May/June 2009

Despite considerable progress in treating patients who suffer an out-of-hospital cardiac arrest, survival andespeciallyneurologic outcomes remain relatively poor. Two areas in which more progress can be made are improved resuscitative measures, including the use of an automatic support pump, and better ventilation control. A third area that is slowly gaining traction is hypothermia therapy, according to Timothy D. Henry, an interventional cardiologist and director of research at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minnesota.

Newer iterations of stents have contributed to better outcomes in the iliac and superficial femoral arteries, prompting cardiologists to take notice.

Cardiovascular Business invited four luminaries in the field of nuclear cardiology to discuss SPECT and SPECT/CT, including advanced technology, utilization in hospital- and office-based settings and reimbursement challenges.

Increasing overhead, decreasing reimbursement, fierce competition and practice buy-outs...all are conspiring against the nuclear cardiologist.

Vascular closure devices after PCI are experiencing an increase in utilization and vendors often speak to their benefits. Yet, complication rates vary widely, with seemingly little intention to explore the root of the problem, particularly in randomized controlled trials.

Cardiovascular care, like other areas of medicine, is feeling the pinch of the economic tourniquet applied to stop the hemorrhaging of dollars and the potential closure of life-saving services. Interestingly, the pulse of electrophysiology is anything but flatlined, and vendors and CFOs are all a-flutter at the staggering growth of EPestimated to be between 12 and 15 percent annually.

While the time is right for practices to seize the opportunity to get federal money for health IT, many details that will affect incentive payments are still being fine-tuned.

Electrophysiology (EP), as a subspecialty, is coming into its own. Electrophysiologists have access to more capital than in the past, and with a 10 to 15 percent annual market growth, it is one of the fastest growing sectors within cardiology. Vendors have taken notice and are focusing on technology and designs that cater specifically to EP docs.

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