'Take as directed'--strategies to improve adherence to cardiac medication.

In patients with cardiovascular diseases, adherence to medication is a fundamental prerequisite for pharmacological therapy to be effective. Nonadherence to medication is a major public health problem that compromises the effectiveness of therapies and results in suboptimal clinical outcomes. The behaviour of nonadherence is complex and is strongly influenced by an interaction between various factors, such as patient education, communication between patients and physicians, drug dosing schedules, and access to health care.

The prevalence and contents of advance directives in patients with pacemakers.

Background: Little is known about the use of advance directives (ADs) in patients who have implantable cardiac pacemakers (PMs).

Methods: We conducted a retrospective review of the medical records of residents of Olmsted County, Minnesota, who underwent implantation of a cardiac PM at Mayo Clinic (Rochester, Minnesota) during 2006 and 2007, and determined the prevalence and contents of ADs in these patients.

Results: During the study period, 205 residents of Olmsted County (men, 53%) underwent PM implantation (mean age [standard deviation] at implantation, 77 [15] years).

The use of advance directives among patients with implantable cardioverter defibrillators.

Background: We aimed to determine the prevalence of advance directives (ADs) among patients with implantable cardioverter defibrillators (ICDs) and of ADs that addressed ICD management at the end of life.

Methods: The medical records of all patients who underwent ICD implantation during 2007 at a single institution were reviewed retrospectively to determine the number of patients with an AD and the number of ADs mentioning the ICD specifically (i.e.

Myocardial viability imaging and revascularization in chronic ischemic left ventricular systolic dysfunction.

The high rate of periprocedural morbidity and mortality associated with revascularization in moderate-to-severe left ventricular systolic dysfunction has provided the rationale for noninvasive viability imaging. The most established viability imaging techniques are PET, single-photon emission computed tomography and dobutamine echocardiography. Cardiac MRI is gaining widespread use and accessibility, and computed tomography is emerging as a promising technique.