Cost-effectiveness and screening performance of ECG handheld machine in a population screening programme: The Belgian Heart Rhythm Week screening programme

Aims Overall, 40% of patients with atrial fibrillation are asymptomatic. The usefulness and cost-effectiveness of atrial fibrillation screening programmes are debated. We evaluated whether an atrial fibrillation screening programme with a handheld electrocardiogram (ECG) machine in a population-wide cohort has a high screening yield and is cost-effective. Methods We used a Markov-model based modelling analysis on 1000 hypothetical individuals who matched the Belgian Heart Rhythm Week screening programme. Subgroup analyses of subjects >= 65 and >= 75 years old were performed. Screening was performed with one-lead ECG handheld machine Omron (R) HeartScan HCG-801. Results In both overall population and subgroups, the use of the screening procedure diagnosed a consistently higher number of diagnosed atrial fibrillation than not screening. In the base-case scenario, the screening procedure resulted in 106.6 more atrial fibrillation patient-years, resulting in three fewer strokes, 10 more life years and five more quality-adjusted life years (QALYs). The number needed-to-screen (NNS) to avoid one stroke was 361. In subjects >= 65 years old, we found 80.8 more atrial fibrillation patient-years, resulting in three fewer strokes, four more life-years and five more QALYs. The NNS to avoid one stroke was 354. Similar results were obtained in subjects >= 75 years old, with a NNS to avoid one stroke of 371. In the overall population, the incremental cost-effectiveness ratio for any gained QALY showed that the screening procedure was cost-effective in all groups. Conclusions In a population-wide screening cohort, the use of a handheld ECG machine to identify subjects with newly diagnosed atrial fibrillation was cost-effective in the general population, as well as in subjects >= 65 and subjects >= 75 years old

Rappels des principes fondamentaux en électrocardiographie

Cet article décrit les principes de base de l’électrocardiogramme (ECG). Il s’adresse aux personnes curieuses d’en connaître un peu plus sur cet examen cardiologique de base et incontournable qui permet de dépister nombre de maladies cardiaques

Fibrillation Auriculaire : les montres connectées pour la détecter, les guidelines pour la traiter

Les derniers Guidelines de la fibrillation atriale (FA) ont été publiés fin août 2020, coïncidant avec le Congrès Européen de Cardiologie (ESC)1. Cet épais document de 126 pages insiste sur de nombreux points dont la prise en charge qui devient non seulement spécialisée mais surtout pluridisciplinaire. [Revivre le WEBINAIRE du Louvain Médical du 27 mai 2021

INNOVATIONS EN CARDIOLOGIE QUE RETENIR DE 2016 ?

Cette année a vu l’apparition en Belgique de 2 nouvelles molécules dans le domaine de la rythmologie, le Praxbind© et le Brivaness©, leur utilisation sera présentée. En 2016, la Société Européenne de Cardiologie a publié de nouvelles recommandations concernant la prise en charge des dyslipidémies, de la fibrillation auriculaire, de l’insuffisance cardiaque et de la prévention cardiovasculaire. Cet article revoit brièvement les points essentiel

Bloc auriculo-ventriculaire complet de cause exceptionnelle

L’apparition de troubles de conduction auriculo-ventriculaire nécessite des examens complémentaires afin de préciser l’étiologie. Le diagnostic différentiel comprend des pathologies infectieuses, infiltratives et néoplasiques. Parmi celles-ci, le lymphome cardiaque primitif est une entité rare dont le diagnostic est souvent tardif. Avec un traitement adéquat, une réponse tumorale complète avec résolution des troubles de conduction peut être obtenue. Que savons-nous à ce propos ? Le lymphome primitif cardiaque est une pathologie rare, représentant 1% des tumeurs cardiaques primitives. Il entreprend souvent le cœur droit et préférentiellement les oreillettes aux ventricules. Exceptionnellement il peut se compliquer d'un bloc auriculo-ventriculaire. Que nous apporte cet article ? Cet article illustre l’importance de rechercher un diagnostic étiologique en présence d’un bloc auriculo-ventriculaire. Le lymphome cardiaque primitif est une pathologie rare avec une mortalité importante sans traitement. Avec un diagnostic précoce et un traitement adéquat, la réponse thérapeutique peut être spectaculaire et permettre de normaliser les troubles de conduction

A pseudo sinus tachycardia originating from the right superior pulmonary vein. Successful ablation by a simplified, targeted ablation strategy.

We report the case of a young woman suffering from a permanent ectopic atrial tachycardia originating from the right superior pulmonary vein and mimicking a sinus tachycardia on the ECG. Using only 2 quadripolar catheters after a transseptal approach, the focus was successfully mapped to the posterior wall of the right superior pulmonary vein. The focus was successfully ablated during the same procedure using a 4-mm tip-irrigated catheter

Quality of life assessment in children before and after a successful ablation for supraventricular tachycardia.

BACKGROUND AND OBJECTIVES: Young patients suffering from rhythm disorders have a negative impact in their quality of life. In recent years, ablation has become the first-line therapy for supraventricular arrhythmias in children. In the light of the current expertise and advancement in the field, we decided to evaluate the quality of life in young patients with supraventricular arrhythmias before and after a percutaneous ablation procedure. METHODS: The prospective cohort consisted of patients <18 years with structurally normal hearts and non-pre-excited supraventricular arrhythmias, who had an ablation in our centre from 2013 to 2018. The cohort was evaluated with the PedsQL™ 4.0 Generic Core Scales self-questionnaire prior to and post-ablation. RESULTS: The final cohort included 88 patients consisted of 52 males (59%), with a mean age at ablation of 12.5 ± 3.3 years. Forty-two patients (48%) had a retrograde-only accessory pathway mediating the tachycardia, 38 (43%) had atrio-ventricular nodal re-entrant tachycardia, 7 (8%) had ectopic atrial tachycardia, and 1 (1%) had atrial flutter. The main reason for an ablation was the patient's choice in 53%. There were no severe complications. Comparison between the baseline and post-ablation assessments showed that patients reported significant improvement in the scores for physical health, emotional and social functioning, as well as in the total scores. CONCLUSIONS: The present study demonstrates that the successful treatment of supraventricular arrhythmias by means of an ablation results in a significant improvement in the quality of self-reported life scores in young patients