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    Ambulatory ECG monitoring for syncope and collapse in United States, Europe, and Japan: The patients' viewpoint
    (Wiley, 2021) Altinsoy, Meltem; Sutton, Richard; Kohno, Ritsuko; Sakaguchi, Scott; Mears, Robin K.; Benditt, David G.
    Background: Practice guidelines provide clinicians direction for the selection of ambulatory ECG (AECG) monitors in the evaluation of syncope/collapse. However, whether patients' understand differences among AECG systems is unknown. Methods and Results: A survey was conducted of USA (n = 99), United Kingdom (UK)/Germany (D) (n = 75) and Japan (n = 40) syncope/collapse patients who underwent diagnostic AECG monitoring. Responses were quantitated using a Likert-like 7-point scale (mean +/- SD) or percent of patients indicating a Top 2 box (T2B) for a particular AECG attribute. Patient ages and diagnosed etiologies of syncope/collapse were similar across geographies. Patients were queried on AECG attributes including the ability to detect arrhythmic/cardiac causes of collapse, instructions received, ease of use, and cost. Patient perception of the diagnostic capabilities and ease of use did not differ significantly among the AECG technologies; however, USA patients had a more favorable overall view of ICM/ILRs (T2B: 42.4%) than did UK/D (T2B: 28%) or Japan (T2B: 17.5%) patients. Similarly, US patient rankings for education received regarding device choice and operation tended to be higher than UK/D or Japan patients; nevertheless, at their best, the Likert scores were low (approximately 4.7-6.0) suggestig need for education improvement. Finally, both US and UK/D patients were similarly concerned with ICM costs (T2B, 31% vs 20% for Japan). Conclusions: Patients across several geographies have a similar but imperfect understanding of AECG technologies. Given more detailed education the patient is likely to be a more effective partner with the clinician in establishing a potential symptom-arrhythmia correlation.
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    Coronary intervention for acute coronary syndrome in a 51-year-old man with immune thrombocytopenic purpura: A case report
    (BioMed Central Ltd. info@biomedcentral.com, 2014) Bora Demirçelik, Muhammed; Altinsoy, Meltem; Bozduman, Fadime; Güneş, Mahmut Fatih; Çakmak, Muzaffer; Eryonucu, Beyhan
    Introduction. Treatment of the rare cases of patients with chronic idiopathic thrombocytopenic purpura with acute coronary syndrome can be a significant problem. The patient in our case report was treated successfully with percutaneous coronary intervention. Case presentation. A 51-year-old man of Turkish origin who had idiopathic thrombocytopenic purpura was admitted to our hospital with severe chest pain. His electrocardiography was normal on admission but dynamic ischemic changes were observed during follow-up. He underwent immediate coronary angiography. In his angiography, left anterior descending artery stenosis was 90% together with the diagonal ostium. Percutaneous coronary intervention was performed successfully. Bleeding complications were not observed after the procedure. Conclusions: We report the presence of a rare case of chronic idiopathic thrombocytopenic purpura in a patient with acute coronary syndrome. In this situation a serious multidisciplinary approach is required before coronary intervention. © 2014 Demircelik et al.; licensee BioMed Central Ltd. © 2014 Elsevier B.V., All rights reserved.