Baptist Heart Specialists Program Report

Connecting with heart Optimizing outcomes for patients throughout the region.

Cardiovascular Program Report

Anchored by Baptist Heart Hospital, the region's only freestanding hospital for heart and vascular care, Baptist Health delivers an unmatched range of services to help people with heart conditions live their lives to the fullest. Our dedicated cardiology group, Baptist Heart Specialists, provides innovative, patient-centered care at convenient locations throughout the community.

Comprehensive services

10

Baptist Heart Specialists locations throughout the region

Innovative treatments

28

enrolling clinical trials

Care with heart

64,974

patients treated in fiscal year 2021

The talented group of physicians at Baptist Heart Specialists, and other physicians providing care at our Baptist Health hospitals, are independent professionals and not employees or agents of our hospitals.

Table of contents WELCOME AND OVERVIEW 3

Message from our system leadership

4

Message from our chair

5

Message from our administrator

COMPREHENSIVE SERVICES 6 Structural Heart Program is changing lives of patients and families 10

A new outlook on life

12

Advancements in cardiac imaging

16

‘Like day and night’

18

Unique support in the Congestive Heart Failure Clinics

20

Don’t live with the exhaustion

INNOVATION 22

New Heart Rhythm Center

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A lot to live for

26

A modern approach to treating peripheral vascular disease

28

Enabeling innovation through interventional cardiology

30

On the leading edge thanks to clinical trials

CARE WITH HEART 36

Facing COVID-19 with preventive cardiology

ABOUT US 38

Our physicians

40

Office locations

42

Connect with us

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WELCOME AND OVERVIEW

Message from our system leadership At Baptist Health, we are committed to providing comprehensive heart care that is unmatched in our community in terms of quality, innovation and expertise.

Michael A. Mayo, DHA, FACHE

Our dedicated cardiology group, Baptist Heart Specialists, brings the full spectrum of cardiovascular care closer to home for patients living throughout the region. This top-performing team uses a multidisciplinary approach to advance innovative treatments, improve patient outcomes and increase satisfaction among referring providers.

As we reflect on the passion and many accomplishments of our cardiovascular program at Baptist Health, we look forward to a future that is even brighter in terms of improving lives!

Michael A. Mayo, DHA, FACHE President and CEO, Baptist Health

Matthew A. Zuino, FACHE

Matthew A. Zuino, FACHE

Executive Vice President and Chief Operating Officer, Baptist Health Timothy G. Groover, MD, MBA, CPE, FACHE

Timothy G. Groover, MD, MBA, CPE, FACHE Senior Vice President and System Chief Medical Officer, Baptist Health

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WELCOME AND OVERVIEW

Message from our chair At Baptist Heart Specialists, our patients are always our No. 1 priority.

Providing the best treatment for our patients starts with empathy and compassion, followed by the latest innovations in science and technology.

Each individual we see is unique, which is why every patient will receive a customized plan that is personalized to their care.

Ruby Satpathy, MD, FACC, FSCAI

Almost every day, we meet patients who have been told there are no other options for their heart condition. When first seeing these patients, we remind ourselves – what would we do if they were one of our family members? Because of the comprehensive cardiovascular program at Baptist Health, we can offer excellent care to our patients, from prevention to intervention.

That’s the most rewarding part of what we do – adding quality of life to our patients’ years.

Ruby Satpathy, MD, FACC, FSCAI Interventional Cardiologist Medical Director, Baptist Structural Heart Program Chair, Cardiology Board

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Message from our administrator To provide the best experience for our patients, access to quality cardiovascular care is essential. At Baptist Heart Specialists, we are increasing access by growing our locations and expanding our team of experts.

In 2021, a Baptist Heart Specialists clinic opened at Baptist HealthPlace at Nocatee (pictured above), bringing additional prevention, diagnosis, treatment and cardiac rehabilitation services to St. Johns County. In late 2022, we are expanding our presence in Clay County, as the new fullservice hospital opens at Baptist Medical Center Clay. In early 2023, we will celebrate the opening of the Heart Rhythm Center at at Baptist Heart Hospital for the diagnosis and treatment of heart rhythm disorders.

Tyrone Stewart, MBA

We are proud of this continued growth, bringing additional access to comprehensive cardiovascular care throughout our region.

Tyrone Stewart, MBA

Administrator, Baptist Heart Specialists

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STRUCTURAL HEART

Groundbreaking program changes lives of patients and families

Celebrating six years of “treating the untreatable” Baptist Health launched its innovative Structural Heart Program and Valve Clinic in March 2016, where patients with complex valve conditions receive heart testing and consults from multiple specialists in one place, often within one day.

