First Word: Challenges and Opportunities in Cardiology

Analysts have predicted that peripheral endovascular procedures will dwarf cardiac procedures in short order. It’s no wonder, then, that an increasing number of cath labs have already begun the transition from single- to multi-specialty rooms.

It’s not an easy transition, but a necessary one in these days of decreasing cath lab volumes and reimbursement, and increasing peripheral vascular disease and innovative treatments. As with any new paradigm in medicine (and there are many), it pays to do your homework and get it right the first time. Our cover story will help guide you in the right direction, showing you why you need to make the change and how to do it.

In a related story about the financial factors facing cath labs, we detail the impact that coronary CT angiography is having on the labs (and will continue to have now that the government decided not to restrict payment, see News & Views), as well as the negative consequences the COURAGE trial has inflicted on cardiology practices. These are not insurmountable problems, but they require savvy and expert planning.

Are drug-eluting stents poised for a comeback? We ask and answer the question in this issue. The news is good and bad. Yes, the deployment of DES in the U.S. will increase from its historic current low of 62%, but it will not reach its historic highs of 90%. That’s just another reason to equip your cath lab with a larger field of view x-ray system to accommodate peripheral vascular work.

One way to shore up the bottom line is by creating better efficiencies. This is increasingly being accomplished through the use of integrated records, which include CT, MR, echo, nuclear studies and much more. But adopting this technology isn’t as simple as swapping out what you’ve got with what you want. It takes a thorough understanding of your current processes and how they will evolve.

And finally, we examine the increasing importance of electrophysiology to a cardiology department’s financial success. This subspecialty has evolved into a multi-million dollar business and the time is quickly growing short when it can remain in the shadow of interventional cardiology.