• Atrial fibrillation in a primary care population: how close to NICE guidelines are we?

      Loo, Bryan; Parnell, Cath; Brook, Gerald; Southall, Ed; Mahy, Ian; South West Cardiothoracic Centre, Department of Cardiology, Derriford Hospital, Plymouth. bloo@nhs.net (Clinical medicine (London, England), 2009-06)
      The National Institute for Health and Clinical Excellence (NICE) guidelines for the management of atrial fibrillation were published in June 2006. It was anticipated that they would potentially lead to increased demand for echocardiography (ECHO), increased access to secondary care services (for example for cardioversion), and require additional resources for monitoring anticoagulation. A primary care survey was therefore initiated in South Devon, in advance of publication of the guidelines as a snapshot of existing practice, to determine any additional resources and education required to meet the new standards. The main aim was to determine what proportion of patients were managed exclusively in primary care, how frequently patients were investigated by ECHO and whether anticoagulation was being appropriately targeted at patients at high risk of thromboembolic events.
    • Dopamine agonist therapy for hyperprolactinaemia and cardiac valve dysfunction; a lot done but much more to do.

      Sherlock, Mark; Toogood, Andy A; Steeds, Richard (Heart (British Cardiac Society), 2009-04)
    • Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy.

      Shah, J S; Esteban, M T T; Thaman, R; Sharma, R; Mist, B; Pantazis, A; Ward, D; Kohli, S K; Page, S P; Demetrescu, C; et al. (Heart (British Cardiac Society), 2008-10)
      Resting left ventricular outflow tract obstruction (LVOTO) occurs in 25% of patients with hypertrophic cardiomyopathy (HCM) and is an important cause of symptoms and disease progression. The prevalence and clinical significance of exercise induced LVOTO in patients with symptomatic non-obstructive HCM is uncertain.