Heart Matters

Host: Doug Weaver, MD Guest: Spencer King, III, MD The performance of percutaneous coronary intervention (PCI) without a surgical backup has long produced controversy. In recent years, off-site PCI has become more common, and clinical evidence demonstrates comparable outcomes for on-site and off-site procedures. How does this shift allow us to serve a broader patient population? Will guidelines ch...

Host: Doug Weaver, MD Guest: Spencer King, III, MD The performance of percutaneous coronary intervention (PCI) without a surgical backup has long produced controversy. In recent years, off-site PCI has become more common, and clinical evidence demonstrates comparable outcomes for on-site and off-site procedures. How does this shift allow us to serve a broader patient population? Will guidelines ch...

Host: Jack Lewin, MD Guest: Chris Jennings It seems we all work so much these days, we might as well get our personal mail delivered at work, or maybe even consider a hide-a-bed for the office. That may seem a bit far-fetched, but many of us do receive our health insurance coverage from our place of employment, and an increasing percentage of us are participating in so-called wellness programs at...

Host: Jack Lewin, MD Guest: Chris Jennings It seems we all work so much these days, we might as well get our personal mail delivered at work, or maybe even consider a hide-a-bed for the office. That may seem a bit far-fetched, but many of us do receive our health insurance coverage from our place of employment, and an increasing percentage of us are participating in so-called wellness programs at...

Host: Jack Lewin, MD Guest: Robert Hauser, MD Because new cardiac technologies are often rapidly integrated into clinical practice, we must be mindful that these innovations can contain a level of risk. Regrettably, we've seen examples of this before with previous generations of implantable cardioverter-defibrillators (ICD), and some experts say the latest advances in ICD technology could pose sim...

Host: Jack Lewin, MD Guest: Robert Hauser, MD Because new cardiac technologies are often rapidly integrated into clinical practice, we must be mindful that these innovations can contain a level of risk. Regrettably, we've seen examples of this before with previous generations of implantable cardioverter-defibrillators (ICD), and some experts say the latest advances in ICD technology could pose sim...

Host: Janet Wright, MD Guest: Mark Hlatky, MD Does the patient with few cardiovascular risk factors who displays little, if any, sign of heart trouble warrant a coronary CT scan? For patients who may not be best suited for a CT scan, is the coronary calcium measurement a reasonable risk-assessment alternative? Dr. Mark Hlatky, professor of medicine and professor of health research and policy at St...

Host: Janet Wright, MD Guest: Mark Hlatky, MD Does the patient with few cardiovascular risk factors who displays little, if any, sign of heart trouble warrant a coronary CT scan? For patients who may not be best suited for a CT scan, is the coronary calcium measurement a reasonable risk-assessment alternative? Dr. Mark Hlatky, professor of medicine and professor of health research and policy at St...

Host: Janet Wright, MD Guest: Mark Hlatky, MD Measuring precise risks in medicine can be a tricky proposition. Factoring risk into cost-benefit analyses can make the situation even less clear. In many ways, this is where we stand with coronary computed tomography angiograms: a scan can be immediately helpful in emergent circumstances, but at other points in the clinical care spectrum, the value of...

Host: Janet Wright, MD Guest: Mark Hlatky, MD Measuring precise risks in medicine can be a tricky proposition. Factoring risk into cost-benefit analyses can make the situation even less clear. In many ways, this is where we stand with coronary computed tomography angiograms: a scan can be immediately helpful in emergent circumstances, but at other points in the clinical care spectrum, the value of...

Host: Janet Wright, MD Guest: Bob Graboyes, PhD Is your practice one of the growing number of small healthcare businesses that cannot afford to provide health insurance for its employees? It’s a startling reality for many medical employers and employees, and more broadly, for the entire small business sector, which, in some states, is the collective employer for upwards of half of the uninsured po...

Host: Janet Wright, MD Guest: Bob Graboyes, PhD Is your practice one of the growing number of small healthcare businesses that cannot afford to provide health insurance for its employees? It’s a startling reality for many medical employers and employees, and more broadly, for the entire small business sector, which, in some states, is the collective employer for upwards of half of the uninsured po...

Host: Janet Wright, MD Guest: Gregory Demske How can individual practitioners interact with industry in a positive, lawful and commendable manner? Are there regulations we can and should put on companies in this arena which fund initiatives such as continuing medical education? Industry certainly plays a major role in health care today, but one wonders whether we are managing these relationships t...

