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Fulltext Post-cardiac surgery patient satisfaction with quality nursing care at institute jantung negara (ijn)

Ho, Siew Eng, Gurbinder Kaur, Syed Rozaidi Wafa, Syed Zulkifli Syed Zakaria, Razali Omar

Medicine & Health, 2006;1(1):14-19.
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Quality nursing care has a great impact on patient satisfaction. Quality nursing care is perceived by the post cardiac surgery patient, as the degree of physical, emotional and spiritual needs that have to be fulfilled while hospitalisation. The objective of this study was to identify factors in quality nursing care that determine post cardiac patient satisfaction. This single cross-sectional descriptive study using ‘NURSQUAL’ instrument consisted of four elements; technical competence, information giving, assurance and empathy to measure patient satisfaction with quality nursing care. It consisted of four research questions with 33 items to measure the four elements. Between January to March 2005, 52 post cardiac surgery patients from Institute Jantung Negara (IJN), who fulfilled the inclusion criteria were recruited for this study. There was a significant difference between technical competence, information giving, assurance and empathy with patient satisfaction with p value < 0.05. The element of assurance made the strongest statistically significant unique contribution to the prediction of patient satisfaction with a p value < 0.05.
Fulltext Anxiety and Depression among Patients Before and After Percutaneous Coronary Intervention (PCI) at National Heart Institute (NHI)

Ho, Siew Eng, Syed Zulkifli Syed, Lexshimi RG, Raja, Hamidah Hassan, Letchmi, Santhna, Teoh, Koi Hong, et al.

Medicine & Health, 2007;2(1):26-33.
MyJurnal

Percutaneous coronary intervention (PCI) is an invasive diagnostic investigation that may result in high level of anxiety and “fear of the unknown” among cardiac patients. An increment in anxiety among PCI patients will augment the level of stress and this extreme stress level will then aggravate depression. The objective of this study was to determine the incidence of anxiety and depression before and after PCI. This was a cross-sectional descriptive study. The Hospital Anxiety and Depression Scale (HADS) was used. It measured two elements, namely, the anxiety and depression levels of patients before and after PCI. This study was conducted in the cardiology wards Anggerik and Dahlia, and Day Care of the National Heart Institute, from January to February 2006. A sample of 61 patients before and after PCI who fulfilled the inclusion criteria were recruited in this study. Of these, 40 and 38 patients before and after PCI respectively, had low anxiety levels; while, 47 and 46 patients before and after PCI respectively, had low depression levels. Anxiety and depression levels before and after PCI were not significantly correlated to socio demographic status. However, a significant correlation (p
Fulltext Deterioration of left ventricular systolic function in extended Pacing to Avoid Cardiac Enlargement (PACE) trial: the predictive value of early systolic dyssynchrony

Fang F, Luo XX, Zhang Q, Azlan H, Razali O, Ma Z, et al.

Europace, 2015 Oct;17 Suppl 2:ii47-53.
PMID: 26842115 DOI: 10.1093/europace/euv130

Biventricular (BiV) pacing was superior to right ventricular apical (RVA) pacing at extended follow-up in the Pacing to Avoid Cardiac Enlargement (PACE) trial. Early pacing-induced systolic dyssynchrony (DYS) might be related to mid-term result. However, it remains unknown whether early pacing-induced DYS can predict long-term reduction of left ventricular (LV) systolic function.
Combining left atrial appendage closure and catheter ablation for atrial fibrillation: 2-year outcomes from a multinational registry

Phillips KP, Romanov A, Artemenko S, Folkeringa RJ, Szili-Torok T, Senatore G, et al.

