News and views

The 21st Annual Scientific Meeting of the American Society of Hypertension (ASH) was held in New York, US from May 16th-20th, 2006. Dr Martin Godfrey reports some of the meeting highlights, which included results from a study looking at the role of the renin-angiotensin system in atherosclerosis development and another which looked at the first orally active agent to block renin....

The ASTEROID trial, which showed regression of atherosclerosis by reducing low-density lipoprotein cholesterol to new lows and simultaneously improving high-density lipoprotein cholesterol, was one of the highlights of this year's American College of Cardiology meeting held in Atlanta, Georgia, US, on March 11–14th 2006. Other successes included two new antithrombotic regimens that improved outcomes compared with unfractionated heparin in ST-elevation myocardial infarction patients, while clopidogrel showed disappointing results in a large study of primary/secondary prevention....

We continue our series in which Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab...and beyond. In this column, he examines the similarities between the cath lab and televised popular sports....

We continue our series where Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab ..... and beyond. In this column, he looks at how cardiologists can personalise their cars....

Patients attending cardiology clinics, particularly those with chronic heart failure (CHF), frequently have co-morbidities and attend other hospital medical clinics. We examined the case notes of 162 patients attending two cardiology clinics. Many patients’ notes extended to more than one volume (20%). Patients with CHF were more likely to require rubber bands to maintain control of their notes than other cardiac patients. Despite efforts to move to a paperless record keeping system, rubber bands still play a major role in the NHS....

A new analysis of the LIFE study has shown that losartan can reduce new-onset atrial fibrillation in hypertensive patients with left ventricular hypertrophy. General practitioner Brian Crichton summarises this new analysis and explains how losartan might achieve these effects....

We publish in full this report by a working group of the British Cardiac Society which shows large disparities in cardiac services between England, Scotland, Wales and Northern Ireland....

Electrocardiographic monitoring by telemetry has become commonplace throughout the UK. This survey was designed to assess its availability, to determine current practice and so to inform future recommendations for optimal telemetry working practice. Data were collected via postal questionnaire followed by telephone contact. Questionnaires were completed by 280 (99.3%) of the 282 coronary care units (CCUs) contacted. Telemetry is now widely available, with 77.3% of CCUs offering a service, though practice varies widely from unit to unit. Only 15% of telemetry services were supported by written protocols, telemetry duration was routinely set in only 17.4% and interrogation was haphazard, with fewer than 27.2% of units investigating each symptomatic event. Overall responsibility for the service was unclear, and routine medical input occurred in only 48.6% of services. The task of telemetry monitoring was delegated to relatively junior CCU nursing staff (94% D/E grade). Verbal information was commonly given to patients, but written information was very rare (2.75%). Some 70% obtained no formal patient consent (written or verbal) prior to commencing telemetry. Nonetheless, CCU staff felt strongly that the service was valuable and affected patient care positively. UK telemetry practice is haphazard, variable and poorly supported by adequate protocols. The potential for missing arrhythmias and/or for mismanaging them is evident, making a strong case for practice guidelines defining the responsibilities of staff involved, identifying best practice and outlining supportive educational requirements....

Rapid Access Cardiology Clinics were introduced many years ago for the assessment of chest pain. Following the publication of the National Service Framework (NSF) for Coronary Heart Disease (CHD)1 the number of rapid access chest pain clinics (RACPCs) has expanded dramatically. Standard 8 of the NSF for CHD describes the use of chest pain clinics to provide specialist advice to people with symptoms of angina or suspected angina. One of the goals of the NSF was that there should be at least 100 RACPCs in the UK by April 2002. This goal has been superseded. More recently, rapid access clinics have also been introduced for the assessment of suspected cases of heart failure and cardiac arrhythmias. While the concept is that a prompt ‘one-stop’ assessment provides care that is clinically superior to traditional services in a cost-effective manner, there are few data describing outcomes of the patients seen in these services. In this report, we review the available evidence on rapid cardiology services....

A consensus statement from representatives of the British Society of Echocardiography, the British Heart Failure Society, the Coronary Heart Disease Collaborative and the Primary Care Cardiovascular Society....