May 2011

While complication rates associated with implantable cardiac devices have decreased, they remain problematic for patients and cardiologists. Better patient selection, physician training and improved device software and/or programming can help improve implantation and reduce complications, including inappropriate shock therapy.

Specialties, such as cardiology, are particularly susceptible to the ongoing transformations and diminishing reimbursements of the U.S. healthcare landscape. In fact, American College of Cardiologys (ACC) CEO Jack Lewin, MD, advised the cardiology community to begin preparing now for a move away from the current fee-for-service model at last months 60th annual ACC scientific sessions.

Many areas in medicine have received a lot of attention regarding their quality of care in terms of provider and facility performance. These include how sites and providers maintain proper hemoglobin A1c levels, as well as how they reduce cath lab complications and heart failure readmissions. However, data regarding the performance of anticoagulation management is scarce.

Advanced electrophysiology (EP) technology is a key component in improving patient care and physician productivity. Texas Health Arlington Memorial Hospital in Arlington, Texas, has implemented the Sensei X Robotic Catheter System in advancing a Center of Excellence. Sponsored by an educational grant from Hansen Medical.

Moving a catheter laboratory inside an operating theater is no easy matter. While hybrid interventional operating rooms (ORs) carry the promise of increased revenue and patient safety, they also come with a sizable price tag, technical considerations and potential turf battles.

Overall, complication rates related to PCI procedures have been drastically reduced, but bleeding complications remain the last barrier to safety. However, ongoing research has shed light on how some techniques and drugs may or may not be effective in reducing bleeding.

In the current economic climate, providers need to make fiscally conservative choices about their inventory, but healthcare systems that focus on quality, such as North Shore-Long Island Jewish (NSLIJ) Health System in New York, continue to keep patient safety at the forefront of that decision-making process, especially for complicated electrophysiology (EP) procedures. Sponsored by an educational grant from PEAK Surgical.

Registries and ongoing research have broadened our understanding of abnormal heart rhythms. Today, much more is known about the etiology of arrhythmias, as well as options for best therapies. Cardiovascular Business spoke with the incoming and outgoing presidents of the Heart Rhythm Society (HRS) about advances in our knowledge of these disease states.

St. Lukes Hospital in Kansas City, Mo., employs a web-based technology that helps patients understand their risks with an upcoming cath lab procedure. The technology executes the American College of Cardiologys (ACCs) multivariable risk prediction models with patient-specific data so that individualized estimates of outcomes can be generated within the routine flow of clinical care and used to support shared medical decision making.

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