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Critical insights for critical decisions
Learn how GE Healthcare’s cardiology solutions deliver insights that can help you make the decisions that matter for your patients, your clinical staff and your cardiology department.
Atrial Fibrillation
Patients with Atrial Fibrillation are hospitalized twice as often as patients without AFib and are 3 times more likely to have multiple admissions.1 AFib costs the United States about $26 billion each year.1
Time is critical for patients with Atrial Fibrillation who present with cardiac issues. GE’s Cardiovascular IT and Diagnostic Cardiology solutions can provide insights throughout the cardiology care pathway to help improve clinical decisions and outcomes.
Early Detection
There is a strong link between AF and stroke - one in five of all strokes can be attributed to this condition. Approximately 30 percent of people who experience AF-related strokes die during the hospital admission and another 20 percent are likely to die within a year. Care for patients with Atrial Fibrillation starts with identifying high-risk populations, for example–patients with sleep apnea, obesity and/or hypertension. Some regional guidelines recommend regular screening of all patients over 65 years old.
ECG Recorders
Instant capture medical-grade single-lead EKGs on mobile device.
Diagnosis
Diagnosis is based in part on ECG interpretation of the heart rhythm and clinical history.3 Studies indicate that one of the key factors is to differentiate between chronic and paroxysmal AF in order to find the optimal management strategy for the patient.3
Initial Management
Patients are typically managed with medical therapy such as anti-coagulation and anti-arrhythmic medications. Cardiovascular imaging can also be employed to help determine cardiac function. For patients who don’t respond to medical therapy alone, there are non-surgical treatment options such as cardioversion and ablation.3
Vivid™ E95
cSound™ beamforming technology for exceptional visualization quality with impressive resolution in 2D, color flow, Doppler and 4D formats.
Pre-Procedure Planning
If considering catheter ablation as a treatment option, pre-procedure planning can involve use of MR or CT imaging to identify anatomical targets for the procedure and understand the extent of AF. These images can help guide decisions on necessity of left atrial appendage closure in certain populations.3
Intervention
During the intervention, it’s important to minimize complications. Interventional system use should be optimized for clinical success while helping to minimize contrast and radiation exposure to patient and clinician.
Patient Follow-Up
After an ablation, regular patient follow up and non-invasive imaging assessment may detect potential return of Atrial Fibrillation.
Atrial Fibrillation Sources
- https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Tools%20and%20Practice%20Support/Quality%20Programs/Anticoag-10-14/GuidelinesAndBackground/1%20January%20ACC%20AHA%20HRS%202014%20Afib%20Guidelines.pdf?la=en
- Centricity Cardio Enterprise is comprised of Centricity Universal Viewer and Centricity Cardio Workflow
- Atrial Fibrillation and Cardiovascular Diseases – a European Heart Network paper September 2015
- CardioGraphe is the only dedicated cardiology CT on the market.
- GE World Class Cardiac CT PPTX, 2017, slide 26 and https://www.gehealthcare.com/products/computed-tomography/revolution-family/revolution-ct, Smart Cardiac section
- This presentation refers to Innova IGS 520.
- DQE values given are typical at f= 0 cycles/mm with RQA5 conditions as defined by IEC62220-1-3standards
- Option
- ICE catheter availability varies by country. Please contact Biosense Webster® directly
- https://www.genewsroom.com/press-releases/ge-healthcare-and-preventice-solutions-collaborate-extend-heart-station-beyond JB57724US – 5th paragraph
Acute Coronary Syndrome
Time to intervention can be a risk: delays to reperfusion correlate with higher rates of mortality and morbidity. Approximately 80 percent of all CVD deaths are due to heart attacks.1
Time is critical for patients who present with acute chest pain, with or without cardiac history. GE’s Cardiovascular IT and Diagnostic Cardiology solutions can provide insights throughout the cardiology care pathway to help improve clinical decisions and outcomes.
Pre-Hospital Transfer
Rapid transport, ECG monitoring and patient stabilization are critical for patients having an ST-segment elevation myocardial infarction. Nearly half of potentially salvageable myocardium is lost within one hour of the coronary artery being occluded, and nearly 2/3 lost within three hours.3
The ability to send observations and test results wirelessly can be invaluable to attending physicians and interventional lab preparations — potentially enabling fast action upon arrival to aid quality patient outcomes such as door to balloon time.4
Diagnosis
There are many potential causes of chest pain. For patients not sent immediately to the interventional lab for revascularization, guidelines suggest use of biomarkers, clinical history, ECG and non-invasive imaging measurement results, and other factors, to determine TIMI risk score which in turn can guide revascularization decisions.5
There are available estimates for sensitivity and specificity for the various non-invasive tests to diagnose the presence of CAD, but other factors are frequently considered such as equipment availability and patient tolerance.6
Intervention
For patients sent for revascularization in the catheterization lab, attempts are made to rapidly access the culprit artery and complete further assessment of coronary tree. Rapid intervention can help minimize time to reperfusion from first medical contact.
