Palpitations (noticeable pounding, fluttering or irregular heart beat) and pre-syncope (near blackout) are common Emergency Department problems sometimes due to an abnormal cardiac rhythm.
This is difficult to diagnose as clinical examination and ECG are commonly normal and symptoms have usually resolved by the time the patient arrives in the Emergency Department. Diagnosing an abnormal heart rhythm as the cause of symptoms rests on capturing it on an ECG and patients are usually discharged with advice to return to the ED again for a 12-lead ECG should symptoms recur.
The IPED study will randomise 242 consecutive patients aged 16 years or over presenting with an episode of palpitations or pre-syncope in the preceding 24 hours and whose underlying ECG rhythm during these episodes remains undiagnosed after ED assessment, to either use of a smart phone based event recorder (the AliveCor Heart Monitor and AliveECG app) or standard care.
Patients will be followed-up at 90 days. The IPED study aims to discover whether a smart phone based event recorder may allow better and earlier diagnosis of these patients, and revolutionise ED care in this area.
The IPED Study Multi-centre Sites:
Royal Infirmary of Edinburgh
Royal Berkshire Hospital
Musgrove Park Hospital
Royal London Hospital
Nottingham University Hospitals NHS Trust
Chesterfield Royal Hospital
Whipps Cross Hospital
Royal Devon and Exeter Hospital
Leicester Royal Infirmary
Derriford Hospital (Plymouth)
Press Reader. 17/05/2018. ‘Heart Trial Helps De-stress Josephine’ Available at: https://www.pressreader.com/uk/the-wokingham-paper/20180517/281857234187133
NIHR. 17/05/2018. ‘Berkshire woman staying healthy since taking part in heart monitor research trial’ Available at: https://www.nihr.ac.uk/news/berkshire-woman-staying-healthy-since-taking-part-in-heart-monitor-research-trial/8478
The Reading Chronicle. 16/05/2018. ‘Registrar praises innovative app which helps monitor heart rate’ Available at: http://www.readingchronicle.co.uk/news/16229340.Registrar_praises_innovative_app_which_helps_monitor_heartrate/
The MediWales LifeStories talk about the EMERGE Research IPED study and how to set up an Ambulatory smartphone palpitation clinic using the AliveCor device is now available at youtu.be/HWqPZqydJCI
Director of EMERGE, Consultant, NRS Career Research Fellow & Honorary Reader in Emergency Medicine
10 Apr 2017 | Megan McGrath
EMERGE will soon begin recruitment to the new SNAP40 trial which will compare the new SNAP40 device with standard monitoring devices in the Emergency Department.Read more
ISARIC/WHO Clinical Characterisation Protocol for Severe Emerging Infections in the UK (CCP-UK)
Early diagnosis is central to improving outcomes for patients with cancer. For cancers without specific risk factors, or with no screening programs are difficult to diagnose and patients often present with non-specific symptoms. Unfortunately this means that these patients are often diagnosed late on in the development of the disease and treatment options are reduced.
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.