Editorial

Dear Readers, Medical technology is constantly widening the diagnostic and therapeutic horizons in our professional lives. It provides hope for the patient who looks to the rapidly developing medical technology of tomorrow for a solution to his or her complex health problems today. Simultaneously, medical technology represents a remarkable sector of corporate activity, on both sides of the Atlantic. Focu...

EU News

The need to strengthen health systems so that they can respond quickly and flexibly to the growing number of new challenges was on the agenda of the WHO’s European governing body, the WHO Regional Committee for Europe. Attended by over 250 health officials from the WHO European Region, its annual session took place in Tbilisi, Georgia from September 15 - 18. The Regional Committee considered several cr...

Cover Story: Patient Access to Medical Technology In Europe

Survey Shows Variety of Causes for Discrepancies Between Guidelines and Practice The practice of cardiovascular medicine differs from country to country despite commonly accepted management guidelines. Discrepancies persist, even when comparisons are based on investigations of the proportion of patients with a defined disease offered a particular treatment modality. Surveys disclose that adherence to Europe...

Overcoming inequality in access to innovative technologies, while ensuring the long term financial sustainability of healthcare systems represents one of the strongest challenges for European governments. Discrepancies in resource allocation are still extant, on both health expenditure on GDP and on per capita spending on medical technology especially between Western and Eastern countries. Homogenising acc...

Equitable access to healthcare forms one of the common objectives for EU Member States in the fight against social exclusion and poverty, yet barriers remain in the way of goals for optimum and homogenous access. For medical technologies, these barriers to access can be multi-factorial, yet broadly classified as stemming from the supply or demand side. In this article, within the focus of cardiovascular dev...

A major aim of health policy in most EU member countries is to regulate and control the price of, access to and the use of new and expensive medical technology. Despite this common objective, there are great differences in the means used to achieve it, because healthcare, pricing and reimbursement systems as well as domestic industry and economic status and priorities are different across countries. This a...

Features

The primary reason for the development of cardiac CT was the expectation that CT could replace diagnostic cardiac catheterisation procedures, an expensive study that, due to the need for arterial catheterisation, has a relatively high complication rate. But where will this relatively new technology go, and how will it improve imaging techniques for cardiologists? This article explores the issues involved....

Why was it Decided to Set Up a Heart Failure Clinic at the UZ Middelheim? This hospital is a university affiliated facility with a large interventional cardiovascular programme of more than 4,000 diagnostic coronary angiograms, and more than 2,000 PCIs per year. Over the years, improved prognosis of acute coronary syndromes has led to an increased burden of chronic heart failure. The older age of the hear...

Improving the Management of Thromboembolitic Prevention in Routine PracticeAnticoagulants are recommended for a wide variety of indications, including the prevention of venous thromboembolism (VTE; comprising deep vein thrombosis [DVT] and pulmonary embolism [PE]), the treatment of VTE, stroke prevention in patients with atrial fibrillation (AF) and secondary prevention of major ischaemic outcomes in patien...

In the twenty years since the demise of the Soviet Union, Latvia has transformed itself, gaining its independence not only politically but also in medicine. While formerly, research, innovations and financial investments were concentrated in Moscow and less in the Baltic States, in present times Latvia is a member of the European Union, is independent, and its citizens can make their own decisions and contr...

Country Focus: Cardiology in the United States

The United States is the only wealthy industrialised nation without a universal healthcare system, according to the Institute of Medicine of the National Academy of Sciences. It has a mixed system of public and private insurance. Most working age Americans have private health insurance through their employers. Private health insurance covers about 57% of the population, while only 27% is insured through gov...

Euro Aspire III Trial Mirrors US Struggle to Empower Patients This article addresses early identification and prevention of cardiovascular disease, to highlight the challenges in motivating patients to participate in their health and well being and focus on motivating insurance companies and national healthcare to empower, enable and encourage better health. National policies have been ineffective at promot...

The American heart association mission is building healthier lives, free of cardiovascular diseases and stroke. To accomplish this, its volunteers and organisation are involved in an extremely broad range of activities. The activities of the Association systematically attack the problem of cardiovascular disease across the knowledge spectrum in the following ways: Discovering knowledge through research;...

Healthcare Economics

Healthcare’s once-upon-a-time days are gone. Simply being the nearby hospital does not automatically stake your organisation’s financial claim. So, in an increasingly competitive industry, what is the ideal way to market a hospital or healthcare service to consumers—who are often no longer just patients? Throughout Europe, healthcare has to date remained largely insulated from normal market mechanism...

Industry News: An Overview of the Latest Updates from Technology & Industry

The Menari Group have been granted exclusive rights to Ranexa. The agreement grants rights to Menarini for Ranexa in 68 countries, including the 27 countries of the European Union, the Commonwealth of Independent States and certain countries in Central and South America. The deal included an upfront payment of 70 million dollars and further payments could amount to 315 million dollars. Ranexa will be launch...

