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Issue

Vol 124 No 1343: 23 September 2011

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Issue Summary

SUMMARY

Under-use of secondary prevention medication in acute coronary syndrome patients treated with in-hospital coronary artery bypass graft surgery

Khang L Looi, Kok L Chow, Jen L Looi, Mildred Lee, Sue Halliday, Harvey White, Chris Ellis

We reviewed all patients admitted to Auckland City Hospital coronary care unit with a heart attack (n=901) over a 13-month period in 2006 to 2007. Of various treatments, 129 patients received a coronary artery bypass operation. These patients are at very high risk of future heart problems, but certain medicines can significantly improve their prognosis, if used long-term. We reviewed these patients 3 years later and found a disappointing use of these medicines. The percentage of patients who were not taking these medicines were aspirin (17%), statins (28%), beta-blockers (38%), ACE-Inhibitors or angiotensin receptor blockers (57%). Clearly, greater efforts to optimise the use of these 'secondary preventative' medicines are needed in our health system.

SUMMARY

Early cardiac morbidity of rheumatic fever in children in New Zealand

Olwen Gilbert, Nigel Wilson, Kirsten Finucane

This study reviewed children who were admitted to the heart ward of Starship Childrens Hospital for rheumatic fever over 2 years. There were 36 children and 49 separate admissions to hospital. 25 children required cardiac surgery. The cost was $1.9 million dollars. In other countries, rheumatic fever has been prevented.

SUMMARY

The incidence of atrial fibrillation and the use of warfarin in Northland, New Zealand stroke patients

Angela Bang, Nicole M McGrath

Atrial fibrillation (AF) is an abnormal heart rhythm that can predispose to stroke by causing cardiac blood clots that can then travel to the brain. For patients with AF, the risk of stroke can be significantly decreased by anticoagulation with warfarin. In our study, approximately one-quarter of Northland stroke patients admitted between January and September 2010 were in AF but only one-third were prescribed warfarin. Of those stroke patients on warfarin, only 1/12 was on a therapeutic dose of warfarin. The main reason for no warfarin was patients wishes.

SUMMARY

Are we meeting cardiovascular risk targets 3 years after acute coronary syndrome? An evaluation in West Auckland, New Zealand

John A Ford, Jocelyn Bell, Colin Edwards

Our study looked at over 100 patients who were admitted to hospital 3 years ago with a heart attack or severe angina. We wanted to see if the patients were reaching target to prevent another heart attack. We have found that blood pressure, cholesterol and medication prescribing was generally good after 3 years. However there is room for improvement in terms of weight, diabetic control and prescription of a drug called an ACE inhibitor.

SUMMARY

Surgical radiofrequency ablation for atrial fibrillation: the Christchurch, New Zealand experience

Frith Coolbear, Ian G Crozier

The long-term results following surgery for the common heart rhythm problem atrial fibrillation as an adjunct to other cardiac surgery at Christchurch Hospital are reported. A total of 44 patients underwent this operation between 2 July 2001 and 28 January 2009. In the short-term the surgery was successful in most patients. However with time the rhythm problem recurred in many patients.

SUMMARY

Pulmonary vein ablation for atrial fibrillation: the Christchurch, New Zealand experience

Matthew Daly, Iain Melton, Ian G Crozier

Atrial fibrillation is New Zealands most common heart rhythm disorder. The upper chambers of the heart, or atria, are subjected to rapid, chaotic electrical currents and can not pump in a coordinated fashion. This may produce intolerable symptoms in some people. Research has shown that these abnormal currents originate from the pulmonary veins. Since 2001 we have endeavoured to cure patients who have failed other approaches by cauterising these veins, thus electrically disconnecting or isolating them from the heart. We found that although this is an invasive and technically challenging approach it can be effective, provided potential candidates are carefully selected.

