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The vaccine developed to treat COVID-19 has been a topic of hot debate since its inception. With questions swirling regarding the speed at which it was developed, its long-term efficacy, potential side effects that may not yet have come to light, and mandates instituted by businesses and governments across the globe, everyone is craving one thing—actual data to dispel or legitimize concern.

One cause for concern has come from the emergence of an unforeseen side effect. Myocarditis, inflammation of the heart muscle, has been linked to the COVID-19 vaccine, adding fuel to the fire of debate. Without long-term research, however, the commonality and severity of this side effect remain unknown.

Different Types of COVID-19 Vaccines

 

 

The Data

A recent study  shed light on this topic by evaluating exactly those issues. How common is myocarditis in COVID-19 vaccine recipients, and how severe are the cases that do occur?

Included in the data set used for this study were patients who had received a minimum of one dose of the Pfizer-BioNTech mRNA vaccine. At the time of this research, this included 2.5 million vaccinated individuals aged 16 or older.

Anyone who fit this demographic and developed myocarditis up to 42 after their first dose was counted as being affected by this side effect. At the time, this was found to be 2.13 people per 100,000. However, this incidence rate varied based on a number of factors. For example, males aged 16 to 29 years old experienced the highest rate of myocarditis, with 10.69 cases per 100,000 vaccinated persons.

The majority of cases (98%) of myocarditis were overwhelmingly mild. 76% of cases fell into this classification, while 22% were considered intermediate.

What it Means

This study is a start, but it is too soon to determine how the data will change as time progresses. Because the research only included patients up to 42 days removed from their first dose of vaccine, it is possible that myocarditis developed in more patients after the 42-day window closed. The research performed does provide actual numbers to inform the concerns regarding vaccination and myocarditis. Majority of the myocarditis cases were mild and no risk of death.

According to CDC, most individuals can safely receive the vaccine and enjoy the benefits of protection and peace of mind.

You can consult with one of our experienced cardiologists through a virtual visit or in person at one of our clinic locations. To schedule an appointment, call Peak Heart & Vascular in Surprise, Avondale, Flagstaff, or Phoenix, Arizona, or connect online to submit an appointment request for an in-office or virtual visit.

References:

  1. https://nejm.org/doi/full/10.1056/NEJMoa2110737
  2. https://cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html
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For many with atrial fibrillation, the standard procedure has long been the administration of one or more antiarrhythmic medications before progressing to catheter ablation. This traditional strategy has long been accepted as the norm, yet it may not be the most effective approach to treating atrial fibrillation, especially when a patient’s quality of life is considered. To test the effectiveness of the common treatment progression, researchers decided to reverse the usual order by assigning patients to early ablation rather than antiarrhythmic drugs.

 

The Study

A total of 303 patients was included in this study, all of whom had symptomatic, paroxysmal, untreated atrial fibrillation. These patients were then randomly assigned to either undergo catheter ablation or receive antiarrhythmic therapy. Every patient also received an implantable device to detect atrial tachyarrhythmia.

After 91 days and over the course of 12 months, any recurrence of atrial tachyarrhythmia was documented. Atrial fibrillation burden, freedom from symptomatic arrhythmia, and quality of life were also examined.

 

The Findings

 

The primary endpoint, a recurrence of atrial tachyarrhythmia, was analyzed at the one-year mark after treatment commenced. Of the 154 patients who underwent ablation, 42.9-percent experienced a recurrence. By comparison, 67.8-percent of patients assigned antiarrhythmic drugs experienced a recurrence of atrial tachyarrhythmia.

Other measured events also seemed to favor treatment via ablation. For example, symptomatic atrial tachyarrhythmia was observed in only 11-percent of ablation patients versus 26.2-percent of those in the antiarrhythmic drug group. Serious adverse effects also occurred less frequently in the ablation group, checking in at 3.2-percent as opposed to 4-percent in the drug group.

 

What it Means

 

Patients with atrial fibrillation may benefit from ablation as an initial treatment rather than drug therapy. This is contrary to the traditional progression of treatment, indicating that the common strategy for treating symptomatic, paroxysmal atrial fibrillation may be misleading.

There is more work to be done to determine the extent to which the findings of this study are accurate. However, the discoveries of this particular analysis could provide individuals suffering from atrial fibrillation hope for a brighter future and a higher quality of life. While more invasive than the use of antiarrhythmic drugs, early ablation may be worth it for those seeking the most effective method of treatment.

