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This article discusses a tele-ECG collaboration between tertiary and primary care in Singapore over a 6-year period. The collaboration involved family physicians serving as a link between cardiologists and polyclinics. The study found that a majority of patients did not require tertiary care referral and could be managed in primary care, resulting in significant cost savings. The tele-ECG collaboration also demonstrated safety and efficacy, and there was a decline in cases requiring kerbside consult as family physicians' skills in ECG interpretation improved. This collaboration between tertiary and primary care providers proved to be viable and sustainable, reducing referrals and optimizing the use of clinical resources. [Extracted from the article]

Background: The Singapore Cardiac Databank was designed to monitor the performance and outcomes of catheter ablation. We investigated the outcomes of paroxysmal supraventricular tachycardia (PSVT)‐ablation in a prospective, nationwide, cohort study. Methods: Atrioventricular nodal re‐entrant tachycardia (AVNRT), atrioventricular re‐entry tachycardia (AVRT), or atrial tachycardia (AT)‐ablations in Singapore from 2010 to 2018 were studied. Outcomes include acute success, periprocedural‐complications, postoperative pacing requirement, arrhythmic recurrence and 1‐year all‐cause mortality. Results: Among 2260 patients (mean age 45 ± 18 years, 50% female, 57% AVNRT, 37% AVRT, 6% AT), overall acute success rates of PSVT‐ablation was 98.4% and increased in order of AT, AVRT, and AVNRT (p <.001). Periprocedural cardiac tamponade occurred in two AVRT patients. A total of 15 pacemakers (6 within first 30‐days, 9 after 30‐days) were implanted (seven AV block, eight sinus node dysfunction [SND]), with the highest incidence of pacemaker implantation after AT‐ablation (5% vs. 0.6% AVNRT vs. 0.1% AVRT, p <.001). Repeat ablations (0.9% AVNRT, 7% AVRT, 4% AT, p <.001) were performed in 78 (3.5%) patients and 13 (0.6%) patients died within a year of ablation. Among outcomes considered adjusting for age, sex, PSVT‐type and procedure‐time, AT was independently associated with 6‐fold increased odds of total (adjusted odds ratio [AOR] 6.32, 95% confidence interval [CI] 1.95–20.53) and late (AOR 6.38, 95% CI 1.39–29.29) pacemaker implantation, while AVRT was associated with higher arrhythmic recurrence with repeat ablations (AOR 4.72, 95% CI 2.36–9.44) compared to AVNRT. Conclusions: Contemporary PSVT ablation is safe with high acute success rates. Long‐term outcomes differed by nature of the PSVT. [ABSTRACT FROM AUTHOR]

A case study of 24‑year‑old female is presented who suffered a sudden out‑of‑hospital cardiac arrest. Topics include examines her colleagues performed cardiopulmonary resuscitation as she was noted to be pulseless and considered the paramedics arrived several minutes later and sinus rhythm was noted on the automated external defibrillator.

Background: Current recommendations by cardiac implantable electronic devices (CIEDs) manufacturers on electromagnetic interference (EMI) are based on extrapolations of studies exposing CIEDs to electromagnetic fields produced by Helmholtz coils and industrial equipment. There are currently little data whether commercially available electronic massagers can cause EMI in CIEDs in vivo. This is of interest as the use of electronic massagers is common in Asia. Methods: The study evaluated CIED patients before, during and after a 10‐minute exposure to a commercially available electronic backrest upper body massager. Post‐exposure sensing, pacing threshold, and lead impedance were compared to baseline values. The presence of artefacts, EMI, and adverse clinical events during exposure was recorded. Results: Eighty‐six patients (59 pacemakers and 27 implantable cardioverter‐defibrillators) with a total of 151 leads (60 atrial, 86 right ventricular, and 5 left ventricular) were evaluated. There was no incidence of EMI causing inappropriate inhibition of pacing or inappropriate defibrillation. There was no significant difference in the pacing threshold, sensing, and lead impedance post‐exposure compared to baseline values. Conclusion: Our study, though limited by small numbers and exposure to only 1 type of electronic massager, shows that it is potentially safe for patients with CIEDs to use commercially available electronic massagers with similar characteristics as the one tested in this study. [ABSTRACT FROM AUTHOR]

Clinical trials have established the benefits of implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) in the treatment of heart failure patients. As adjuncts to guideline-directed medical therapy, ICDs confer mortality benefits from sudden cardiac arrest, while CRT reduces mortality, hospitalisation rates and improves functional capacity. This review discusses the use of ICDs and CRT devices in heart failure management, outlining the evidence supporting their use, indications and contraindications. [ABSTRACT FROM AUTHOR]