Tracleer®, a dual endothelin receptor antagonist has been approved in the European Union for the treatment of patients with mildly symptomatic pulmonary arterial hypertension (WHO FC II). A clinical study of patients with mildly symptomatic WHO FC II led to approval and revealed that even patients with mild symptoms are at risk of rapid deterioration. Tracleer delays disease progression in these patients a...

BIOTRONIK’s wireless remote monitoring technology for patients with cardiac devices has been approved in Europe. It identifies patients with the most clinically relevant events to streamline clinic workflow and improve patient care. The traffic-light severity-based display of patients’ status identifies the most important information with one click and allows the review of the clinical status of patient...

TeraRecon has announced the release of new innovations in its flagship Aquarius iNtuition™ platform. Showcased in September at the ASNC annual meeting in Boston, this client server aims to improve efficiency within cardiac imaging. The new device is said to improve speed and accuracy in CT technology. It is workflow orientated, “available anywhere” through the healthcare enterprise and integrates with...

New data shows anticlotting medicine Tirofiban (AGGRASTAT®) lowers incidence of heart attack in patients who respond poorly to aspirin or Clopidogrel after elective coronary angioplasty. Dr Marco Valgimigli, Chair of Cardiology, University of Ferrara, Italy and the principal investigator of the study emphasised the significance of the findings as they “Demonstrate a proof of concept for a new treatment s...

Physio-Control, a wholly owned subsidiary of Medtronic Inc. received clearance from the FDA on October 3, 2008 to market the LIFEPAK 20e defibrillator / monitor within the US. It is an enhancement of the LIFEPAK 20 with a more powerful lithium-ion battery doubling ECG monitoring time. It is a non-evasive way to monitor the oxygenisation of a patient’s haemoglobin and has been developed so it can be easily...

The Wall Street Journal has reported that Pfizer have abandoned the development of medicines for heart diseases. In the past Pfizer dominated the cardiovascular drugs sector with Lipitor being named as the worlds best selling drug in 2007. Due to a reorganisation of research they will be leaving drugs such as Lipitor to focus on other programmes including oncology and Alzheimers. They have however confirmed...

Previously only cleared for use in the coronary and peripheral blood vessels, PressureWire Certus can now be used to assess pressure measurements across heart valves and into various chambers of the heart. It can also be used in the assessment of Fractional Flow Reserve (FFR). FFR expresses the maximum achievable blood flow in a coronary artery with abnormal stenosis as a fraction of maximum blood flow in t...

The SJM Confirm™ implantable cardiac monitor (ICM) is a compact device designed to help physicians detect abnormal heart rhythms in patients with unexplained symptoms. It enables the evaluation of heart rhythm signals over a longer period of time compared to standard monitoring tests and it is the smallest ICM available which can be implanted in an outpatient procedure under local anaesthetic. Patients ca...

Cordis have released clinical data indicating that percutaneous coronary intervention with the CYPHER sirolimuseluting coronary stent is comparable to bypass surgery in key safety measures in patients with diabetes and multi-vessel disease. The data was recently presented at the European Society of Cardiology meeting. It is the only drug-eluting stent with such randomised clinical data indicating that it is...

Shands HealthCare at the University of Florida medical centre have installed the Toshiba Aquilion ONE dynamic volume CT. This may change the way hospitals and physicians treat and diagnose patients with cardiovascular and neurological disease. Aquilion ONE can perform single heart beat studies and capture organ perfusion, actions that cannot be performed by other systems. The system uses 320 ultra-high reso...

These hybrid surgical rooms will provide optimal imaging during open and minimally invasive cardiovascular surgical procedures in a bid to enhance workflow. The combination of Philips cardiovascular x-ray systems and Steris HD 360 suites technologies and design service aims to create a flexible treatment environment in a single suite. It will in turn provide hospitals with opportunities for surgical innovat...

Medtronic sponsored trials by REVERSE and PARTNERS HF have shown that cardiac resynchronisation therapy (CRT) delays the time to the first hospitalisation or death in patients with mild heart failure, and devices equipped with OptiVol® Fluid Status Monitoring identified patients who were at a significantly higher risk of having heart failure events in the near future. Although normally for patients with mo...

Cardiology Leaders

Firstly Congratulations on Your New Appointment as ESC President 2008 – 2010. Do You Feel You have Now Reached the Greatest Heights in Your Professional Life? Yes, I consider the Presidency of the ESC a great honour. Which of Your Previous Roles Within the ESC are Close to Your Heart? Co-chairman of the Working Group on Pathophysiology of the Cardiac Myocite from 1992 – 94;Chairman of the Working Group...


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