Patient Follow-Up
Follow-up treatment and rehabilitation strategies typically include non-invasive monitoring of LV function and strain.
Acute Coronary Syndrome Sources:
- https://www.who.int/cardiovascular_diseases/en/
- Centricity Cardio Enterprise is comprised of Centricity Universal Viewer and Centricity Cardio Workflow.
- NICE. Myocardial infarction with ST-segment elevation. Clinical Guideline 167, December 2013.
- Myocardial infarction with ST-segment elevation. Clinical Guideline 167, December 2013.
- Grech ED. ABC of Interventional Cardiology, Wiley-Blackwell, Oxford 2011.
- Montalescot G et al European Heart Journal (2013) 34, 2949–3003.
- CardioGraphe is the only dedicated cardiology CT on the market.
- 8. GE World Class Cardiac CT PPTX, 2017, slide 26 and https://www.gehealthcare.com/products/computed-tomography/revolution-family/revolution-ct, Smart Cardiac section.
- Mollema et al., Viability assessment with global left ventricular longitudinal strain predicts recovery of left ventricular function after acute myocardial infarction. Circ Cardiovasc Imaging 2010;3:15-23
- Stanton et al., Prediction of all-cause mortality from global longitudinal speckle strain: Comparison with ejection fraction and wall motion scoring. Circulation Cardiovasc Imaging 2009;2;356-364
- Lafitte et al., Impact of impaired myocardial deformations on exercise tolerance and prognosis in patients with asymptomatic aortic stenosis, Eur J Echocardiogr 2009;10;414-419
- DQE values given are typical at f= 0 cycles/mm with RQA5 conditions as defined by IEC62220-1-3standards.
- PCI ASSIST refers to features of Innova IGS 520, Innova IGS 530 and Discovery IGS 730.
- http://www.ncbi.nlm.nih.gov/pubmed?term=Prediction%20of%20all-cause%20mortality%20from%20global%20longitudinal%20speckle%20strain%3A%20 comparison%20with%20ejection%20fraction%20and%20wall%20motion%20scoring Circ Cardiovasc Imaging. 2009 Sep;2(5):356-64. Epub 2009 Jul 21.
Aortic Stenosis
Among symptomatic patients with medically treated moderate-to-severe aortic stenosis, mortality from the onset of symptoms is approximately 25 percent at one year and 50 percent at two years.1 GE Healthcare Cardiology Solutions help you make decisions that matter for your patients, staff and hospital.
Time is critical for AS patients who present with significant cardiac issues. GE’s Cardiovascular IT and Diagnostic Cardiology solutions can provide insights throughout the cardiology care pathway to help improve clinical decisions and outcomes.
Diagnosis
Diagnosis involves assessment of valve morphology, amount of stenosis or insufficiency, LV function, LV hypertrophy, and severity of symptoms. For patients with Aortic Stenosis, there are surgical and catheterization treatment options in addition to medical or palliative care. A risk calculator is typically used to quantify the risk and make a treatment decision.
Pre-Procedure Planning
For patients choosing a transcatheter replacement, non-invasive cardiovascular imaging, such as Ultrasound, CT, and MR are typically used to assess anatomy to plan the access site and size the valve.
Intervention
During the transcatheter aortic valve replacement, steps are taken to ensure the most effective result, including valve sizing, position, and function are optimal.
Patient Follow-Up
After the procedure, care is taken to ensure functionality of the valve typically using non-invasive imaging and ECG.
Aortic Stenosis Sources:
- https://emedicine.medscape.com/article/150638-overview
- Centricity Cardio Enterprise is comprised of Centricity Universal Viewer and Centricity Cardio Workflow.
- CardioGraphe is the only dedicated cardiology CT on the market.
- GE World Class Cardiac CT PPTX, 2017, slide 26 and https://www.gehealthcare.com/products/computed-tomography/revolution-family/revolution-ct, Smart Cardiac section.
