Acute myocardial infarction in Singapore - An epidemiological study

Ph.DDOCTOR OF MEDICIN

Emerging concepts in the management of acute myocardial infarction in patients with diabetes mellitus

AbstractAlthough fibrinolysis has improved survival of patients after myocardial infarction (MI), such therapy is less likely to be administered to patients with diabetes. Furthermore, these patients present later (15 min) than nondiabetics. Moreover, even with the use of early potent fibrinolytic agents, patients with diabetes continued to suffer excessive morbidity and mortality. This finding is not related to the ability of fibrinolytic agents to restore complete reperfusion or increased risk of reocclusion of the infarct-related artery. Instead, the impaired ventricular performance at the noninfarct areas and metabolic derangements during the acute phase of MI may account for the adverse outcome. The efficacy of percutaneous coronary revascularization procedures for treatment of acute MI requires further evaluation. Therapeutic approaches should consider correcting these abnormalities to afford greater survival benefit for this subset of high-risk patients

Progressive surface reconstruction for heart mapping procedure

The composite imaging of measured cardiac properties like electrical activation and contractile properties on a reconstructed endocardial surface allows for the diagnosis of cardiac arrhythmia and myocardial infarct. However, it is difficult for an interventionalist to acquire heart surface contacts by navigating a catheter to the desired region of interest under minimal visual aid. This paper discusses a new method for the progressive reconstruction of an endocardial surface during a heart mapping procedure. A generic mesh is first aligned with a set of anchor points to obtain a first approximation of the surface. Subsequent deformations are constrained by the preservation of local surface characteristics and the fidelity of new contact points. The mesh is refined by local subdivision and its geometrical shape is further improved by edge swapping. Compared to prior art, the new method can reconstruct a realistic surface from a set of sparse and random data. It can advantageously provide a smooth reconstruction at initial acquisition and ensure a geometrical consistency between consecutive reconstructions. The accurate reconstruction of a heart chamber provides important visual cues for an interventionalist to decide on the next mapping site, thus constructively influencing the final diagnosis

Apparatus for the simulation of image-guided surgery

US6538634Granted Paten