Baptist Heart Specialists interventional cardiologist Ruby Satpathy, MD, FACC, FSCAI, was instrumental in launching the Structural Heart Program. Before joining Baptist, Dr. Satpathy performed the first minimally invasive aortic valve replacement and mitral valve repair in Nebraska in 2012 and 2013, respectively, and served as the National Director of Transcatheter Valve Therapy for all Catholic Health Initiative (CHI) hospitals across the country. In her current role as a national expert, she continues to help write the guidelines for mitral regurgitation and

Ruby Satpathy, MD, FACC, FSCAI

Interventional Cardiologist Medical Director, Baptist Structural Heart Program, Chair, Cardiology Board

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Siddharth Wayangankar, MD, FACC, FSCAI, RPVI Interventional Cardiologist; Medical Director, Peripheral Vascular Program

minimally invasive valve therapies in collaboration with the American College of Cardiology (ACC), Society for Cardiovascular Angiography & Interventions (SCAI), the Society of Thoracic Surgeons (STS), as well as CMS and the FDA. Siddharth Wayangankar, MD, FACC, FSCAI, RPVI, joined Baptist Health in 2020 and brought his extensive experience from Cleveland Clinic in Cleveland, Ohio, and has added an extra dimension to the Baptist Structural Heart Program. He is an international proctor for minimally invasive valve therapies and a national faculty for training courses for cardiologists and cardiology fellows across the nation. Within the southeastern U.S., he has helped start more than 15 structural heart programs and has more than 200 citations for his research within the cardiovascular field.

“I believe innovation is the key to providing expert care to my patients and knew I wanted to join a system that places emphasis on advancing the field of cardiology with research and clinical trials,” said Dr. Wayangankar.

Transforming structural heart care through innovation For years, structural heart disease was treated with conventional open-heart surgery, resulting in lengthy hospital stays and recovery times.

Betty Sanders, 90, always enjoyed an active social life with family and friends. But when mitral regurgitation caused her to easily become out of breath in 2016, she visited the Baptist Valve Clinic, where the team recommended a MitraClip™ procedure. Betty was the first patient at Baptist Health, and first in the region, to receive the MitraClip™ to close her leaking mitral valve.

She was thrilled to be actively socializing again within a week after the procedure. Pictured: Sanders at a follow-up visit with Ruby Satpathy, MD, FACC, FSCAI, and Stephanie Hembach, ARNP.

Today, advances in cardiovascular imaging capabilities, catheter-based techniques and the development of innovative devices through clinical trials have transformed the field of structural heart and created minimally invasive treatment options for patients who previously had none.

• Left Atrial Appendage Occlusion (LAAO) (WATCHMAN™/Amulet™)

“Now we have the ability to ‘treat the untreatable’ using these minimally invasive procedures, and our patients can start feeling better right away,” said Dr. Satpathy.

• Transcatheter Mitral Valve Replacement (TMVR®/ Mitral VIV)

Baptist Heart Specialists is at the forefront of cardiovascular innovation, offering groundbreaking treatment options including:

• Transcatheter mitral valve repair (MitraClip™) • PVL closure (Paravalvular leak) • Transcatheter Aortic Valve Replacement (TAVR™)

“Transcatheter therapies have revolutionized clinical medicine and practice in a huge way.

We at Baptist are leading this change,” said Dr. Wayangankar.

• Alcohol septal Ablation (HOCM) • Transcatheter closure (ASD/PFO)

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From left to right: The Structural Heart team includes Shreya Ghetiya, MD; independent physician John Pirris, MD; Siddharth Wayangankar, MD, FACC, FSCAI, RPVI; Praveen Kanaparti, MD, FACC, RPVI; Ruby Satpathy, MD, FACC, FSCAI; Salvatore DiLoreto, MD, FACC and independent physician Nathan Bates, MD. Alejandro Pena, MD (not pictured above; pictured on pg. 9).

Leading the way in high-risk heart valve repair Baptist Health is often the first and/or only system in the region to offer leading-edge technologies and serves as a national training site for new learners. Some of the cardiovascular “firsts” in our region include: • First to bring transcatheter mitral valve repair (MitraClip™) to the region for high-risk patients with congestive heart failure and mitral regurgitation.

• First in Jacksonville to perform a TAVR™ procedure using conscious sedation and no groin incision, which makes recovery easier for patients and reduces their hospital stay to only one or two days.