You can consult with one of our experienced cardiologists through a virtual visit or in person at one of our 10 clinic locations conveniently located throughout the valley and Northern Arizona. To schedule an appointment, call Peak Heart & Vascular or submit an online request form.

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Typically, when a patient receives a stent, it’s recommended that they take blood thinners for up to a year after—but all of this could change with new generations of stents. Now, some research suggests that patients with newer stents might quality for a shortened blood thinner treatment, reducing the amount of time on blood thinners overall.

Mitigating the risk of bleeding and clotting post-surgery in patients with blocked arteries is essential to positive outcomes. Traditionally, this balancing act is achieved through dual antiplatelet therapy (DAPT), during which patients receive an antiplatelet agent and aspirin to manage bleeding and clotting.

Typically, this DAPT regimen continues for a minimum of 12 months after receiving a stent. This strategy, which is designed to reduce the risk of death—particularly from cardiovascular issues, including clotting near the stent, heart attack, major bleeding, and stroke—has long been the standard treatment method for those recovering from the implementation of a stent.

However, modern medical treatments and technologies are in a constant state of evolution and innovation. This march forward includes stents, with the latest generation of stents potentially revolutionizing the post-surgery approach to risk mitigation.

The Study

A recent study set out to determine the exact effect these new stents have on recovery and the necessity of DAPT.

The New Stent Advantage

Medical technology changes at a rapid pace and the latest generation of stents is a testament to this fact. They boast several features that differentiate them from the stents of old and provide advantages that benefit the patient both in the short and long term.

Composed of mesh, these tubes are designed to prop the artery in question open. However, the function of these new stents does not stop there. The latest stents also release drugs directly, helping prevent new blockages from forming. In this way, the new stent is both corrective and preventative.

The Trial

Traditional medical wisdom advocates for a 12+ month regimen of DAPT, which includes a combination of aspirin and a P2Y­12 inhibitor. With the advent of new stents that deliver drugs on their own, there is debate surrounding the necessity of this DAPT regimen and the best new combination of drugs for post-surgery patients.

One theory suggests that aspirin can be safely stopped one month after surgery, while a P2Y12 inhibitor, such as clopidogrel, continues for 12 months. To test this theory, researchers designed a trial in which 3,009 patients from 89 Japanese medical centers were enrolled.

Each of these patients was a recipient of drug-eluting stents. The patients were then divided into two groups—half received standard DAPT, while the other took aspirin for only one month and a P2Y12 inhibitor alone after that point.

Over the course of a year, several outcomes were measured. The results from the two groups were then compared to determine the benefits (or lack thereof) of diverting from standard DAPT following the implementation of a new-generation, drug-eluting stent.

The Findings

Of the patients in the one-month DAPT group, 96% ceased taking aspirin after one month. In the traditional DAPT group, 88% of patients continued 12-month DAPT treatment. Among these patients, it was found that adverse events were reduced by 36% in the one-month group. At the completion of one year, the composite primary endpoint occurred in only 2.4% of one-month DAPT patients compared to 3.7% in the standard group.

Even the secondary outcomes favored the one-month group. Bleeding was reduced from 1.5% in the standard group to 0.4% in the one-month group. Even more encouraging was the fact that stopping aspirin after one month did not correlate to higher occurrences of clotting, often called ischemic events. Ceasing aspirin after one month also did not lead to an increased risk of death from cardiovascular causes, defined as clotting around the stent, heart attack, or stroke.

What it Means

The results of this study are very encouraging for those receiving new-generation stents. They not only indicate that traditional 12-month DAPT may be unnecessary but also demonstrate improved recovery and reduced risk of adverse outcomes in those who stop DAPT after one month.

Thanks to the miracle of modern medical science and consistent march toward improved treatments, the projection for those in position to receive a stent is far more positive than in years past.

Disclaimers and Notes

While this study is insightful and gives reason for optimism, the researchers are not finished. They plan to continue to track the patients and their outcomes until the five-year mark to develop a clearer picture of long-term outcomes. This should provide even more insight into the effectiveness of the new stents and the long-term effects of the modified DAPT approach.

One important piece of information to note is that all the patients included in this particular study had a low to intermediate risk for ischemic events. As such, the application of this study to cases where risks are higher is unknown. To rectify this gap in knowledge, researchers do plan to enroll more at-risk patients in future studies. Doing so will allow them to collect data for patients with a higher risk of ischemic events and determine the effectiveness of one-month DAPT in such cases.

