This nationwide complete analysis of all adult deaths in #England & #Wales has found that the #COVID pandemic has resulted in an abrupt inflation in acute #cardiovascular deaths above that expected for the time of year. heart.bmj.com/content/early/… That is, about 2000 additional deaths over a 4 month period.

Emerging data from @PHE_uk suggests a synergistic detrimental effect of co-infection with #SARS_CoV_2 & #flu viruses. The preprint (not peer reviewed) article is available here medrxiv.org/content/10.110… ‘The risk of testing positive for #SARS_CoV_2 was 68% lower among #influenza positive cases, suggesting possible pathogenic competition between the two viruses.’

Advances in #cancer treatment have improved clinical outcomes, leading to an increasing population of cancer survivors. Yet, this success is associated with high rates of short‐ & long‐term #cardiovascular toxicities. The Cancer Patient and Cardiology onlinelibrary.wiley.com/doi/abs/10.100… The number & variety of #cancer drugs & #cardiovascular toxicity types make long‐term care a complex undertaking.

The rise in admissions with #COVID19 does not mean that you shouldn’t attend hospital if you have a medical emergency #heartattack During the first peak, admissions with #heartatrack declined & was of grave concern : COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England @TheLancet thelancet.com/journals/lance…

Subsequent to #Surgisphere, all @TheLancet journals will now introduce additional peer-review requirements for papers based on large, real-world #datasets. thelancet.com/journals/lance… @TheLancet journals now require all #research papers, irrespective of method, to include a data-sharing statement that details what #data will be shared, whether additional documents will be shared, when data will become available & by what access criteria data will be shared.

Patients with mitral annular disjunction present with frequent premature ventricular contractions; in this study, one-third had ventricular arrhythmias & one-tenth had severe arrhythmic events. @JACCJournals onlinejacc.org/content/72/14/… A total of 82 (71%) patients reported #palpitations, 47 (41%) patients reported previous pre-syncope, 40 (34%) had ventricular arrhythmia, 15 (13%) had experienced #syncope, & 14 (12%) patients had experienced a severe arrhythmic event prior to inclusion

This cluster randomised controlled trial found that opportunistic screening in primary care did not increase the detection of #AFib compared with usual care in patients aged 65 & over @bmj_latest bmj.com/content/370/bm…

Exploring variation in the use of feedback from national clinical #audits: a realist investigation @HSRatBMC by @tasha_alvarado  
bmchealthservres.biomedcentral.com/articles/10.11… National Clinical Audits (NCAs) are a well-established quality improvement strategy used in #healthcare settings.@CardiacAudit @HQIP #NHS #MINAP #PICANET @BCIS_uk

National Data Strategy - ⁦@GOVUK⁩ : ‘The UK response to the global #coronavirus pandemic has powerfully illustrated the potential benefits of #data.’ gov.uk/government/pub… ‘Our understanding of this disease [#COVID19], our ability to support people and our cooperation across borders have all relied on the responsible and effective use and sharing of #data.’

@QualDash is a #dashboard generation engine that allows the dynamic configuration & deployment of #visualisation dashboards for #healthcare quality improvement. By @MaiShehaly @HCIforHealthIT @tasha_alvarado @IEEEXplore @IEEETBioCAS

‘Although proportionately scarce, exercise may paradoxically trigger sudden cardiac arrest in individuals with #cardiovascular disease (CVD), particularly those who were previously sedentary or have advanced CVD.’ ‘In parallel with the drive to promote #exercise in all individuals, physicians will be confronted with an increasing number of enquiries from individuals with established risk factors for coronary artery disease or established CVD about participation in exercise‘

‘Overall, #antiplatelet monotherapy is ineffective for #stroke prevention [for #AtrialFibrillation] & potentially harmful (especially #elderly), whereas #DAPT associated with bleeding risk similar to OAC. Hence, antiplatelets should not be used for #stroke prevention in #AF’ 2020 ESC Guidelines for the diagnosis and management of #AtrialFibrillation #ESCCongress : academic.oup.com/eurheartj/adva…

‘Very short episodes (≤10-20 s/day) of AHRE/subclinical #AFib are irrelevant, as not associated with longer episodes or increased risk of #stroke / systemic embolism. However, longer episodes (minimum 5-6 min) are associated with increased risk of #AF, ischaemic stroke & MACE’ 2020 ESC Guidelines for the diagnosis and management of #AtrialFibrillation #ESCCongress : academic.oup.com/eurheartj/adva…

#Myocarditis & #Takotsubo syndrome ≠ MINOCA. @escardio NSTEACS Guidelines 2020. #ESCCongress MINOCA = plaque rupture, plaque erosion, coronary emboli/thrombosis, SCAD, coronary artery spasm, microvascular disease & unclassified MINOCA. #ESCCongress

2020 @escardio Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation #ESCCongress #heartattack #NSTEACS #NSTEMI ⁦@ESC_Journals⁩ academic.oup.com/eurheartj/adva… @JeanPhilippeCollet, @thiele_holger, @EkateriniL, @JBauersachsMD, @DLBHATTMD, et al

‘Hospital tests & procedures used to diagnose & monitor a range of #heart & circulatory conditions are often among the vital first steps in someone's treatment journey. Delaying them could have a domino effect on the rest of their care’ by ⁦@TheBHF⁩ dailymail.co.uk/news/article-8… The impact of the #COVID19 pandemic on #cardiology services @Heart_BMJ openheart.bmj.com/content/7/2/e0…

In this national longitudinal study of 4570 patients with #heartattack, attendance at #CardiacRehab was associated with a temporal improvement in health related quality of life (#HRQoL) at up to 12 months following hospital discharge. @Heart_BMJ heart.bmj.com/content/early/…. ‘Health-related quality of life (#HRQoL) is an important outcome measure following #heartattack’, states @benhurdus first author.

The problem with remote consulting is one of unknown unknowns—you don’t always know what you’re not seeing. Teleconsultations for all by ⁦@HelenRSalisbury⁩ ⁦@bmj_latest⁩ bmj.com/content/370/bm… “Many of the clinical examinations I do are normal or confirm what I already suspect from the history, but I’m sometimes surprised by an unexpected finding.”

~1/2 patients undergoing coronary angiography for known or suspected #angina have nonobstructed epicardial coronary arteries, & microvascular angina &/or vasospastic angina may be relevant by ⁦@ColinBerryMD⁩
⁦@JACCJournals⁩ interventions.onlinejacc.org/content/13/16/… Patients with symptoms of ischaemia with nonobstructive coronary arteries (INOCA) can have treatable coronary vasomotion disorders.

This population-based, multicentre, 10-year study of the use of oral #anticoagulants for #stroke prophylaxis for ~0.5M patients with #AFib found that their prescription for patients with #AF at high risk of stroke increased by nearly 60%. Between 2009 & 2018, 3352 individual General Practices provided a total of 5968 uploads into the GRASP-AF database. From the first upload per General Practice, there were an estimated 450 518 patients with #AFib from a total of 24 644 210 people.

The #Cummings effect: Analyses of 220755 surveys from 40597 individuals in #England, #Scotland, & #Wales (April 24 - June 11, 2020), show that these events undermined confidence in the @GOVUK to handle the #COVID19 pandemic“. @TheLancet thelancet.com/journals/lance… 🤔, “Do as I say, not as I do” (John Selden c. 1654; English jurist, legal antiquary & oriental scholar).