF. Overall, acute success rate was 97.9% and periprocedural complications were observed in 35 (3.9%) patients, 13 (1.4%) of which were classified as major complications. With respect to the patient's inclusion time analysis, an increase in treatment of persistent AF was observed, a significant decrease in CBA times (procedure, ablation, and fluoroscopy: 136.0 ± 46.5 minutes, 28.8 ± 19.6 minutes, and 34.3 ± 15.4 minutes, respectively) was observed, with comparable acute success rate and intraprocedural complications over time. The rate of major complications was extremely low (1.4%); no death, atrioesophageal fistula, stroke, or other major periinterventional or late complications occurred. CONCLUSION This series represents the largest experience of CBA in the treatment of AF that also describes the adoption curve of this relatively recent technology. CBA showed an excellent safety profile when performed in a large real-world clinical setting, with satisfactory acute success rate and, on average, short procedural times. CLINICAL TRIAL REGISTRATION clinicaltrials.gov (NCT01007474).
Collapse
Affiliation(s)
- Luigi Padeletti
- University of Florence, Firenze, Italy.,IRCCS Multimedica, Milano, Italy
| | | | - Claudio Tondo
- Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, University of Milan, Milano, Italy
| | | | | | | | | | | | | | - Loira Leoni
- Azienda Ospedaliera di Padova, Padova, Italy
| | | | - Pietro Delise
- Ospedale Civile di Conegliano, Conegliano Veneto, Italy
| | | | | | | |
Collapse
|
16
|
Saldarriaga C, Bedoya L, Gómez L, Hurtado L, Mejía J, González N. Conocimiento del riesgo de presentar un infarto de miocardio y las barreras para el acceso al estilo de vida saludable. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2015.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|