• Only comprehensive LAAO program in the Jacksonville area to offer both FDA-approved devices for LAAO (WATCHMAN™ and Amulet™).

• First Transcatheter Mitral Valve In Ring procedure (TMVIR) in Florida (see sidebar on page 9).

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• First in the state and second in the country to perform procedures as part of the Amulet IDE and CATALYST trial.

• One of the first centers in the Jacksonville area to perform a transcatheter mitral valvein-valve procedure (TMVIV).

Weekly multi-disciplinary valve conference A key differentiator of the Structural Heart Program is a weekly valve conference where a multi-disciplinary team of interventional cardiologists and cardiothoracic surgeons meet to review the unique aspects of each case and determine the best care plan for the patient.

“Our team at Baptist Health consists of talented physicians of many different disciplines who come together to determine the best treatment options for our patients through collaborative conferences,” said Dr. Satpathy.

First TMVIR in Florida

STRUCTURAL HEART

Since the inception of the Structural Heart Program in 2016, more than 1,000 procedures have been completed at Baptist Health, with better outcomes than national medians. “For successful outcomes, every step from the first clinic visit to post-surgery follow up is important. I am proud that we have the best outcomes in our region because of our team’s collaboration, experience, expertise and skills,” said Dr. Satpathy.

Advancing care locally, nationally and internationally Drs. Satpathy and Wayangankar are key participants in research studies that lead to the approval of many new devices and are often among the first in the nation to deploy these devices in structural heart procedures.

Both cardiologists spread their knowledge and expertise as national and international proctors for TAVR™. Dr. Satpathy is also a proctor for MitraClip™, WATCHMAN™ and Amulet™.

Some of the most recent clinical trials in structural heart diseases at Baptist include: • AMULET ™ LAAO vs. NOAC (CATALYST Trial) • Impella® in STEMI – Door-to-Unload • TAVR™ in Moderate AS • TAVR™ and CAD • WATCH-TAVR™ • TMVR (Apollo), anticipated clinical trial “I believe that every life deserves the best care and we at Baptist Health are proud to be able to provide the same for our patients,” said Dr. Wayangankar. “Our team believes in contemporary and innovative medicine, and we have the skills and the belief to provide this to our community.”

Frequently invited as a national speaker on structural heart, Dr. Satpathy recently performed a live case for the Cardiovascular Research Technologies (CRT) conference in Washington, DC, which was broadcast virtually from the Hybrid Structural Lab in Baptist Heart Hospital to teach an international crowd of interventional cardiologists.

Pictured: Dr. Satpathy (operator, right) and Dr. Pena (echocardiographer, left).

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI (left), and independent physician Nathan Bates, MD (right).

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI, interventional cardiologist, Baptist Heart Specialists, and independent physician Nathan Bates, MD, cardiac and thoracic surgeon and chief of cardiac surgery, Baptist Medical Center Jacksonville, performed the first Transcatheter Mitral Valve In Ring procedure (TMVIR) in Florida following FDA approval of the procedure. TMVIR is used to fix failing mitral valve repairs (prior mitral valve surgical repair with a ring) in patients where a second open-heart surgery is considered too risky.

“These procedures require extensive planning, multispecialty, collaborative strategies focused on preprocedural planning, imaging guidance during the procedure and extensive skills,” said Dr. Wayangankar. “We are lucky to have a group that provides all of this and makes such technically challenging cases possible.”

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STRUCTURAL HEART

A new outlook on life

Baptist Heart Specialists take patient from ‘on the way out’ to ‘on the mend.’

trouble doing everyday activities, despite optimal medical therapy.

Liniado stated, “I was in gradual deterioration where you just kind of fade away. I'd had a stent implanted. I'd had a heart attack. I was so sick I could hardly walk to my mailbox, and I had to rest for hours after a shower. I just couldn't breathe.”

Stopping the leaks

Ralph Liniado, left, and his wife Ethel, were able to celebrate their 55th wedding anniversary thanks to his successful procedure at Baptist Heart Hospital.

The day before Ralph Liniado had surgery, his thoughts were about dying. Now he thinks about living.

For nearly 10 years, Liniado has been under the care of Baptist Heart Specialists cardiologist George Le-Bert, DO, chief of cardiology at Baptist Medical Center Nassau. During a recent visit, Dr. Le-Bert described his patient as having rapidly declining congestive heart failure.