No matter the results of the long-term study and inclusion of increased-risk patients, one thing is certain—anyone in a position to receive a new generation stent will benefit from the findings. With such optimistic outcomes found in the initial research, hopes are certainly high for the positive outcomes associated with new stents and one-month DAPT to continue and to apply to a broader spectrum of patients.

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There is a phenomenon that casts a shadow over the joy of the holidays. Often called “holiday heart syndrome,” the reality of the situation is not as festive or fun as the titles may imply. In fact, suffering from this condition can cause the holiday spirit to quickly shift.

So, what is holiday heart, if not the tremendous joy that fills your chest around the holidays? Unfortunately, it is not the coronary condition of the Grinch when he finally understands the beauty of the season; rather, it is a disturbing pattern of increased heart-related issues that occurs between Christmas and New Year’s Day, specifically an irregular heartbeat resulting from increased alcohol consumption.

The factors that contribute to holiday heart are many, especially if you have underlying conditions, but the most common cause is the heavy drinking often associated with the holidays. Check out the risk factors and symptoms below and be sure to take steps to combat them.

Symptoms of Holiday Heart Syndrome

Recognizing the symptoms of holiday heart is essential in nipping problems in the bud before they evolve into more serious issues. While this syndrome does typically resolve itself if there are no preexisting heart conditions or a history of heart problems, you should take the warning signs seriously. If you experience any of these warning signs, contact your doctor and utilize emergency services if necessary.

Chest Pain

Heart problems often manifest themselves as chest pain. Holiday heart syndrome is no different, so be aware of this symptom and do not neglect to listen to your body when it gives you this clear warning sign of the condition.

Difficulty Breathing

Trouble breathing or catching your breath could be a warning. Holiday heart syndrome is often accompanied by labored or challenging breathing—this symptom is not something to ignore or write off as happenstance.

Dizziness

The irregular heartbeat related to holiday heart, also known as alcohol-induced atrial arrhythmias, can cause dizziness. If you do not typically experience dizziness and find this symptom accompanied by an unusual heart rhythm, you may be suffering from holiday heart syndrome.

Passing Out

Anytime someone loses consciousness, it is vital to take it seriously. Often, there is an underlying reason for such an occurrence. In the case of holiday heart syndrome, losing consciousness is a telltale sign that should be addressed.

Stay heart healthy this holiday season by knowing the risks of holiday heart, recognizing the warning signs, and acting accordingly. While this syndrome does not always result in long-term or serious problems, adverse outcomes are possible. If you are concerned or find yourself suffering from potential cardiovascular problems, do not hesitate to talk to your doctor. They will address the concerns you have, help you avoid poor heart health, and aid you in recovery if necessary.

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It may be the most wonderful time of the year, but when it comes to heart health, it can also be the most dangerous. The frequency of heart attacks spikes during the period from Christmas to New Year’s Day, quickly transforming the joy of the season into tragedy.

While no one thinks a heart attack will happen to them, especially during the holidays, there is a myriad of factors that contribute to this increased risk and frequency. So, what is it about the holidays that lead to a nearly 5% higher occurrence of cardiac death? Read on to find out.

Stress

As happy as the holidays can be, they are also stressful. From the hustle and bustle to the emotional toll of family to navigating the season after the loss of a loved one, the potential stresses are many and profound.

There is a direct link between stress and heart problems. From anxiety to depression and beyond, the increased distress experienced is certainly a factor in holiday heart attacks.

Diet

One of the most exciting holiday traditions is the food and beverages that have become synonymous with the season. Unfortunately, the food is often high in sodium—which can increase blood pressure—and people tend to eat a lot of it. Overeating can create new health problems or worsen preexisting ones.

Alcohol consumption also tends to increase during this time of year, which is not good for heart health, either.

Viral Illnesses

It would not be the holidays without at least one family member getting sick and inevitably spreading it to others. From the common cold to the flu, these respiratory illnesses can create more stress on the heart, leading to cardiovascular illnesses. Now, with COVID in the mix, even more people are likely to suffer from the cardiovascular effects of respiratory disease.

Forgetfulness

How can forgetfulness during the holidays lead to an increase in heart attacks? It is quite simple—people get so wrapped up in the hustle and bustle of the moment that they neglect important things like taking or filling their medication, making time for exercise, and more.

When these vital health habits are broken, especially more often than the occasional lapse, the consequences can be severe.

Do not let a season that is supposed to be full of cheer devolve into a time of tragedy. Be sure to make yourself and others aware of the holiday heart attack risk factors and actively work to combat them. Doing so can keep your heart healthy and the focus where it should be—on spending quality time with your friends, family, and loved ones.

