Located in Erie, Pennsylvania, Saint Vincent Health Center is a 450-bed regional referral center recognized as a leader in a number of medical specialties, including cardiovascular disease. In 1990, the Saint Vincent Heart Center introduced the first comprehensive electrophysiology lab in the northwestern Pennsylvania region and has continued innovations in both diagnosis and treatment. The Saint Vincent Heart Center has three board-certified electrophysiologists, two dedicated EP Labs and an outpatient Pacemaker/Defibrillator Clinic. We have four full-time RNs, one part-time RN, a full-time RT and a full-time pacemaker specialist on our team.

What types of procedures are performed at your facility? Approximately how many are performed each week? What complications do you find during these procedures?

The EP lab performs comprehensive EP studies, radiofrequency ablations, pacemaker/defibrillator implants, non-invasive-programmed stimulation, and tilt studies, as well as organizing all cardioversions in the hospital. We average eight implants and four ablations a week. Our pacemaker clinic checks 15-20 outpatient and in-house devices a day. Our complication rates are lower than the national and local average.

How is your EP lab managed, and by whom?

Jeff Buetikofer, MD, is the Director of EP Services, and I am the EP lab supervisor. We work together on daily operations as well as on long-term goals for the EP service.

Is the EP lab separate from the cath lab? Are employees cross-trained?

The EP labs and cath labs are in the same area of the hospital, but EP procedures are separate from all cath procedures. The strength of our service is that the responsibilities of the nurses and techs are only to the EP lab and Pacer Clinic.The majority of us have cath lab/critical care experience and help out in those areas when needed.

Do you have cross-training inside the EP Lab? What are the regulations in your state?

The nurses in the lab are also cross-trained to work in the Pacemaker Clinic. In the lab, nurses and techs perform all the same duties, with the exception of conscious sedation and medication administration handled by the RNs.

What are some of the new equipment, devices and products introduced at your lab lately?

We have participated in the MADIT II, Companion and Rid AF studies. Currently, we are in Medtronic s Marquis study and Biosense s Navistar study, which uses an 8 mm tip catheter for atrial flutter ablations. We have the expertise of two certified Clinical Research Coordinators for the smooth operations of the clinical trials. Recently, we have also started implanting biventricular pacers using Medtronic s InSync device. Our labs are fitted with Prucka recording systems and Radionics stimulators. We utilize the Biosense CARTO Mapping System and Stockert RF generator with all of our ablations and have cut fluoro time considerably. For transseptal ablations, we use Acuson s intra-cardiac echo machine to visualize cardiac anatomy. We have a Trex pulse fluoro in one lab and a Ziehm mobile c-arm in the other.

Is your EP lab filmless?

Our labs are completely filmless.

Who handles your procedure scheduling? Do you use a particular software? How do you handle physician timeliness?