Host: Janet Wright, MD Guest: Gregory Demske How can individual practitioners interact with industry in a positive, lawful and commendable manner? Are there regulations we can and should put on companies in this arena which fund initiatives such as continuing medical education? Industry certainly plays a major role in health care today, but one wonders whether we are managing these relationships t...

Host: Jack Lewin, MD Guest: Elliott Antman, MD New treatment guidelines regularly make headlines in medicine, recommending advances in our approach to care. In recent years, we have accelerated the speed at which we can update our guidelines and welcomed more global input into the process. Will these trends continue? Where else can we improve our process for authoring treatment guidelines? Host Dr...

Host: Jack Lewin, MD Guest: Elliott Antman, MD New treatment guidelines regularly make headlines in medicine, recommending advances in our approach to care. In recent years, we have accelerated the speed at which we can update our guidelines and welcomed more global input into the process. Will these trends continue? Where else can we improve our process for authoring treatment guidelines? Host Dr...

Host: Doug Weaver, MD Guest: Doug Zipes, MD Sudden cardiac deaths are rare among elite athletes. Yet these abrupt events are confounding, in part, because they strike some of our most physically dynamic individuals, and because there remains a lengthy list of potential causes. How are we advancing our grasp of the underlying triggers of these life-threatening arrhythmias? Host Dr. Doug Weaver talk...

Host: Doug Weaver, MD Guest: Doug Zipes, MD Sudden cardiac deaths are rare among elite athletes. Yet these abrupt events are confounding, in part, because they strike some of our most physically dynamic individuals, and because there remains a lengthy list of potential causes. How are we advancing our grasp of the underlying triggers of these life-threatening arrhythmias? Host Dr. Doug Weaver talk...

Host: Doug Weaver, MD Guest: Martin Leon, MD Will drug-eluting stents prove safer and more effective without a metal structure? For all their merits, current stent technologies still present a series of drawbacks, including the severe complication of late thrombosis. Biodegradable polymers may hold the key to minimizing this and other concerns. Host Dr. Doug Weaver discusses the most promising are...

Host: Doug Weaver, MD Guest: Martin Leon, MD Will drug-eluting stents prove safer and more effective without a metal structure? For all their merits, current stent technologies still present a series of drawbacks, including the severe complication of late thrombosis. Biodegradable polymers may hold the key to minimizing this and other concerns. Host Dr. Doug Weaver discusses the most promising are...

Host: Doug Weaver, MD Guest: Mohammed Khan, MD Investigators are pursuing more aggressive strategies to maintain sinus rhythm. One area of current inquiry for certain arrhythmias centers on pulmonary vein isolation as an alternative to atrioventricular node ablation with biventricular pacing. How effective is pulmonary vein isolation for preventing an arrhythmia relapse? Dr. Mohammed Khan, an elec...

Host: Doug Weaver, MD Guest: Mohammed Khan, MD Investigators are pursuing more aggressive strategies to maintain sinus rhythm. One area of current inquiry for certain arrhythmias centers on pulmonary vein isolation as an alternative to atrioventricular node ablation with biventricular pacing. How effective is pulmonary vein isolation for preventing an arrhythmia relapse? Dr. Mohammed Khan, an elec...

Host: Doug Weaver, MD Guest: Peter Berger, MD It is no longer a question of whether antiplatelet therapy should be used following implantation of a drug-eluting stent, but rather to what extent and to what duration. With this in mind, many new challenges arise, from bleeding risks to drug intolerance and product cost. Host Dr. Doug Weaver welcomes Dr. Peter Berger, associate chief research officer...

Host: Doug Weaver, MD Guest: Peter Berger, MD It is no longer a question of whether antiplatelet therapy should be used following implantation of a drug-eluting stent, but rather to what extent and to what duration. With this in mind, many new challenges arise, from bleeding risks to drug intolerance and product cost. Host Dr. Doug Weaver welcomes Dr. Peter Berger, associate chief research officer...

Host: Janet Wright, MD Guest: Charles Kerr, MD Dr. Charles Kerr, president of the Canadian Cardiovascular Society, and director of the electrophysiology program at St. Paul's Hospital in Vancouver, British Columbia, joins host Dr. Janet Wright, to discuss the challenges of managing patients with atrial fibrillation. For those patients who may warrant ablation, what is the current thinking about wh...