If you do experience chest pain during the holidays, do not hesitate to contact emergency services. Addressing cardiac issues promptly can be the difference between a positive and negative outcome, so act quickly.

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It is no secret that influenza infection, also known as the flu, can wreak havoc on one’s health, especially if preexisting health conditions are present. This is especially true for those with cardiovascular disease, with whom the risk of morbidity and mortality is significantly increased.

Thanks to the flu shot, the severity of the flu in individuals—and in society at large—is reduced. It has long been known that for those with risk factors, including cardiovascular disease, the benefits are even more pronounced.

Benefits of Flu Vaccine

The flu vaccine is available by shot and nasal mist. In two weeks of vaccination, vaccines cause antibodies to develop in the body. It reduces the severity of the disease and helps to prevent hospitalization. The vaccine offers protection to your family from the influenza virus which can be enhanced by ensuring other families in your community also get their flu shot. According to CDC “Everyone 6 months of age and older should get a flu vaccine every year”. Some people are more likely to develop flu-related complications as compared to others. This high-risk group should get a vaccine every year.

  1. Adults older than 65 years
  2. Pregnant women
  3. Children younger than 5 years
  4. People who have medical problems like congestive heart failure, blockage in heart arteries, diabetes, COPD, cystic fibrosis, etc

Benefits of Flu Vaccine for Cardiac Patients

A recent study determined to demonstrate the advantages that the influenza vaccine offers those with heart problems and prove that receiving the flu shot drastically alters outcomes for those with cardiovascular disease.

Using data from 16 total studies, including both randomized controlled trials (4) and observational studies (12), researchers set out to determine the effect the flu vaccine may have on mortality and the cardiovascular outcomes of those with cardiovascular disease.

Those included in the study had a mean age of 69.2 years. Approximately 63% were men, 65% had hypertension, nearly a third had diabetes mellitus, and nearly a quarter identified as smokers. The median follow-up period was 19.5 months.

Through the course of the study, researchers found that receiving the flu shot was associated with lower incidence of death from any cause or cardiovascular reasons, and major adverse cardiovascular events when compared to the control (no flu shot).

What it Means

The flu shot has been a proven option for reducing the risk of influenza infection and severe illness for years now. This study expands the known benefits of the flu shot to include significant risk reduction of death and major adverse cardiovascular events in individuals with heart problems.

Not only is this important for those who have preexisting cardiovascular conditions and consistently receive the flu shot when appropriate, but it also provides extra incentive for those who have not traditionally opted to receive the influenza vaccine. The research should further encourage at-risk populations to get the flu shot and may be used as an effective resource for doctors when explaining the benefits to their unsure patients.

You can consult with one of our experienced cardiologists through a virtual visit or in person at one of our clinic locations. To schedule an appointment, call Peak Heart & Vascular or connect online to submit an appointment request. We have 10 locations across the valley and in Northern Arizona with clinics in Surprise, Avondale, Flagstaff, Prescott, Peoria, Sun City West and Phoenix, Arizona.

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Peak Heart & Vascular, Prescott is a medical center for all your cardiology needs. If you are suffering from any heart or vascular-related disease or illness, then visit Peak Heart & Vascular for services including cardiology, cardiac electrophysiology, and vascular surgery. Please call 602-698-7325 to book your appointment. You can also request an appointment online. We are accepting both in-person and virtual appointments. Same-day appointments may be available.

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There’s much we still need to learn about the impact of COVID-19 on your cardiovascular health, but one thing is certain: The virus can directly affect your heart.

Medical experts currently estimate that 20-25% of patients hospitalized for COVID-19 develop heart muscle inflammation, a condition called myocarditis.

Heart problems aren’t limited to people who were sick enough to go to the hospital. In one study, 78% of patients who recovered from COVID-19 had signs of ongoing heart inflammation, and two-thirds of them recovered at home.

In other words, you might not have symptoms or experience mild to moderate illness due to COVID-19, but you’re still at risk for myocarditis. And myocarditis can lead to cardiomyopathy.

Our team at Peak Heart & Vascular keeps up with the most current research about COVID-19 and heart disease. If you had, or currently have, COVID-19 and have any questions or concerns about your heart health, don’t hesitate to call — we’re here to help.

Meanwhile, here’s what we know so far about COVID-19 and how it can lead to cardiomyopathy.