Because his heart was having difficulty pumping enough oxygenated blood, Liniado was having

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Dr. Le-Bert determined Liniado's deteriorating condition was caused by mitral regurgitation (MR), the most common type of heart valve disorder. In Liniado's case, 60% of his blood was not flowing properly, which meant he wasn't getting the oxygen he needed. The leaks had to be repaired, and the answer was a MitraClip™ procedure.

MitraClip™ is a small, clip-based device that repairs MR without the need for open-heart surgery. In this catheter-based procedure, the device is delivered to the heart through a vein in the leg. It works by bringing together both leaflets of the mitral valve to reduce the backflow of blood, allowing the heart to pump blood more efficiently. Because it is a minimally invasive way to repair mitral valves, patients typically can ambulate within hours and usually go home the next day.

It takes a team Dr. Le-Bert knew the best place to send Liniado was the Structural Heart Clinic at Baptist Heart Hospital. So, he introduced him to Dr. Satpathy and Jenna Effron, PA-C. “From that moment on, I knew why Dr. Le-Bert said this was the best valve clinic and team in the country,” said Liniado. “The experience was so personal, thorough and professional, and the level of care was exceptional.”

Dr. Satpathy has been doing transcatheter mitral valve repair for more than 10 years and serves as one of the few international proctors for this procedure.

“This was the best option for Mr. Liniado with his other conditions,” said Dr. Satpathy. “Optimal outcome requires experienced and skilled operators, expert echocardiographers and a team of dedicated physicians, nurses and techs. We have all three, which has helped us to be a high-volume program with excellent outcomes.”

On the mend “I did a lot of research on the device. A lot of hospitals do this procedure, but if you don't have the very best team and doctor doing the procedure, your outcomes are not necessarily as good as mine.

There is no doubt I have the best team,” said Liniado. “I went from being on the way out to on the mend. Within hours after the surgery, I was walking around my hospital room in absolute amazement – no pain, no problems.”

“The procedure was a huge success. His leaky valve went from severe to a trivial amount. It's the best outcome possible.”

George Le-Bert, DO

Cardiologist, Chief of Cardiology at Baptist Nassau

“The procedure was a huge success. His leaky valve went from severe to a trivial amount. It's the best outcome possible,” said Dr. Le-Bert.

Just a couple of weeks after the procedure, Liniado said he was taking walks with his wife and doing more with his three grown sons and five grandchildren.

“I was diagnosed with heart failure and given five years to live about 14 years ago. Dr. Le-Bert is a wonderful, talented heart doctor. I'm still here, aren't I? All I can say is thank you to the Baptist team for such world-class care. I have a completely different outlook now.”

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CARDIAC IMAGING

Innovative new treatments rely on advanced cardiac imaging

Advanced cardiac imaging enables the accurate diagnosis and treatment of heart disease – and is absolutely vital to the growing number of interventional heart procedures requiring intraoperative imaging.

“The progress made in the last few years in the realm of cardiac imaging has distinguished our cardiovascular program from all of the rest,” said Ron Roberts, MHA, director of Cardiovascular Services, Baptist Health.

Cardiac MRI Cardiac electrophysiologists at Baptist Health who specialize in implanting defibrillators rely on the cardiac MRI team for advanced imaging.

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“Our ability to treat complex structural heart diseases has been transformed due to Praveen Kanaparti, continued innovation MD, FACC, RPVI Cardiologist, Director, Advanced Cardiac and acquisition of Imaging new knowledge in transcatheter valve therapies.

Advanced cardiac imaging is an integral and critical component of this process,” said Praveen Kanaparti, MD, FACC, director of advanced cardiac imaging.

“Precise assessment of anatomic details particular to each patient is vital for the success of these procedures. In addition, our ability to image myocardium and identify abnormalities at tissue level also has improved, thanks to advances in cardiac MRI,” said Roberts. “In the past three years, our volume has grown tenfold in this area, and the word is out that Baptist Health is the place to go for cardiac MRI.”

Cardiac CTA (computed tomography angiography), which combines a CT scan with an injection of dye, plays an important role in the Structural Heart Program at Baptist Health, especially when it comes to minimally invasive Transcatheter Aortic Replacement (TAVR™) procedures and other therapies.

In fact, Baptist Heart Hospital is one of only four heart centers in the state participating in a prestigious national clinical trial involving cardiac MRI and STEMI DTU (Door-to-Unload).

“For TAVR, a CTA helps our interventional cardiologists determine the appropriate type and size of the prosthesis and also helps predict and prepare for potential complications,” Roberts said.

