Publications

Atrial fibrillation (AF) is the most common cardiac arrhythmia and accounts for substantial morbidity and mortality. Recently, we created a mouse model with spontaneous and sustained AF caused by a mutation in the NaV1.5 channel (F1759A) that enhances persistent Na+ current, thereby enabling the investigation of molecular mechanisms that cause AF and the identification of novel treatment strategies. The mice have regional heterogeneity of action potential duration of the atria similar to observations in patients with AF. In these mice, we found that the initiation and persistence of the rotational reentrant AF arrhythmias, known as spiral waves or rotors, were dependent upon action potential duration heterogeneity. The centers of the rotors were localized to regions of greatest heterogeneity of the action potential duration. Pharmacologically attenuating the action potential duration heterogeneity reduced both spontaneous and pacing-induced AF. Computer-based simulations also demonstrated that the action potential duration heterogeneity is sufficient to generate rotors that manifest as AF. Taken together, these findings suggest that action potential duration heterogeneity in mice and humans is one mechanism by which AF is initiated and that reducing action potential duration heterogeneity can lessen the burden of AF.

BACKGROUND

Medical supplies and equipment are unevenly distributed throughout the world.

OBJECTIVE

Our aim was to describe, quantify, and monetize unused supplies suitable for recovery produced from two urban emergency departments (EDs).

METHODS

We trained ED staff to place opened, unused, uncontaminated medical supplies in strategically located bins located in two urban EDs for 30 days. We sorted and quantified collected supplies, then used hospital-specific supply catalogs to determine the total cost of recovered medical supplies during the 30-day study period. We extrapolated the amount of collected medical supplies and associated costs to yearly estimates.

RESULTS

We recovered 39.9 kg ($6,096) from the trauma center and 3.4 kg ($539) from the academic center during the 30-day study period. The most commonly collected supplies included open but unused procedure kits ($1,776), catheter needles ($1,009), and sutures ($698). We estimated that the trauma center produces $73,158 of unused medical supplies per year and the academic center produces $6,467 of unused medical supplies per year.

CONCLUSIONS

We present a novel approach to decreasing waste and recovering usable medical supplies, in which we found that substantial, valuable medical supplies can be recovered in two urban EDs.