Tag: syncope

Categories : Cardiovascular DiseaseTags : Leave a comment

Monitoring After Syncope Identifies Cardiovascular Conditions

On By ModernMedia
Source: CC0

Fitting a wearable heart monitor for 14 days when patients go to A&E (accident & emergency) with unexplained fainting improves the detection of life-threatening heart problems, a study shows.

Using the two-week monitor more than doubled the detection rate of heart rhythm problems. After one year, heart rhythm problems were identified in 22% of the monitor group compared with 9% of those who received standard care.  

The death rate after one year in the two-week monitoring group, at 1.5%, was almost half that of the standard care group, at 2.9%. 

The reduction in death rate is strong evidence that the new strategy can save lives, experts say. 

Difficult diagnosis 

Around 650 000 people visit A&E with unexplained fainting each year in the UK. Although the cause is often harmless, fainting episodes can be a sign of abnormal heart rhythms – known as arrhythmias – which can be dangerous. 

Arrhythmias in these patients are hard to diagnose. People who have fainted have usually recovered by the time they reach A&E, meaning their heart rhythm has likely returned to normal, and tests won’t show any abnormalities. 

Currently, patients with unexplained fainting are referred for tests such as a Holter monitor – a small wearable device that records the heart’s rhythm. However, a Holter monitor is usually only worn for 48 hours, so can only identify an arrhythmia in this small window.  

Patients must also attend an outpatient cardiology clinic first, meaning that monitoring is done at any point from six weeks to two years after they attend A&E.   

Earlier monitoring 

The new heart monitor is smaller – about the size of a car key fob – and is worn in the middle of the chest. It can be worn continuously for the two-week period.  

The University of Edinburgh-led research team studied 2234 people who attended UK A&E departments with unexplained fainting. Half of the study volunteers were fitted with the new monitor, while the other half received the current standard monitoring. 

Data from the monitors were sent to clinicians after the two-week monitoring period, who then determined whether their recordings showed signs of an arrhythmia and if treatment was needed. If the monitor picked up a serious arrythmia, the patient’s clinician was alerted within 24 working hours.

We were able to begin patient monitoring within 72 hours of people arriving at A&E, which is much faster than the current standard. Continuous data on a patient’s heart rhythm for two weeks is invaluable to cardiologists when they are trying to diagnose an arrhythmia. As the results show, more patients with hidden heart rhythm problems were identified, and their treatment could be sped up. 

We believe that the lower death rate seen for this group is strong evidence that this new strategy can save lives. Hopefully it will be adopted by hospitals across the country, so that fewer people with a potentially life-threatening condition slip through the net. 

 Professor Matthew ReedStudy lead and Honorary Professor of Emergency Medicine at the Usher Institute

Faster treatment 

Arrhythmias were identified in an average of 22 days in those with chest-worn monitors, compared to 54.5 days with standard care. This included life-threatening arrhythmias like complete heart block and a pause in the heartbeat of over six seconds.  

As a result of increased and quicker detection, more people who used the chest-worn monitor started treatment for their arrhythmia.  

For the monitoring group, 10.8 per cent were given anti-arrhythmic medication and 6.8 per cent had a pacemaker implanted, versus 7.3 per cent and 4.6 per cent respectively for the standard care group. 

Experts hope that the strategy will become standard practice in the NHS now it has been shown to help doctors treat dangerous heart problems and reduce death rates.

This large trial is a good example of how BHF investment in research can drive life-changing innovations in healthcare. The study shows that monitoring the heart with simple new technology after a patient has had a sudden collapse can identify potentially life-threatening disturbances in heart rhythm that can be treated to reduce risk of death. 

The results of this trial should certainly help inform future clinical practice when treating patients with sudden unexplained collapse in the future. 

 Professor Bryan WilliamsChief Scientific and Medical Officer at the British Heart Foundation

The study, funded by the British Heart Foundation, is published in the New England Journal of Medicine and being presented at the European Society of Cardiology Congress in Munich. 

Read the study in the New England Journal of Medicine 

Source: The University of Edinburgh

Categories : COVIDTags :

Vaccine-related Fainting Down to Anxiety, CDC Says

On By ModernMedia

A brief bout of anxiety was likely the cause of possible COVID vaccine-linked symptoms that people experienced, said researchers with the US Centers for Disease Control and Prevention say.

Several reports emerged in early April that people in at least five different vaccination sites in the US, all in different states, experienced symptoms almost immediately after receiving a vaccination jab. 

These symptoms, all from people who received the Johnson & Johnson vaccine, were largely reported as being fainting, dizziness, lightheadedness, and rapid breathing. These incidents resulted in four of these sites being temporarily shut down, with pledges to investigate being made by both the CDC and local health officials.

The CDC investigation examined 64 cases documented across five vaccination sites between April 7 and 9, and interviewed providers who were at the sites when the events took place. Real-world safety data collected through the Vaccine Adverse Event Reporting System was also looked at.

While some people went to the hospital afterwards, none of the symptoms were deemed to be serious in severity, and most symptoms improved within 15 minutes. A total of 17 people experienced fainting, while more than half reported feeling lightheaded and dizzy and about a third experienced nausea and/or vomiting. Thirteen patients had also told staff members beforehand of past fainting due to a fear of needles or vaccines.

The CDC’s report on the investigation and its findings were published Friday in its Morbidity and Mortality Weekly Report (MMWR).

Fainting and similar short-term symptoms occasionally occurs following vaccination, and measures to reduce them are being investigated. In the CDC’s investigation of these cases and safety data doesn’t point to any other cause of these symptoms besides simple anxiety. In their report, the authors observed that these incidents took place before the more recent reports of a rare blood clotting condition possibly linked to the Johnson & Johnson vaccine were made known to the public. Use of the J&J vaccine has since resumed in many countries, with a warning of the risks.

Since the J&J vaccine is administered in a single dose, it’s possible that people who are more likely to be anxious about vaccines would also opt for it more often, which could then account for the higher incidence of vaccine-related fainting associated with the shot. Another possibility is that early media coverage of the first incidents on April 7 (or physically seeing someone faint) further increased people’s anxiety. However, it was widely reported that one of the first members of the public to take the Pfizer vaccine last December — a nurse — fainted right after. But the nurse pointed out at the time that she had a history of fainting.

The authors of the report summed it up in saying, “the stress of an ongoing pandemic might also increase anxiety surrounding covid-19 vaccination.”

Of course, fainting and these other symptoms can still be a scary experience, no matter the cause. And just because anxiety may be the root cause of these cases, that doesn’t mean there isn’t a real risk worth caring about. 

Since fainting is still an upsetting experience no matter the cause and the risk of it should not be dismissed, so the authors recommend that people are routinely monitored after vaccination for at least 15 minutes. This is not only the chance that fainting may occur but other rare symptoms that could appear post-vaccination, such as a strong allergic reaction.

Source: Gizmodo