Cardiac CTA

Praveen Kanaparti, MD, FACC, a cardiologist with Baptist Heart Specialists, is the director of advanced cardiac imaging.

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CARDIAC IMAGING

Ken Adams, MD, FACC Cardiologist

Andre Macedo Dias, MD Cardiologist

Shreya Ghetiya, MD

Cardiologist, Co-Director, Echo Program

J. H. “Houston” Mooney, MD Cardiologist

Alejandro Pena, MD Cardiologist

Recently, the American College of Cardiology and the American Heart Association assigned a Class 1A status to coronary CTA for the evaluation of patients with chest pain and no known coronary artery disease.

Vascular ultrasound Vascular ultrasound imaging is an important component of evaluating and treating peripheral vascular disease (PVD), which can cause pain and poor circulation in the legs and arms.

Baptist Health has several highly trained cardiologists who specialize in peripheral interventions. This select group includes Siddharth Wayangankar, MD, Nayan Agarwal, MD, Salil Patel, MD, Bharat Gummadi, MD, Alejandro Pena, MD, and Nehu Patel, MD, for venous disease.

Dr. Wayangankar, a structural interventionalist, also performs minimally invasive endovascular carotid artery stenting, formerly a neurovascular procedure that crossed over to cardiology.

A CT scan can help cardiologists diagnose conditions associated with abnormal blood flow, like PVD. Deysi Marts, a lead CT technologist, operates a CT scanner at Baptist Medical Center Beaches.

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Echocardiography Alcohol septal ablation is an interventional procedure that helps treat patients with hypertrophic obstructive cardiomyopathy (HOCM).

Dr. Wayangankar is trained to perform this procedure and is the only one doing it in North Florida. These challenging HOCM procedures require echocardiography as well as cardiac MRI support.

A fellowship-trained cardiologist who is board certified in echocardiography, Shreya Ghetiya, MD, is experienced in transthoracic and transesophageal echocardiogram, including 3D image acquisition and interpretation in valvular and intra-procedural structural echocardiography. Her research has appeared in The Journal of the American College of Cardiology and The Journal of Geriatric Cardiology.

“I have a great interest in interventional echocardiography and take pride in being involved in intra-procedural imaging,” Dr. Ghetiya said.

Reaccredited by the Intersocietal Accreditation Commission (IAC) in echocardiography in the areas of adult transthoracic, transesophageal and stress.

J.H. “Houston” Mooney, MD, a cardiologist at Baptist Medical Center Nassau, specializes in echocardiography and cardiac CT imaging.

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CARDIAC IMAGING AND STRUCTURAL HEART

‘Like day and night’

Innovative heart procedure transforms woman’s life.

To Jennifer May, a medical supply warehouse employee, feeling exhausted after a hard day’s work is part of the trade. Outside of work, the Jacksonville native lives by the motto "work hard, play hard."

However, at just 40 years old, she noticed a flutter in her heart that made working her day job and living life to the fullest impossible.

“Unbelievably scary” episodes In Fall 2018, May developed palpitations and a feeling that her heart was pounding fast and was “going to burst” inside her chest.

She tried to ignore the sensation, but it worsened and began to impact her performance at work. After just a few minutes of standing, May felt short of breath and needed to sit down and rest.

“I had trouble sleeping,” May said. “I started to withdraw from my family because the feeling in my chest would give me such anxiety. It was unbelievably scary.”

After remembering the comprehensive care her niece received for a neuromuscular disorder at Baptist Health, May decided to self-refer to Baptist Heart Specialists.

“I trusted Baptist Health’s care,” May said. “I knew that I was going to be taken care of.”

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From evaluation to exceptional solution Working together, Electrophysiologist Aaditya Vora, MD, and Interventional Cardiologist Salil Patel, MD, FACC, met with May and ordered a full cardiac workup, including a stress test and an echocardiogram.

May was diagnosed with hypertrophic cardiomyopathy, a condition in which the heart muscle becomes abnormally thick, increasing blood pressure and making it more difficult for blood to be pumped throughout the body.

“This condition can put patients at risk of developing an irregular heartbeat or having a heart attack,” Dr. Vora said. “It’s critical for anyone who is young and experiencing symptoms such as chest pain, shortness of breath or a faster-than-normal heartbeat get evaluated by a cardiologist.”

Dr. Patel realized May required an exceptional solution.

“We didn’t want her to undergo an invasive heart procedure if she didn't have to, especially due to her young age,” Dr. Patel said. “We wanted to find a balance between alleviating her symptoms and subjecting her to an open-heart procedure.”