Europace, 2020 02 01;22(2):225-231.
PMID: 31665276 DOI: 10.1093/europace/euz286

AIMS: Clinical practice guidelines do not recommend discontinuation of long-term oral anticoagulation in patients with a high stroke risk after catheter ablation for atrial fibrillation (AF). Left atrial appendage closure (LAAC) with Watchman has emerged as an alternative to long-term anticoagulation for patients accepting of the procedural risks. We report on the long-term outcomes of combining catheter ablation procedures for AF and LAAC from multicentre registries.
METHODS AND RESULTS: Data were pooled from two prospective, real-world Watchman LAAC registries running in parallel in Europe/Middle-East/Russia (EWOLUTION) and Asia/Australia (WASP) between 2013 and 2015. Of the 1140 patients, 142 subjects at 11 centres underwent a concomitant AF ablation and LAAC procedure. The mean CHA2DS2-VASc score was 3.4 ± 1.4 and HAS-BLED score 1.5 ± 0.9. Successful LAAC was achieved in 99.3% of patients. The 30-day device and/or procedure-related serious adverse event rate was 2.1%. After a mean follow-up time of 726 ± 91 days, 92% of patients remained off oral anticoagulation. The rates of the composite endpoint of ischaemic stroke/transient ischaemic attack/systemic thromboembolism were 1.09 per 100 patient-years (100-PY); and for non-procedural major bleeding were 1.09 per 100-PY. These represent relative reductions of 84% and 70% vs. expected rates per risk scores.
CONCLUSION: The long-term outcomes from these international, multicentre registries show efficacy for all-cause stroke prevention and a significant reduction in late bleeding events in a population of high stroke risk post-ablation patients who have been withdrawn from oral anticoagulation.
Fulltext Left atrial appendage closure with WATCHMAN in Asian patients: 2 year outcomes from the WASP registry

Phillips KP, Santoso T, Sanders P, Alison J, Chan JLK, Pak HN, et al.

Int J Cardiol Heart Vasc, 2019 Jun;23:100358.
PMID: 31008181 DOI: 10.1016/j.ijcha.2019.100358

Background: Left atrial appendage closure is a non-pharmacological alternative for stroke prevention in high-risk non-valvular atrial fibrillation patients, but has not been widely studied in Asian patients. The prospective WASP registry assessed real-world outcomes for patients undergoing WATCHMAN implant in the Asia-Pacific region.
Methods: Data were collected from consecutive patients across 9 centres. Major endpoints included procedural success, safety and long-term outcomes including occurrence of bleeding, stroke/transient ischaemic attack/systemic embolism and all-cause mortality.
Results: Subjects (n = 201) had a mean age of 70.8 ± 9.4 years, high stroke risk (CHA2DS2-VASc: 3.9 ± 1.7), elevated bleeding risk (HAS-BLED: 2.1 ± 1.2) with 53% patients from Asian countries. Successful implantation occurred in 98.5% of patients; 7-day device/procedure-related SAE rate was 3.0%. After 2 years of follow-up, the rates of ischaemic stroke/TIA/SE and major bleeding were 1.9 and 2.2 per 100-PY, respectively, representing relative reductions of 77% and 49% versus expected rates per risk scores. The relative risk reductions versus expected rates were more pronounced in Asians vs. Non-Asians (89% vs 62%; 77% vs 14%). Other significant findings included larger mean LAA ostium diameter for Asians vs. Non-Asians (23.4 ± 4.1 mm vs. 21.2 ± 3.2 mm, p 
Fulltext Combining Watchman left atrial appendage closure and catheter ablation for atrial fibrillation: multicentre registry results of feasibility and safety during implant and 30 days follow-up

Phillips KP, Pokushalov E, Romanov A, Artemenko S, Folkeringa RJ, Szili-Torok T, et al.

Europace, 2018 06 01;20(6):949-955.
PMID: 29106523 DOI: 10.1093/europace/eux183

Aims: Long-term results from catheter ablation therapy for atrial fibrillation (AF) remain uncertain and clinical practice guidelines recommend continuation of long-term oral anticoagulation in patients with a high stroke risk. Left atrial appendage closure (LAAC) with Watchman has emerged as an alternative to long-term anticoagulation for patients accepting of the procedural risks. We report on the initial results of combining catheter ablation procedures for AF and LAAC in a multicentre registry.
Methods and results: Data were pooled from two prospective, real-world Watchman LAAC registries running in parallel in Europe/Middle-East/Russia (EWOLUTION) and Asia/Australia (WASP) between 2013 and 2015. Of the 1140 patients, 139 subjects at 10 centres underwent a concomitant AF ablation and LAAC procedure. The mean CHA2DS2-VASc score was 3.4 ± 1.4 and HAS-BLED score 1.5 ± 0.9. Successful Watchman implantation was achieved in 100% of patients. The overall 30-day serious adverse event (SAE) rate was 8.7%, with the device and/or procedure-related SAE rate of 1.4%. One pericardial effusion required percutaneous drainage, but there were no strokes, device embolization, or deaths at 30 days. The 30-day bleeding SAE rate was 2.9% with 55% of patients prescribed NOAC and 38% taking warfarin post-procedure.
Conclusion: The outcomes from these international, multicentre registries support the feasibility and safety of performing combined procedures of ablation and Watchman LAAC for patients with non-valvular AF and high stroke risk. Further data are needed on long-term outcomes for the hybrid technique on all-cause stroke and mortality.