What is the size of the EP lab facility and number of staff members? What is the mix of credentials in the lab?

The Cleveland Clinic is composed of 7 EP labs and 1 cardioversion suite. A hybrid operating room is available within the Heart and Vascular Institute for complex procedures. In addition, we have 20 staff physicians, 10 EP fellows, 40 registered nurses (RNs), 1 clinical engineer/RN, 2 office specialists, 1 supply coordinator, and 1 patient care assistant. All technical support is provided by RNs. We do not employ CT or radiology technologists. Radiology technical support is available when needed.

When was the EP lab started at your institution?

The EP laboratory originated in 1980 with 2 electrophysiologists, 2 RNs, and 1 secretary. The procedures were performed in a single, dedicated EP lab or in the cardiothoracic operating room. The EP Section currently has more than 150 personnel comprised of physicians, fellows, clinical nurses, research nurses, secretaries, monitoring technicians, and others who assist in the care we provide.

What types of procedures are performed at your facility? Approximately how many are performed each week?

On average, we perform 100 procedures per week (over 5,700 cases in 2010). Procedures performed include: pacemakers, defibrillators, biventricular devices, device/lead extractions, loop recorders, and cardioversions. We also perform diagnostic EP procedures and ablations of atrial and ventricular arrhythmias using transvenous or percutaneous epicardial techniques. Procedure duration can range from 1 hour up to 12 hours for patients with exceptionally complex arrhythmias.

The Cleveland Clinic Syncope Center is located near the electrophysiology laboratories, but it is a separate facility staffed by other nurses and physicians. In aggregate, approximately 2,000 diagnostic studies are performed in the Syncope Center each year. These include tilt testing, blood volume studies, and other hemodynamic and neuroregulatory evaluations.

What is the primary goal of your program?

Our mission is to alleviate symptoms related to cardiac arrhythmias and heart failure, thereby reducing the risk of sudden cardiac death. Through world-class care and state-of-the-art technology, we help patients from all over the world who travel to Cleveland because of the expertise we offer. We also accept referrals from other hospitals whose patients have medical problems that are particularly complex or in whom a prior procedure was unsuccessful. This may include extraction of infected leads, or ablation of complex atrial or ventricular arrhythmias.

Who manages your EP lab?