Jennifer May (right) and her husband, Brett (left), travel whenever they can to remind themselves that every day can bring a new adventure.

Alcohol septal ablation: an ideal option Dr. Patel referred May to Siddharth Wayangankar, MD, interventional cardiologist who offered May a state-of-the-art heart intervention called alcohol septal ablation to improve her blood flow.

“Ms. May did not want open-heart surgery to address her condition, making alcohol septal ablation an ideal option,” Dr. Wayangankar said.

During this procedure, patients are awake under twilight sleep while a catheter delivers 100% alcohol to areas where the heart muscle is too

thick. This causes the tissue to shrink and die, restoring blood flow and greatly decreasing symptoms.

Baptist Heart Hospital is one of a few in the country to offer this unique procedure.

“I feel free” After receiving her ablation, May said, “I feel so much better, I was back to myself just one day later,” May said. “I can finally sleep. I can exercise or walk without feeling fatigued or out of breath.

For the first time in four years, I feel free.”

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CONGESTIVE HEART FAILURE CLINIC

Unique support for patient care Baptist Health is the only health system in the region offering outpatient Congestive Heart Failure (CHF) Clinics.

The Congestive Heart Failure (CHF) Clinics at Baptist Health provide an outpatient treatment program for patients with a CHF diagnosis. This includes patients with coronary artery disease, heart attack, high blood pressure, damaged heart valves or heart muscle, congenital heart defects, arrhythmia and more.

Physicians can refer patients directly to the CHF Clinic for support in managing their quality of life issues, which can include the inability to sleep, shortness of breath and related respiratory problems. Patients receive a physical assessment at each visit.

“Each person is different with a unique story and individual needs,” said Russell Stapleton, MD, cardiologist and director of the CHF Clinics.

“At the CHF Clinic, our skilled team reviews the patients’ exercise ability, emotional status, diet and medication with the goal of achieving an optimum and individualized plan for each person.”

Patients are also taught how to recognize any escalating symptoms of CHF, so action can be taken early.

“The clinic helps our patients and their caregivers participate in improving their health and maintaining as healthy a life as possible,” said Andre Dias, MD, cardiologist with Baptist Heart Specialists. “Educating patients is integral to their success and helping to minimize the risk for future cardiac events.”

Back on track Wayne Poole, 69, credits the CHF Clinic for helping him turn his life around following surgery to put five stents in his heart.

FEWER READMISSIONS*

11.3% 21.9% BAPTIST HEALTH

NATIONAL AVERAGE

Percentage of patients readmitted between January – February 2021.

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A smoker for 61 years, Poole said that in the year of his life prior to surgery, he couldn’t walk from the den to his bedroom without losing his breath, and he couldn’t do much more than “sit around and do nothing.”

After surgery, he was referred to the CHF Clinic, where the team was able to help him mentally and physically recover.

“Initially you’re scared to think about recovery. You wonder if it’s worth it – this person wants you to

At the Congestive Heart Failure Clinic, coordinators like Jessica Saliba, APRN, work together with patients and their caregivers to design an individualized health plan.

run on a treadmill, ride a bike, lift weights? After a while, you see it’s definitely worth it!”

“Mentally, you see that the better your body functions, the less stress you have,” he said.

“Physically, if I knew I’d feel as good as I do now, I’d never have smoked a cigarette!”

The CHF Clinic helped Poole drop his waist size, adjust his diet to eat less sodium and more healthy food, quit smoking and drinking, and start an exercise routine he enjoys.

“I got up to 25 minutes on the treadmill and now I look forward to walking 30 minutes every morning,” he said.

Jacksonville resident Roger Bowes, 59, came to the CHF Clinic following a history of heart issues and repairs treated at other hospitals. His last surgery to implant a defibrillator took place at Baptist Health, where he felt a difference in the treatment he received.

“Baptist doctors care. They weren’t just trying to get me in and out quickly,” he said. “They have helped me get relief from a lot of my issues. I’m walking and talking, and I can go out and live life. I don’t have to stay home by some machine.”

Prior to surgery, his heart was operating at only 15 – 25% capacity. Following surgery and physical therapy at the CHF Clinic, he’s back on track to a better life.

“I don’t have to worry anymore,” he said.

Serving patients where they live Baptist Health has CHF Clinics in multiple locations: • Baptist Medical Center Beaches • Baptist Medical Center Jacksonville • Baptist Medical Center Nassau • Baptist Medical Center South • Baptist North Medical Campus

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SLEEP MEDICINE

Don’t live with the exhaustion Sleep is nature’s way of repairing and restoring body and heart function.