How COVID-19 causes heart damage

COVID-19 can cause myocarditis and cardiomyopathy through:

Inflammation

COVID-19 causes a body-wide inflammatory response. Inflammation normally helps your body fight infection, but COVID-19 triggers such an immense reaction that the extensive inflammation can lead to heart problems.

Inflammation induced by COVID-19 causes myocarditis, but it can also affect the tissues surrounding your heart, causing a type of inflammatory disease called pericarditis. Inflammation also has the ability to disrupt the heart’s electrical system and cause arrhythmias (irregular heartbeats).

Direct heart injury

The COVID-19 virus can also directly attack your heart, a characteristic that sets it apart from other members of the coronavirus family. COVID-19 has a protein that attaches to and then enters heart cells. Once the virus is in cardiac cells, it damages them, causing scarring or cellular death.

Oxygen deprivation

As the virus infects your lungs, your body is deprived of oxygen. Acute respiratory distress is known to cause heart complications such as arrhythmias, reduced cardiac output, heart attack, and endocarditis. Endocarditis occurs when the inner lining of your heart becomes inflamed.

COVID-19 and cardiomyopathy

There are many possible causes of cardiomyopathy, including tissue damage and inflammation due to viral infections such as COVID-19.

Even though COVID-19 is most often linked with myocarditis rather than cardiomyopathy, the fact is that myocarditis can cause cardiomyopathy.

Up to 20% of patients who get myocarditis due to viral infections other than COVID-19 go on to develop chronic inflammatory cardiomyopathy.

Though further research is needed to verify the overall impact of COVID-19, chances are it causes just as many, if not more, cases of cardiomyopathy as other viral infections.

Symptoms of myocarditis and cardiomyopathy

Cardiomyopathy may cause an enlarged left ventricle, lead to thickened muscles in the left ventricle, or generally cause loss of elasticity, making the heart muscles rigid. All three types restrict the heart’s ability to pump oxygen-rich blood into your body.

Since myocarditis causes inflamed heart muscles, this condition also reduces the heart’s pumping ability. And myocarditis often interrupts the heart’s built-in electrical system.

Myocarditis and cardiomyopathy both cause symptoms such as:

  • Fatigue
  • Chest pain or pressure
  • Shortness of breath (at rest and when you’re active)
  • Swelling in your legs, ankles, and/or feet (due to fluid retention)
  • Fast or abnormal heart rhythms (arrhythmias)

If you have cardiomyopathy, you may also experience dizziness, abdominal bloating, or a cough that occurs when lying down.

If you develop any of these symptoms during or after your recovery from COVID-19, don’t wait to contact us for a complete heart evaluation.

It doesn’t matter if you had asymptomatic, mild, or severe COVID-19, you’re at risk for ongoing heart problems. You may prevent serious complications with early treatment.

You can consult with one of our experienced cardiologists through a virtual visit or in person at one of our clinic locations. To schedule an appointment, call Peak Heart & Vascular in Surprise, Avondale, Flagstaff, or Phoenix, Arizona, or connect online to submit an appointment request for an in-office or virtual visit.

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At Peak Heart & Vascular, we are pioneers in outpatient surgery for cardiovascular conditions. Many procedures traditionally performed in a traditional hospital setting can be done in an outpatient surgery center with the same quality and safety. We are able to perform many cardiovascular procedures such as heart catheterization, stenting, ablation, vein ablations, pacemakers, and lower extremity revascularizations for PAD at Peak Surgery Center of Surprise. This center is expected to open soon.

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Peak Heart and Vascular Medical Center offers the full spectrum of cardiovascular care ranging from comprehensive diagnosis to innovative treatment plans. Our clinic in Avondale is open for virtual as well as in-person visits. To book an appointment for cardiology, electrophysiology, and vascular consultations, call 602-698-7325 or request an appointment online.  Same-day appointments may be available.

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Flagstaff residents do business with a variety of companies in Flagstaff, Sedona, Williams, and Winslow. Flagstaff Business News asked readers to vote for their favorite Flagstaff businesses. Our readership responded to the call, which business they think are the best in the categories designated. The results are in!

Best of Business Winners
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Peak Heart & Vascular specializes in the complete assessment and treatment of patients suffering from cardiovascular conditions such as coronary artery disease, heart failure, peripheral artery disease, etc. Our clinic in Cottonwood is open for both virtual and in-person visits. Book your appointment for cardiology, electrophysiology, or vascular by calling 602-698-7325 or submitting a request online. We offer same-day appointments when available.

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