ANZCTR search results

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide. Surgical ablation for the treatment of AF during concomitant cardiac surgery is a class I recommendation per Society of Thoracic Surgeons (STS) and Heart Rhythm Society (HRS) guidelines. The AtriCure Isolator Synergy EnCompass-S ARFA PFA Dual Energy Ablation System will be used to treat AF as part of planned cardiac surgery. The objective of this study is to evaluate the safety and feasibility of the Isolator Synergy EnCompass-S2 AFRA PFA Dual Energy System in participants with atrial fibrillation (AF) undergoing cardiac ablation concomitant to cardiac surgery.

In addition to medical therapy, current guidelines recommend early invasive management for patients with acute coronary syndrome (ACS) due to data supporting myocardial revascularisation (PCI or bypass surgery) for obstructive large (conduit) artery disease in this setting. Despite advances in medical therapy and the adoption of emergency pathways that facilitate the delivery of timely invasive assessment and revascularisation, patients with ACS remain at significant risk of future adverse cardiovascular (CV) events. The coronary microcirculation plays a pivotal role in the autoregulation of myocardial blood flow and ability of the myocardium to recover following ACS. Indeed, following ACS, the presence of CMD predicts an increased risk of repeat myocardial infarction and heart failure hospitalisation. Therefore, in this study we aim to investigate the health and reactivity of the coronary microcirculation at the time of ACS (during index admission and staged invasive re-assessment). Furthermore, we aim to measure cOCT at baseline (time of ACS) and at follow up (3-months) to assess for longitudinal change and an association between central (coronary) and peripheral (cutaneous) microvascular reactivity.

Among patients undergoing invasive coronary angiography for the investigation of anginal chest pain, the absence of angiographically obstructive coronary artery disease that may account for symptoms remains common, occurring up to 60% of the time. In this situation it is possible that symptoms may be due to conditions of the coronary microcirculation (coronary microvascular dysfunction, CMD) or vasomotor disorders (vasospastic angina) with these conditions being referred to collectively as angina with non-obstructive coronary arteries (ANOCA). Following the exclusion of secondary causes of CMD, such as cardiomyopathy or valvular heart disease, patients with ANOCA represent a cohort of primary CMD within which we may study the relationship between central (coronary) and peripheral (Cutaneous OCT) microvascular reactivity. This may provide novel insights into the physiological interplay between vascular beds so that we may be able to advance the development of urgently needed less or non-invasive tests helpful in the detection of patients with CMD.

This retrospective, observational cohort study will include nonagenarians admitted to the intensive care unit (ICU) between 2010 and 2023 across Australia and New Zealand. The study will utilise data from the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database. Who is it for? You are eligible if you are greater than 90 years old and admitted to ICU. Patients will be categorised into those with a normal body mass index and thiose with either a high or low body mass index. Study details This study will evaluate and compare the prognostic performance of common ICU risk stratification scores including the APACHE III, SOFA, and ANZROD scores in a large binational cohort of ICU-admitted nonagenarians and centenarians. Discriminative ability, risk stratification, and predictive utility for both short- and long-term mortality will be assessed. We hope these findings will emphasise the importance of shared decision-making that respects patient autonomy and considers clinical, cultural, and systemic factors.

Exercise improves wellbeing of people living with Parkinson’s disease (PD). However, travelling to and participating in exercise classes at a community centre may be difficult. This study will investigate whether an online PD targeted exercise program is acceptable and feasible for people living with PD. We will recruit up to 20 people with PD and allocate them randomly into two groups. Both groups will participate in a 1-hour exercise class twice a week for 8 weeks. Group 1 will participate in the online class and Group 2 in the face-to-face class. We will also investigate how this program can improve mobility and balance in people with PD.

This project will aim to examine the feasibility of an 8-week, tailored, multimodality exercise intervention tailored for people living with young onset dementia, as well as the potential benefit to physical health, mood and cognition. We hypothesize that tailored physical activity interventions will be both feasible and acceptable for people with young onset dementia, in particular with the removal of transportation barriers.

Outcomes for child anxiety treatment are suboptimal. Exposure therapy is the key technique to reduce anxiety, and involves facing the feared situation to learn that it is safe (i.e., safety learning). However safety learning can be forgotten, and fears come back. This clinical trial will assess whether adjunctive memory rehearsal after exposure therapy enhances outcomes and prevents relapse. Results will advance understanding of treatment mechanisms and optimise child anxiety treatment.

The aim of this study is to test the feasibility, efficacy, and acceptability of a co-designed digital body image intervention, a website, intended to provide non-clinical adult women with cognitive behavioural, psychoeducational, and media and health literacy activities. We hypothesise that relative to pre-intervention, participants in the treatment group would report decreased body dissatisfaction and ideal internalisations, and higher body acceptance and health confidence at post-intervention. We hypothesise sustained effects at one -month follow-up, compared to a wait list control group. We also aimed to learn more about how treatment group participants would rate the website in acceptability, and how the website could be improved. By evaluating the efficacy of the present co-designed website, there is potential to address the gap in scalable, user-centred body image interventions that are suitable for preventative and early care.

Delirium is a clinical condition characterized by an acute disturbance in a person's attention, cognition, and awareness. It can occur in any age group but is more common in older adults. It can be caused by the combined effect of hospital admissions, certain medications, and underlying medical conditions. Delirium is associated with poor outcomes for patients, with increased postoperative complications, delayed functional recovery, and prolonged hospital stays, and increased risk of death. Healthcare providers face difficulties in identifying or diagnosing delirium and providing high standard care for patients experiencing delirium. In this project, we will evaluate a comprehensive approach involving data from wearable devices and clinical records of patients to develop a predictive model to detect the onset of delirium and to classify the hypoactive and hyperactive states of delirium. The wearable device, which is a smartwatch designed for clinical trials, can monitor physical activity and physiological parameters in older adults, and the clinical records can provide valuable patient health information. This project aims to develop Artificial Intelligence (AI)-based predictive and diagnostic applications using the data collected from the wearable device worn by inpatients along with their clinical records to predict and classify delirium. This will help in timely identification and management of the underlying causes and risk factors, which are crucial in preventing the development of delirium and understanding its symptoms. The developed predictive and diagnostic applications could assist healthcare providers in enhancing health outcomes for older adults admitted to hospitals.

This study will investigate whether smartwatches can be used to diagnose heart problems early. Participants will use their smartwatches to record 12-lead electrocardiograms (ECG) similar to those done in hospitals and clinics, and also provide a snapshot of their daily physical activity for the preceding year. The purpose of this research is to see if self-recorded heart data and activity data can help in the early detection of heart disease and provide a better understanding of how physical activity affects heart health. We hypothesize that using smartwatch ECG technology for at-home heart check can lead to earlier identification of cardiovascular risks. ECG Heart Age, as a marker of increased cardiovascular risk, has the advantage of being easily understood by the patient and may provide strong incentives for life-style changes or compliance to medication. If ECG Heart Age can be obtained without the use of conventional ECG machines, but instead applied by non-health care professionals at their own home, impact may be even greater. WHO identified the need for more research on the dose-response relationship between volume and/or intensity of physical activity and health outcomes. However, accurately measuring activity volume and intensity in the general public is challenging. Whilst there are many benefits to wearable devices, there are potential confounders to measuring activity in trials and extrapolating to general exercise levels. A potential solution to this issue is through collection of objectively measured physical activity in individuals who own a smartwatch or an activity monitor.