Accredited through the American Academy of Sleep Medicine, the Sleep Disorders Center offers extensive experience diagnosing and treating individuals with sleep disorders.

Sleep disorders can lead to sleep deprivation, which can lead to negative outcomes on cardiovascular, neurological, behavioral and endocrine systems. The most prevalent sleep disorder, obstructive sleep apnea (OSA), is a condition in which the muscles of the throat relax during sleep and block the airway. About 17 million people in the United States have OSA, which causes a person to periodically stop breathing while sleeping. Approximately 90% of the patients who come to the Sleep Disorders Center are treated for OSA. In addition to fragmented and nonrestorative sleep, fatigue, daytime sleepiness, headaches, memory and concentration issues, clinical studies have shown how untreated OSA can lead to a number of heart conditions, including: • Atrial Fibrillation (AFib): Patients with untreated OSA are 2 to 5 times more likely to experience cardiac arrhythmias.

• Depression: People with untreated sleep apnea exhibit higher anxiety and depression scores.

• Palpitations: Patients, particularly women, with OSA are 3 to 5 times more likely to experience “heart flutters.”

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• Chronic Heart Failure: Patients with OSA are placing stress on the heart during their interrupted sleep cycles, which can lead to cardiovascular problems and heart failure.

• Hypertension: 90% of patients with OSA have higher blood pressure and require more medicine to normalize that pressure.

• Obesity: Exhaustion leads to lethargy and an increase in the hormone that drives hunger signals, which causes patients to eat more.

Being overweight can also cause OSA. • Stroke: Patients with untreated sleep apnea are 2 to 3 times more likely to have a stroke due to various reasons including AFib, unstable hypertension, negative effects of chronic oxygen deprivation on blood vessels’ tissue (hypoxia), etc.

PATIENTS WITH UNTREATED OSA ARE

2-5X

MORE LIKELY to experience cardiac arrhythmias

Comprehensive care The Sleep Disorders Center is home to two board-certified sleep specialists, Peter Nassar, MD, pulmonary, critical care, and Nura Festic, MD, family medicine, and three advanced practice providers offering consultation and evaluation services at the Jacksonville Sleep Center, which is a part of Baptist Heart Specialists.

A full sleep disorder evaluation begins with a comprehensive history and physical examination.

If the patient is a candidate for a more indepth sleep study, the noninvasive test will be scheduled and conducted overnight to identify if or when sleep patterns are disrupted, and where in the sleep cycles the disruptions occur. The test records brain waves, heart rate and breathing through a series of painless sensors placed on the patient. Sleep lab testing services are offered at all of Baptist Health’s hospitals in the Northeast Florida region.

Treatment is a collaborative effort between the patient and medical team.

Peter Nassar, MD, FAASM, FCCP Sleep Medicine

Nura Festic, MD Sleep Medicine

“Our approach is simple.

We educate the patient regarding the disease, impart the importance of treatment by explaining related health conditions, and provide the knowledge and tools for success,” said Dr. Nassar. “Our emphasis is on patient care versus testing and equipment.”

“CPAP therapy is still the most effective and reliable treatment for managing OSA and is an important tool in reducing

Treatment for sleep disorders is a collaborative effort between the patient and medical team.

cardiovascular and neurological risks associated with it,” said Dr. Festic. “As the only center in the area 100% focused on sleep medicine, we are able to develop a comprehensive and customized treatment program for the patient.”

For the patients for whom CPAP therapy isn’t successful, the Jacksonville Sleep Center offers Inspire™ therapy. This “pacemaker for the airway” is an FDA-approved, small implanted device that uses a gentle pulse to keep the airway open.

“Research shows that untreated sleep apnea may raise your chance of dying from heart disease by up to five times,” said Dr. Nassar. “People often delay treatment for a sleep disorder. We want to help prevent these problems, and improve their quality of life. They don’t need to live with being exhausted.”

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ELECTROPHYSIOLOGY

A new Heart Rhythm Center offers focused care to patients with arrhythmias

New facility is designed as a one-stop destination for pre-operative, procedure and post-operative EP care.

Cardiac electrophysiology (EP), a subspecialty of cardiology that focuses on the heart’s electrical activity, is a rapidly growing field at the forefront of efforts to find new treatments and cures for heart rhythm problems.

