Issue link: https://viewer.e-digitaledition.com/i/254272
highest level of integrated cardiac care, from diagnostics to treatment. Based at Charlton Memorial Hospital, the team of all-board- certified electrophysiologists at Southcoast Hospitals' Cardiac EP Lab offers 24/7 comprehensive inpatient and outpatient diagnostic and treatment capabilities for cardiac arrhythmias. Standard noninvasive testing, including echocardiograms, electrocardiograms, Holter monitoring and treadmill tests, identify underlying conditions. To confirm a diagnosis of arrhythmia, Southcoast electrophysiologists conduct an EP study, during which they guide electrode catheters into the heart via the veins. These catheters measure the heart's electrical activity and can stimulate areas of the heart to induce arrhythmia for analysis. Atrial fibrillation ablation, cardiac resynchronization, drug therapies, as well as pacemaker and defibrillator implants can all be used to keep the heart beating normally. Full-service Center When patients present with signs of circulatory insufficiency, Southcoast Hospitals' interventional cardiology program offers comprehensive diagnostic and treatment modalities, highlighted by innovative technologies and techniques to locate and treat blocked arteries, from elective angioplasty to innovative ventricular assist devices. Patients whose hearts are too weak for standard interventions may benefit from an innovative temporary percutaneous left ventricular assist device that supports ventricular function. For example, when a patient suffering from myocardial infarction arrives at the hospital in cardiogenic shock, interventional cardiologists at Southcoast Hospitals could use an Impella LD pump to restore cardiac output and reduce strain on the heart. Through a catheter inserted into the groin area, interventional cardiologists thread the Impella LD pump to the left ventricle, explains Mitchel Sklar, MD, FACC, FSCAI, Medical Director of the Cardiac Catheterization Laboratory at Charlton Memorial Hospital. The device is connected to a bedside console that monitors function. Its 5-liters-per-minute output does not take over circulatory function for the weakened ventricle, but it does offer critical support that reduces ischemia and encourages healing. "This device offers a higher level of support than any we previously had available," Dr. Sklar says. "It increases survival rates over the first hours or days of a cardiac event and enables high-risk, complicated interventions on patients who might not have previously tolerated them due to the weakened condition of their hearts." Precise Timing Southcoast treats 150 ST-elevation myocardial infarctions (STEMIs) per year, Dr. Sklar estimates, making it the fourth busiest STEMI center in the state. Even with invaluable assist devices at their disposal, interventional cardiologists at Southcoast know that the most important tool they have is time. When patients initially feel the chest tightness and shortness of breath associated with a heart attack, or STEMI, it's imperative they get to the hospital immediately so interventional cardiologists can remove blockages and restore circulation. Mitchel Sklar, MD, FACC, FSCAI, Medical Director of the Cardiac Catheterization Laboratory at Charlton Memorial Hospital N O N S U R G I C A L E X P ERTI S E Some cardiac patients are unable to tolerate open-heart surgery. For them, treating complex coronary, congenital heart, connective tissue and valvular disease requires a different approach. Cardiac surgeons work with Adam J. Saltzman, MD, who leads the Structural Heart Program, to offer minimally invasive procedures for patients who can't tolerate open surgical procedures, as well as therapeutic options for those patients who are not candidates for surgery. The collaborative Structural Heart Program brings together physicians from various cardiac specialties to determine effective treatment plans for individual patients. Advanced technology — currently available in one hybrid operating room with another under construction — enables physicians to perform procedures that would be impossible in normal operating rooms. M D N E W S . CO M ■ MD NEWS Greater Boston | 7