June 2011

Heart Rhythm Society (HRS) Chair of Health Policy Richard I. Fogel, MD, echoed the thoughts of many during the 32nd annual HRS meeting: This is a very dynamic healthcare environment with a lot of unknowns. While I am not sure what the picture will look like in the next five years, one thing is for certain, healthcare in the U.S. will be forever different.

The patent foramen ovale (PFO) is frequently associated with cryptogenic stroke. PFO is present in about 25 percent of the population, but is not harmful to the vast majority. Even as the evidence surrounding this congenital condition expands, practitioners find themselves clashing on if and how to treat this common heart defect.

To optimize outcomes for PCI procedures, new technologies have emerged to assist interventionalists with clinical decision making and patient selection. With fractional flow reserve (FFR) gaining more adoption since the release of the FAME trial in 2009, physicians are now exploring newer complimentary intravascular imaging technologies, such as optical coherence tomography (OCT). To assess the impact in U.S. cath labs, five interventional cardiologists discussed the practice management considerations. Sponsored by an educational grant from St. Jude Medical.

Due to the commonality of arrhythmias and the number of procedures necessary to treat them, practitioners have turned to cardiac PET and PET/CT to help guide electrophysiology (EP) procedures and aid in pre-procedural planning.

Christopher Herzog, MD, PhD, can pinpoint the precise moment he got it about cloud computing vis a vis advanced visualization for cardiovascular imaging. The Munich-based radiologist was preparing for an advanced visualization workstation face-off when his IT preparation partner suggested they try something a little different. The IT partner would log him into a thin-client workstation and, looking at the same images, guide him through the steps hed need to perform at the face-off. Nothing unusual thereexcept that Herzog was at his companys satellite facility in Garmisch, Germany, while the IT partner was somewhere in Portugal.

Healthcare organizations of all sizes are enlisting clinical decision support (CDS) systems to assist providers with decision making. However, to ensure proper utilization and improve the practice of evidence-based medicine, workflow integration at the point of care needs to improve.

Treating cardiovascular disease, in particular those patients with heart failure (HF) and myocardial infarction (MI), is costly. Studies show that HF and MI patients are particularly vulnerable in the 30-day post discharge period for hospital readmission. Therefore, changes in care strategies during this period of time could greatly improve outcomes.