Tell us about your cath lab.

Orlando Regional Medical Center (ORMC) is the only Level I Trauma Center in central Florida. It is the flagship hospital for Orlando Health, an eight-hospital organization. ORMC recently received full accreditation from the Society of Chest Pain Centers’ Accreditation Review Committee. We are the first Level I Trauma Center in Florida to receive this designation.

The first cardiac catheterization was performed at ORMC in the mid-1960’s by Dr. Clarence Gilbert. We currently have six state-of-the-art cardiac cath labs. Four of our labs are dedicated

Can you describe the EXCEED trial and its purpose?

There are two components of the post-marketing evaluation of Abbott’s Xience V stent. First is the Xience V USA program, which is looking at long-term clinical outcomes in about 8,000 patients. Supplementing that study is the EXCEED trial, a real-world trial looking at how cath labs and physicians are using the Xience V stent in real practice. Specifically, EXCEED studied the acute performance of the stent and resource utilization in the cath lab in patients receiving the Xience stent.

What we mean by ‘acute’ is really the p

The American College of Cardiology’s Annual Scientific Session will be in Atlanta this March. Tell us about the launching of the radial lounge at Saint Joseph’s, planned for the beginning of the meeting.

Dr. King: Saint Joseph’s has made a commitment to develop a comprehensive system for transradial patients with same-day discharge to ensure safety, comfort and hopefully, cost savings. Under the direction of Dr. Jack Chen, we are developing a post procedure radial lounge. After prep, the patient has the cath and then, if needed, intervention. Once the procedure is comple

As America’s waistlines grow, there is an escalating rate of cardiac disease. With it comes the ever-increasing problem as to how to perform standard cardiac catheterizations on these patients. In Pennsylvania alone, 27.1% of the population was found to have a body mass index (BMI) greater than 30, according to a 2007 Centers for Disease Control and Prevention (CDC) survey.¹ The difficulty in performing these procedures arises from the percentage of patients who are morbidly obese and exceed standard weight limits on catheterization tables. At Geisinger Medical Center in Danville,

We changed the daily tour of duty for our cath lab team. Instead of 10-hour days with one shift to run 2 labs, we split overlapping 8-hour shifts. This brought up the question, “Exactly how many people (and what kind of training) should you have to do a cardiac cath?”

The answer to this question depends on several factors. Decisions for more or less staff will mostly depend on what type of case, such as interventional vs. diagnostic cath, elective vs. emergency, and what type of practice (private vs. university training hospital) as well as state regulations for hospitals. Although I

Tell us about Saint Thomas’ two separate cath lab facilities.
We have an 8-room interventional cath lab located in the hospital between our emergency department and medical imaging, and a separate one-room outpatient diagnostic cath lab also in the hospital, just across the hall from the hospital interventional cath lab. We usually run about 5 or 6 rooms in our regular cath lab, and do 30-35 cases per day. From December 1, 2008 through November 30, 2009, in our hospital cath lab, we did 5,842 diagnostic caths and 3,098 interventions. The outpatient cath lab does anywhere from 8 to 13

Dear Dr. Mehta,

I enjoyed your STEMI article in the December Cath Lab Digest. I found the ten commandments to improve the STEMI process very interesting. I would like to ask you to elaborate on #7 - Make that critical second call to the nurse in the CVL.

Thank you,
Kristine McMurtrie, RN, MSN,
Director, Invasive Cardiology
Lehigh Valley Hospital -
Cedar Crest
Allentown, PA
kristine.mcmurtrie@lvh.com

[Editor's note: Read the December 2009 interview with Dr. Mehta at http://tinyurl.com/CLDSINCERE]

Dear Kristine,

Thank you for your kind note and for you

Patient History at Presentation
A 59-year-old man was referred to California Pacific Medical Center for treatment of decompensated heart failure. The patient had a past history of ischemic cardiomyopathy, implantable cardioverter defibrillator (ICD) implantation, five-vessel coronary artery bypass graft (CABG) surgery in 1997, insulin-dependent diabetes mellitus, tobacco dependence, and chronic atrial fibrillation on anticoagulation therapy. The patient’s ejection fraction was <15% and he was on home intravenous dobutamine therapy. A coronary angiography, performed at the referring h

“HELP! I am new to the cath lab. When I took the ECG class that my hospital required, I was very confused about heart blocks and understanding which one is which. I have 5 people giving me their opinions about the best way to learn and memorize these. Any suggestions?”
– Cath lab employee, Mississippi

I can certainly appreciate your situation. As I was undertaking my paramedic training 29 years ago, I had the same difficulty. Nothing really sunk in and I had a hard time getting it. I obtained my training at Mary Greeley Medical Center in Ames, IA. One of my preceptors

For those of us who have been working the cath lab circuit for several years, you may have noticed that we no longer operate in a cave. Some may liken this to “flying above the radar.” Whatever the metaphor, the cath lab, like all other departments, has come under intense scrutiny for several reasons. Chief among these is finances. As dollars dwindle, hospital finance departments are looking very closely at departments that have, until recently, operated in a vacuum of sorts. Administrators rarely came to the cath lab except for Joint Commission inspections or the occasional “feces hitti