Dear Editor,

I appreciated the Cath Lab Digest November 2005 article, Recruitment and Retention: A Cath Lab Perspective by Dennis Holloway and found it to be very accurate, based on my experience in the cath lab. Working in a variety of cath labs over an 8-year period, I've found that very few managers/supervisors/directors are proficient in these skills. I've since moved on to an industry job, but I often think fondly on my time spent as a cath lab tech. One of the contributing factors to my departure from the lab was a lack of motivation. I staved this feeling off for several years by throwing myself into any new technology or program that came along. In the end, it came down to lack of advancement opportunities within the cath lab that led to my departure. Most labs I worked in had a nurse manager, and that was it. I yearned for more lead tech?...lab supervisor? ...education coordinator? These positions were few and far between, if they existed at all.

One quick point on recruitment; it is a very difficult process. However, there are several programs that train specifically for the cath lab. I know because I went to and graduated from one: Geneva College's Program in Cardiovascular Technology (accredited) (Beaver Falls, PA). Students attend three years of undergraduate classes, taking the necessary prerequisite courses (physics, chemistry, A&P, etc.). After three years, the students then go to Fairfax Hospital in Falls Church, Virginia, for 3 additional semesters of clinical and didactic training. When it’s all said and done, students come out with a bachelor’s degree and a professional certificate in cardiovascular technology (CVT), not to mention ACLS and BLS credentials, among others. This program has been putting out formally educated, trained, and certified cath lab technologists for over 20 years. Schools such as this one would be an excellent source for recruitment. I know of a few other programs/schools that also train specifically for the cath lab, although most are associates programs. Geisinger Health System also has a very good program. Please see the following link to Geneva's Program in Cardiovascular Technology: http:// www.geneva.edu/object/bio_cvtech.html

Kind Regards,
Chad Eicher RCIS, BS, MS
Cardiovascular Clinical Specialist, Marketing
MEDRAD, Inc.
CEicher@medrad.com

Dear Editor,

I am writing regarding the book chapter, Functional Assessment of Coronary Artery Disease, edited by Watson and Gorski, and reprinted in the September 2005 Cath Lab Digest, vol. 13, no. 9. The chapter has a definite error in the section which describes the DEFER trial and FFR (page 12 of the September issue). Angioplasty in this trial was performed as planned in patients with an FFR < 0.75, not > 0.75.

Thank you,
Debbie Kuehne, BS, MT, ASCP
Clinical Science Liaison
KAI Pharmaceuticals, Inc.
debbie.kuehne@kaipharma.com

The author responds:

Dear Debbie,

Thank you for pointing this out. The sentence you refer to should correctly read as follows:

If the FFR was > 0.75, they were randomized to either deferred angioplasty (91 patients) or performance of angioplasty (90 patients). If the FFR was found to be < 0.75, angioplasty was performed as planned (144 patients).

The intent of the DEFER study was to find out if there was any benefit to performing a coronary intervention on a patient with an angiographically significant lesion, and a relatively new physiologic measurement (Fractional Flow Reserve). In previous correlation studies, an FFR of < 0.74 was uniformly associated with abnormal stress tests.

Invasive Cardiology: a Manual for Cath Lab PersonneI 2nd Edition took three years to put together. A number of people were involved in reviewing the chapters, and I personally wrote the section related to FFR. I offer my apologies to readers of CLD and our textbook for overlooking this typographical error.

Kenneth A. Gorski, RN, RCIS, FSICP
Assistant Manager, Sones Cardiac Catheterization Laboratories
The Cleveland Clinic Foundation Cleveland, Ohio
gorskik@ccf.org