EP Lab Digest - September 2007 - (Page 10)

10 SPOTLIGHT INTERVIEW SEPTEMBER 2007 Spotlight Interview Morristown Memorial Hospital (Updated!) Jay H. Curwin, MD, Robert F Coyne, MD, Jonathan S. Sussman, MD, and Stephen L.Winters, MD . Morristown, New Jersey orristown Memorial Hospital was the first EP lab to be featured as a Spotlight Interview in EP Lab Digest’s inaugural September 2001 issue. We check back in with them after six years to get an update on their lab and staff. M What is the size of your EP lab facility and number of staff members? What is the mix of credentials at your lab? The cardiac rhythm management program at Morristown Memorial Hospital has grown from one lab with a single cardiac electrophysiologist and three full-time staff members to a full-service cardiac rhythm management team, comprised of four board-certified electrophysiologists, a physician assistant, three full-time technologists, nine nurses, an office manager and four office staff members. In addition, we work with a full-time cardiac research nurse coordinator and a team of dedicated cardiac research nurses. implantations (including resynchronization devices), cardioversions and tilt table testing. The complication rate is extremely low and compares to that of other outstanding laboratories on both a local and national level. Our success rate with catheter ablation procedures is very respectable as well. electrophysiology laboratory and the interventional cardiac catheterization laboratory has not been encouraged, to enable a higher degree of concentration and focus on patients with cardiac rhythm problems.The rhythm management team is dedicated to the clinical care, education, and support of the patients treated, as well as participation in continuing education and clinical research. How is your EP lab managed, and by who? Is the EP lab separate from the Cath lab? Are employees crosstrained? Do you have cross-training inside the EP lab? Our laboratory has a full-time physician director as well as a nurse coordinator. The electrophysiology laboratory is a separate entity from the cardiac catheterization laboratory, although our staff and physicians work closely with members of the catheterization laboratory. Some of the electrophysiology laboratory employees have had cardiac catheterization laboratory experience. Our nurses have also had prior cardiac care or subacute cardiac care unit experience. However, cross-training between the cardiac What new equipment, devices and/or products have been introduced at your lab lately? Is your EP lab filmless, or does it plan to become filmless in the foreseeable future? The facility that housed the original electrophysiology laboratory was originally the hospital's radiology special procedures room. The area then served as the first diagnostic and interventional cardiac catheterization laboratory. In 1991, the space was renovated to become the electrophysiology laboratory. For the first five years, the radiology equipment included a non-mobile Siemens image intensifier in conjunction with a "cradle" designed table, which was more than a decade old. In 1997, a modern, single-plane GE pulsefluoroscopy system replaced the nearly two-decade-old system. In 2005, we moved down the hall to the Huff Family Electrophysiology Laboratory, a beautiful new room with a flat panel GE fluoroscopy system. This summer a second laboratory opened, with a Siemens flat panel biplane system. In the interest of radiation safety, the staff typically operates the radiologic equipment with the lowest output and at a relatively slow pulsing rate. There are strict regulations for monitoring the dose (DAP) during procedures and notification mechanisms for preventing excessive exposure to patients, as well as to the staff. In addition, we continue to receive a mandatory annual review of appropriate use of fluoroscopy from the hospital’s radiation safety officer. Over the years,equipment has been added on an ongoing basis. Biosense Webster’s CARTO mapping system has been very useful in the performance of complex ablations for atrial flutter, atrial tachycardia, accessory What types of procedures are performed at your facility? We perform comprehensive electrophysiology studies, radiofrequency ablations for both ventricular and supraventricular tachycardias, including atrial fibrillation, pacemaker and cardioverter-defibrillator pathways, atrial fibrillation and ventricular tachycardia. A GE NT CardioLab upgrade replaced the pre-existing computer-based physiologic recording system. We use two Bloom stimulators and Stockert radiofrequency generators. Images can be stored via a high-definition video system or directly on the Prucka system. Our CardioLab recordings are networked and can be retrieved in remote locations in the hospital. Our intracardiac Acuson ultrasound system has enabled safer performance of procedures that entail left atrial and pulmonary vein mapping and ablation. Presently, we have two electroanatomic mapping systems with the latest upgrades inclusive of CT merge, the newest integrated Acuson ultrasound mapping package, and Complex Fractional Atrial Electrogram (CFAE) detection software. Biosense Webster’s CARTOMERGE system has been used extensively in our ablations for atrial fibrillation, and along with the EsophaStar probe is used to delineate esophageal position during these procedures. We also have incorporated Biosense Webster’s THERMOCOOL irrigation catheter system at times to help ensure high success rates and maximum safety during ablation procedures. Who handles your procedure scheduling? Do you use a particular software? All procedure scheduling is performed via the main clinical office, located adjacent to the physicians' hospital-based offices and exam room in the hospital.A full-time office manager and secretaries are responsible not only for scheduling, but for report editing and dissemination, patient instruction, and coordinating activities among the various staff members as well as between the staff and the hospital.We had relied upon a manual scheduling mechanism together with fax machines, but have now begun to use the Office Hours Professional appointment scheduler software. Figure 1. These are just some of the members of our team. Seated are Roberta Prisco, RN, Karen Quinlan, CVT, and Sherri Raquet, RN. Standing are Jay Curwin, MD, Robert Coyne, MD, Yana Abkin, CVT, Stephen Winters, MD and Keri Spiegel, PA. What processes does your lab use for pulling sheaths post-diagnostic and interventional procedures? How does your lab handle hemostasis?

Table of Contents Feed for the Digital Edition of EP Lab Digest - September 2007

The ICD Shock and Stress Management Program: Interview with Samuel F. Sears Jr., PhD Universal ECG Screening: The Advocate’s Perspective Contents Letter from the Editor Spotlight Interview: Morristown Memorial Hospital 10-Minute Interview: About the Mended Hearts and Mended Little Hearts Organizations ICD Patient Support Groups Email Discussion Group: September 2007 Technology: Only As Good As the Attitude Behind It! Electrophysiologic Management and Treatment of Chronic and Acute Cardiac Device Infection First Annual EP Lab Digest Salary Survey Events Calendar Industry News and Products

EP Lab Digest - September 2007

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