- Valve ASSIST 2 is a commercial package which includes TAVI Analysis + HeartVision 2 and requires AW workstation with Volume Viewer, Volume Viewer Interventional. These applications are sold separately
Stable Ischemic Heart Disease
Managing risk factors and follow up for patients with Stable Ischemic Heart Disease is critical. GE’s Cardiovascular IT and Diagnostic Cardiology solutions can provide insights throughout the cardiology care pathway to help improve clinical decisions and outcomes.
Early detection and management including counseling, and medical therapy are important for patients with cardiovascular disease or who are at a high risk, including those with risk factors such as hypertension, diabetes, and high cholesterol.1
Diagnosis & Risk Stratification
Non-invasive methods for observing response to guideline-directed therapy can be employed, two examples of these methods are 12 SL ECG interpretation and stress imaging. Additionally, if the patient is not responsive to therapy, CT, MR or Nuclear studies may help show functional degradation which might necessitate a follow on intervention such as PCI or CABG.
Intervention
Successful PCI of the stenotic lesions involves planning, guidance, and assessment of the culprit lesion and assessment of the remainder of the coronary tree.
Patient Follow-Up and Monitoring
Follow-up treatment and rehabilitation strategy can include behavior modification and medical therapy in addition to monitoring cardiac function non-invasively using ALARA principles.
Stable Ischemic Heart Disease Sources:
- https://www.who.int/en/news-room/fact- sheets/detail/cardiovascular-diseases-(cvds)
- Centricity Cardio Enterprise is comprised of Centricity Universal Viewer and Centricity Cardio Workflow
- CardioGraphe is the only dedicated cardiology CT on the market.
- GE World Class Cardiac CT PPTX, 2017, slide 26 and https://www.gehealthcare.com/products/computed-tomography/revolution-family/revolution-ct, Smart Cardiac section.
- This presentation refers to Innova IGS 520.
- PCI ASSIST refers to features of Innova IGS 520, Innova IGS 530 and Discovery IGS 730.
Heart Failure
Heart Failure cost is 2-3 percent of the total health-care expenditures in high-income countries, and costs are projected to increase 200 percent in next 20 years world-wide. Current cost in the U.S. is $30.7 billion dollars.1 Congestive heart failure affects people of all ages, from children and young adults to the middle-aged and the elderly.
Time is critical for Heart Failure patients who present with cardiac issues. GE’s Cardiovascular IT and Diagnostic Cardiology solutions can provide insights throughout the cardiology care pathway to help improve clinical decisions and outcomes.
Early Detection
About half of people who develop heart failure die within five years of diagnosis.3 Important risk factors include HTN, DM, Metabolic Syndrome, and Coronary Artery Disease, but there are many other conditions that put patients at risk. Early identification and treatment of comorbidities can delay the onset of Heart Failure.4
Diagnosis and Risk Assessment
Diagnosis typically involves assessment for ECG abnormality and assessment of cardiac structure, function and possible cause. Guidelines suggest use of echocardiography due to its widespread availability, but other non-invasive imaging modalities can be used. In certain cases, invasive monitoring provides useful information for patients with persistent symptoms. Biomarkers provide helpful information about progression of disease. 4
Treatment and Intervention
Guidelines suggest lifestyle modifications, and use of specific medical therapies, such as ACE inhibitors and beta blockers. For certain patients not responding to medical therapies, guidelines suggest use of ICD or CRT. Revascularization and valve repair are used in certain stages of HF.4
Patient Follow-Up and Monitoring
Guidelines recommend regular follow up to assess severity and extent of left ventricular dysfunction, and development of a follow-up treatment strategy, including monitoring, to prevent acute decompensation and re-admission.4
Heart Failure Sources:
- https://www.escardio.org/static_file/Escardio/Subspecialty/HFA/WHFA-whitepaper-15-May-14.pdf
- Centricity Cardio Enterprise is comprised of Centricity Universal Viewer and Centricity Cardio Workflow
- Mozzafarian D, Benjamin EJ, Go AS, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133:e38-e360.
- 2013 ACC guidelines Yancy et al. JACC Vol. 62, No. 16, 2013 2013 ACCF/AHA Heart Failure Guideline: Full Text October 15, 2013:e147–239
- The device has been verified for limited use outside of professional healthcare facilities during transport. Use is restricted to environmental properties described in the user manual, please contact your GEHealthcare sales representative for detailed information.
- This presentation refers to Innova IGS 520.
GE Healthcare Services
Flexible offerings can help ensure optimal equipment and clinical performance, and includes tools and resources to optimize uptime to reduce patient disruptions. With the ability to add services beyond maintenance, clinical confidence is further supported through remote and on-site applications training and support.
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JB01451IN March 2023