SUMMARY

Prediction of cardiac rhythm 1 year following cardioversion for atrial fibrillation

Amjad K Hamid, A Mark Richards, Ian G Crozier, John G Lainchbury, Iain Melton, Paul G Bridgman, Suetonia C Palmer, Chris M Frampton, M Gary Nicholls

Atrial fibrillation is the most common cardiac arrhythmia. There are two different strategies when treating this condition: restoring normal rhythm or controlling the hearts ventricular rate. Cardioversion, a procedure done to restore normal rhythm, has an initial success rate of 80-90%. Most of the patients with initial successful outcome will revert back to atrial fibrillation (only one third of those who had successful cardioversion initially will remain in normal sinus rhythm a year later). A combination of clinical characteristics will help accurately identify those patients most likely to enjoy sustained return to normal rhythm after cardioversion.

ALL ARTICLES
SUMMARY

Non-adherence to medication and cardiovascular risk

Ralph A H Stewart, Andrew Kerr

Managing atrial fibrillation: the growing challenge

Nigel A Lever, Peter D Larsen

Rheumatic fever in New Zealand: from perennial failure to successful eradication

Norman Sharpe

How safe is the ‘safe triangle’?

Sisira Jayathissa, Stephen Dee

Under-use of secondary prevention medication in acute coronary syndrome patients treated with in-hospital coronary artery bypass graft surgery

Khang L Looi, Kok L Chow, Jen L Looi, Mildred Lee, Sue Halliday, Harvey White, Chris Ellis

Pre-hospital antibiotics for meningococcal disease remains low

Bronwyn Morris, Don Bandaranayake

Early cardiac morbidity of rheumatic fever in children in New Zealand

Olwen Gilbert, Nigel Wilson, Kirsten Finucane

Peter John Little

Medical image. Post mortem diagnosis of severe sepsis

Piet Krijtenburg, Harvey B M Fijn, Petra Heutink, Roel Schellaars, Marco Knook, Dries Mulder, Dave H T Tjan

The incidence of atrial fibrillation and the use of warfarin in Northland, New Zealand stroke patients

Angela Bang, Nicole M McGrath

A case of fracture of the patella by indirect violence without separation of the fragments

Medical Benevolent Fund

Are we meeting cardiovascular risk targets 3 years after acute coronary syndrome? An evaluation in West Auckland, New Zealand

John A Ford, Jocelyn Bell, Colin Edwards

Is colorectal cancer preventable?

Michael Cooper

Response to review article by Ernst and Posadzki on spinal manipulation

Corrian Poelsma

Surgical radiofrequency ablation for atrial fibrillation: the Christchurch, New Zealand experience

Frith Coolbear, Ian G Crozier

Pulmonary vein ablation for atrial fibrillation: the Christchurch, New Zealand experience

Matthew Daly, Iain Melton, Ian G Crozier

Prediction of cardiac rhythm 1 year following cardioversion for atrial fibrillation

Amjad K Hamid, A Mark Richards, Ian G Crozier, John G Lainchbury, Iain Melton, Paul G Bridgman, Suetonia C Palmer, Chris M Frampton, M Gary Nicholls

Portrayal of tobacco in televised music videos: content analysis and trends

Nick Wilson, Kate Sloane, Fiona Imlach Gunasekara, George Thomson

Response to letter ‘New Zealand’s shocking diabetes rates can be reduced—9 urgently needed actions'

Cat Paus 00e9, Seth Brown, Jenny Carryer, Fran Wolber, Lynda Finn, Robyn Longhurst, Lisa Hunter, Katie Fitzpatrick, Trudie Cain, Lisette Burrows, Wil Hoverd, Andrew Dickson

Anti-tumour-necrosis-factor-alpha agents and the heart: beyond left ventricular systolic dysfunction?

Vassilis Vassiliou, Eleana Ntatsaki

SUMMARY

Under-use of secondary prevention medication in acute coronary syndrome patients treated with in-hospital coronary artery bypass graft surgery

Khang L Looi, Kok L Chow, Jen L Looi, Mildred Lee, Sue Halliday, Harvey White, Chris Ellis

We reviewed all patients admitted to Auckland City Hospital coronary care unit with a heart attack (n=901) over a 13-month period in 2006 to 2007. Of various treatments, 129 patients received a coronary artery bypass operation. These patients are at very high risk of future heart problems, but certain medicines can significantly improve their prognosis, if used long-term. We reviewed these patients 3 years later and found a disappointing use of these medicines. The percentage of patients who were not taking these medicines were aspirin (17%), statins (28%), beta-blockers (38%), ACE-Inhibitors or angiotensin receptor blockers (57%). Clearly, greater efforts to optimise the use of these 'secondary preventative' medicines are needed in our health system.

