The AngelMed Guardian® System in the Detection of Coronary Artery Occlusion: Current Perspectives.
Syed Hassan Abbas KazmiSudarshana DattaGerald ChiTarek NafeeMegan YeeAkshun KaliaSadaf SharfaeiFahimehalsadat ShojaeiSabawoon MirwaisC Michael GibsonPublished in: Medical devices (Auckland, N.Z.) (2020)
Total ischemic time, which specifies the time from the onset of chest pain to initiation of reperfusion during percutaneous coronary intervention, consists of two intervals: symptom to door time and door to balloon time. A door to balloon time of 90 mins or less has become a quality-of-care metric in the management of ST elevation myocardial infarction (STEMI). While national efforts made by the American College of Cardiology (ACC) and American Heart Association (AHA) have curtailed in-hospital door to balloon time over the years, a reduction in pre-hospital symptoms to door time presents a challenge in modern interventional Cardiology. Early and complete revascularization has been associated with improved clinical outcomes in MI and strategies that may help reduce symptom to door time, and thus the total ischemic time, are crucial. Rapidly evolving ST-segment changes commonly develop prior to ischemia-related symptom onset, and are detectable even in patients with clinically unrecognized silent MIs. Therefore, a highly intelligent ischemia detection system that alerts patients of ST segment deviation may allow for rapid identification of acute coronary occlusion. The AngelMed Guardian® System is a cardiac activity monitoring and alerting system designed for rapid identification of intracardiac ST-segment changes among patients at a high risk for recurrent ACS events. This article reviews the clinical studies evaluating the design, safety and efficacy of the AngelMed Guardian System and discusses the clinical implications of the device.
Keyphrases
- percutaneous coronary intervention
- st elevation myocardial infarction
- acute coronary syndrome
- coronary artery
- acute myocardial infarction
- coronary artery disease
- st segment elevation myocardial infarction
- loop mediated isothermal amplification
- quality improvement
- healthcare
- coronary artery bypass grafting
- antiplatelet therapy
- end stage renal disease
- patient reported
- ejection fraction
- cerebral ischemia
- atrial fibrillation
- newly diagnosed
- pulmonary artery
- cardiac surgery
- real time pcr
- systematic review
- prognostic factors
- palliative care
- chronic kidney disease
- coronary artery bypass
- oxidative stress
- ischemia reperfusion injury
- drug induced
- aortic stenosis
- acute care
- extracorporeal membrane oxygenation
- emergency department
- transcatheter aortic valve replacement
- peritoneal dialysis
- health insurance
- acute respiratory distress syndrome
- thoracic surgery
- pulmonary arterial hypertension
- pulmonary hypertension
- subarachnoid hemorrhage