8 (August 2006)

Using Cryoablation for AVNRT Cases:Interview with Efrain Gonzalez, MD, Medical Director of Electrophysiology at Baptist Cardia

When did Miami Baptist Cardiac & Vascular Institute begin using cryoablation?

We began using cryo here when it first became available, which was about two-and-a-half years ago.

In particular, how long have you been using CryoCath's 6mm Xtra ablation catheter for AVNRT ablation cases? Why did you begin using this catheter for your AVNRT cases?



Survival Rates of Sudden Cardiac Arrest in Young Athletes

What made you decide to study this population of patients (i.e., young athletes who suffer SCA)? Why do you think this population has not been studied before?



Hypertrophic Cardiomyopathy and the Hypertrophic Cardiomyopathy Association

While it is true that nearly 40% of the cardiac deaths on the playing field are from HCM,4 it is not only athletes who die young from this disease, they simply capture the headlines in a striking fashion. The advances in public access automatic defibrillation (AED) have increased the occurrences of out-of-hospital resuscitation and the opportunity to bring those with sudden cardiac arrest from all causes, including HCM, to medical attention and treatment with implantable defibrillators. The efforts of AED advocates and public access defibrillation programs (PADs) should be commended. However, AED placement and appropriate utilization in the HCM population should not be viewed as the best manner in which we identify young patients. The Hypertrophic Cardiomyopathy Association (HCMA) works with families, patients and the medical community in providing advocacy, education, and support.



Spotlight Interview: Methodist Hospital

What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab? We have three EP Labs: one single-plane lab, one biplane lab and one Stereotaxis lab. We perform about 1,200 cases a year. We have eight regular staff members and two supplemental, all of whom are nurses (except for one technologist).

When was the EP lab started at your institution?

The EP Lab was started here in 1994. 

What types of procedures are performed at your facility?

We perform diagnostic EP studies, all types of ablations, and all types of device implants, including BiVs and lead extractions.

What is the primary goal of your program (AF ablations, lead extractions, BiVs, etc.)?



CMS Proposes Dramatic Cuts in Reimbursement to Hospitals: An Editorial

Earlier this year, the Centers for Medicare and Medicaid Services released its Fiscal Year (FY) 2007 Inpatient Proposed Rules for public comment. The proposed changes would affect both the current Diagnosis Related Group Weighting Methodology and the Patient Classification System in the Inpatient Prospective Payment System. While the official period ended on June 12, it did not happen without significant response from the medical community at large including just about every society involved with the provision of cardiac care.  The major reasons for the dramatic opposition to the proposed rules are threefold:  First, as detailed in the analysis provided by The Health Economics and Outcomes Research Institute of the Greater New York Hospital Association, the proposed reimbursement methodology for cardiac devices including AICDs, pacemakers, stents and cardiac valves, is flawed.



Back Pain in the Cath/EP Lab: My Experience

At first, it was just a general soreness in my lower back at the end of the day. However, I was young and did not think it was anything to be concerned about. Back then, I thought my new job in the cath lab was the best thing that had ever happened to me. I envisioned a long and exciting career in a field that I loved. As it turned out, that career was much briefer than I could have imagined. As a former Emergency Medical Technician, I was drawn to the cath lab by the fast pace and excitement that it offered. In 1991, my career started at Boston Children's Hospital as a cath lab technician. Anyone who has worked in a pediatric cath lab can attest that it is among one the most exciting and fast-paced environments in interventional cardiology. Back then, the lead aprons that we wore were a bit heavier than they are now, and were not ergonomically designed. The pediatric cath lab procedures would often times last many hours. A simple hemodynamic case could last two to four hours.



Email Discussion Group: August 2006

New Questions:

Job Description: RCIS in EP Lab

I'm presently a member of a dedicated EP team with a job description for our Cardiac Cath Lab. Does any lab presently have a job description for an RCIS in the EP lab? I would appreciate any input. Thanks! Christine J. Reoch, RCIS, St. Mary's Hospital, Richmond, Virginia (Readers, to reply to this question, please type RCIS in the EP Lab in your subject line.)

Quality Assurance