SUMMARY

Early cardiac morbidity of rheumatic fever in children in New Zealand

Olwen Gilbert, Nigel Wilson, Kirsten Finucane

This study reviewed children who were admitted to the heart ward of Starship Childrens Hospital for rheumatic fever over 2 years. There were 36 children and 49 separate admissions to hospital. 25 children required cardiac surgery. The cost was $1.9 million dollars. In other countries, rheumatic fever has been prevented.

SUMMARY

The incidence of atrial fibrillation and the use of warfarin in Northland, New Zealand stroke patients

Angela Bang, Nicole M McGrath

Atrial fibrillation (AF) is an abnormal heart rhythm that can predispose to stroke by causing cardiac blood clots that can then travel to the brain. For patients with AF, the risk of stroke can be significantly decreased by anticoagulation with warfarin. In our study, approximately one-quarter of Northland stroke patients admitted between January and September 2010 were in AF but only one-third were prescribed warfarin. Of those stroke patients on warfarin, only 1/12 was on a therapeutic dose of warfarin. The main reason for no warfarin was patients wishes.

SUMMARY

Are we meeting cardiovascular risk targets 3 years after acute coronary syndrome? An evaluation in West Auckland, New Zealand

John A Ford, Jocelyn Bell, Colin Edwards

Our study looked at over 100 patients who were admitted to hospital 3 years ago with a heart attack or severe angina. We wanted to see if the patients were reaching target to prevent another heart attack. We have found that blood pressure, cholesterol and medication prescribing was generally good after 3 years. However there is room for improvement in terms of weight, diabetic control and prescription of a drug called an ACE inhibitor.

SUMMARY

Surgical radiofrequency ablation for atrial fibrillation: the Christchurch, New Zealand experience

Frith Coolbear, Ian G Crozier

The long-term results following surgery for the common heart rhythm problem atrial fibrillation as an adjunct to other cardiac surgery at Christchurch Hospital are reported. A total of 44 patients underwent this operation between 2 July 2001 and 28 January 2009. In the short-term the surgery was successful in most patients. However with time the rhythm problem recurred in many patients.

SUMMARY

Pulmonary vein ablation for atrial fibrillation: the Christchurch, New Zealand experience

Matthew Daly, Iain Melton, Ian G Crozier

Atrial fibrillation is New Zealands most common heart rhythm disorder. The upper chambers of the heart, or atria, are subjected to rapid, chaotic electrical currents and can not pump in a coordinated fashion. This may produce intolerable symptoms in some people. Research has shown that these abnormal currents originate from the pulmonary veins. Since 2001 we have endeavoured to cure patients who have failed other approaches by cauterising these veins, thus electrically disconnecting or isolating them from the heart. We found that although this is an invasive and technically challenging approach it can be effective, provided potential candidates are carefully selected.

SUMMARY

Prediction of cardiac rhythm 1 year following cardioversion for atrial fibrillation

Amjad K Hamid, A Mark Richards, Ian G Crozier, John G Lainchbury, Iain Melton, Paul G Bridgman, Suetonia C Palmer, Chris M Frampton, M Gary Nicholls

Atrial fibrillation is the most common cardiac arrhythmia. There are two different strategies when treating this condition: restoring normal rhythm or controlling the hearts ventricular rate. Cardioversion, a procedure done to restore normal rhythm, has an initial success rate of 80-90%. Most of the patients with initial successful outcome will revert back to atrial fibrillation (only one third of those who had successful cardioversion initially will remain in normal sinus rhythm a year later). A combination of clinical characteristics will help accurately identify those patients most likely to enjoy sustained return to normal rhythm after cardioversion.

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