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Cardiologists at Florida Hospital’s cardiac catheterization lab in Orlando know exactly how much their work matters by the number of lives they save.

The lab performs about 750 emergency angioplasties a year, let alone the thousands of other catheter-based interventions and non-emergent balloon angioplasties, where a balloon is placed to open a blocked coronary artery.

For patients that undergo a heart attack, especially a large one known as an ST-elevation myocardial infarction (STEMI), the medical team has 90 minutes to regain their blood flow or the patients will likely die.

“We want to stop the damage from happening to the heart muscle, and every minute that goes by, the more damage you’re allowing to happen,” said Danielle Johnson, RN, assistant vice president of cardiovascular services for Florida Hospital.
Beginning in January, Florida Hospital began staffing its cardiac cath lab 24 hours a day, seven days a week. Before that, the lab had about 24 hours from Thursday night through Sunday when it only had on-call cardiologists.

The extended hours make Florida Hospital the only facility in Central Florida to staff its cath lab around the clock. Based on the mortality rates over the past several years, any improvement in response time will likely save additional lives.

The hospital has stepped up operations of its cath lab since 2002 when it created a system of airlifting patients quickly by helicopter from any of Florida Hospital’s Central Florida locations to the cath lab in Orlando. Before that time, 13 percent of all patients who presented to the hospital as having a heart attack died in the hospital. Last year, the mortality rate was 3 percent.
“Seventy-five patients are alive every year celebrating an anniversary or a birthday with their family who wouldn’t be here today if we hadn’t put that process in place.” Johnson said.

Catheter-based procedures are performed by inserting a long, thin tube into an artery in the groin that travels up toward the heart. In the case of balloon angioplasty, the tube has a tiny balloon at the end, which is inflated at the blockage site to compress the plague on the artery wall. Following a balloon angioplasty, patients can normally return home in 24 hours.

A similar catheter can also be used to insert a stent, which acts like a support or scaffold in the artery. When doctors get inside the artery with a catheter, it may reveal the need for other interventions such as bypass surgery or open-heart surgery.

For Douglas Dychko, a 59-year-old who had a heart attack in January, Florida Hospital’s cath lab made all the difference. Dychko arrived at another Florida Hospital and was airlifted to the cath lab. Because of the quick intervention, he fully recovered.

“I’m so glad to be back to living my normal everyday life,” Dychko said.
Providing timely access to heart attack patients remains a challenge across America, said Dr. Alice Jacobs, president of the American Heart Association, noting that coronary artery disease (CAD) affects 1.3 million Americans, making it the most common form of heart disease.

Out of roughly 5,000 acute care hospitals in the United States, there are about 1,700 cath labs. Fewer than 1,300 cath labs perform percutaneous coronary intervention (PCI).

“Although PCI is the preferred treatment for STEMI patients if it is performed rapidly at experienced centers, it’s not widely available,” Jacobs said.

The AHA is currently conducting a survey to find out just how many cath labs are staffed 24 hours a day, seven days a week like Florida Hospital’s.



April 2008

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