Matthew McKillop, MD, (left) and CV Technologist Lana Clements (right) view an ultrasound of the inside of the left atrium where ablation catheter technology is used to target areas causing AFib.

Arrhythmias can be life-limiting, or life-threatening, so treatment is important. The new Heart Rhythm Center, opening February 2023, will help Baptist Health meet the growing need for this specialized care and help save lives in our community. Located on the second floor of Baptist Heart Hospital, this 14,400-square-foot facility will include three EP labs, three central staff and physician work areas, 10 patient recovery rooms and a family lounge.

“The overall population is increasing and aging,” said Matthew McKillop, MD, electrophysiologist and medical director of the EP Program at

Matthew McKillop, MD, FACC, FHRS

Medical Director, Electrophysiology Program

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Christopher Austin, MD, FACC Electrophysiologist

Christopher Ruisi, MD Electrophysiologist

Venkata Sagi, MD Electrophysiologist

Aaditya Vora, MD Electrophysiologist

Three electrophysiology labs will be located in the new Heart Rhythm Center.

Baptist Health. “The risk of developing some heart arrhythmias along with other predisposing factors like cardiomyopathy increase with age. Therefore, we are seeing a distinct rise in these health concerns. People now have access to better diagnostic mechanisms, including wearable devices with electrocardiogram technology, along with better patient education, which has led to more timely diagnoses.”

Enhancing Baptist Health’s current comprehensive EP program, this new $17 million facility will focus on treatments and cures for heart rhythm abnormalities.

“The Heart Rhythm Center is a comprehensive, hospital-based facility that will offer patients a one-stop destination for EP procedures, including catheter-based ablations, and implantation of defibrillators, pacemakers and other devices,” said Dr. McKillop. “All pre-operative, procedure and post-operative care, including overnight stays if needed, will be performed in this state-of-the-art center, allowing patients to stay in this community for the care they need.”

NEARLY

70%

of patients go home the same day as their procedure (AFIB and ICD).

January – December 2021

23

ELECTROPHYSIOLOGY

A lot to live for

New device gives heart failure patient hope for future.

Charles Lancaster, 80, has a simple reason for undergoing surgery using a new device designed to improve heart failure symptoms and quality of life: “I’m not ready to go yet.”

Charles Lancaster, a twice-retired military veteran (Navy and Air Force) and retired truck driver, had been suffering from extreme weak spells and fatigue. He met with Cardiac Electrophysiologist Aaditya Vora, MD, who told Lancaster he had an irregular heartbeat, likely from previous heart attacks.

Dr. Vora successfully administered a defibrillator to restore normal rhythm. Five years later, when Lancaster began suffering again with weak spells and fatigue, Dr. Vora recommended a newly approved pacemaker-like device that could improve the 80-year-old’s heart function and quality of life.

A unique solution Lancaster became one of the first patients in Northeast Florida to receive the BAROSTIM NEO® System. This FDA-approved electrical stimulator is implanted under the collarbone

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with a lead going up to the carotid artery, where it stimulates the heart’s natural blood pressure sensors. These “baroreceptors” detect blood pressure and send information to the brain, which responds by relaxing blood vessels. This slows the heart rate and reduces fluid in the body through improved kidney function.

“The device is continuously fine-tuned by medical personnel to provide optimal stimulation to the carotid baroreceptors, which in turn allows the body to turn off many of the negative signals that impact the heart,” said Dr. Vora.

It is programmable for each patient’s unique cardiac needs.

“We’re excited to bring this new technology to our advanced heart failure patients,” said Erin Moore, MD, a vascular surgeon who has a private practice in Jacksonville and performs surgeries at Baptist Jacksonville. “This implant uses the power of the brain and nervous system to help these patients feel better, be more active and have a better quality of life.”

Dr. Moore, Dr. Vora and the Baptist Heart Specialists team performed the first of these implants at Baptist Health.

Physicians at Baptist Health, like Aaditya Vora, MD, strive to provide the most advanced health care for patients with one goal in mind – improving the patient's quality of life.

A centennial goal Lancaster said he’s feeling better since surgery, and his energy and outlook have improved.

“I have people to live for, places to go,” he said.

His goal is to reach age 100 so he can keep making memories with his wife of 62 years, his two grown children, five grandchildren and 11 great-grandchildren.

“The device is continuously fine-tuned by medical personnel to provide optimal stimulation to the carotid baroreceptors, which in turn allows the body to turn off many of the negative signals that impact the heart.”

Aaditya Vora, MD Electrophysiologist

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PERIPHERAL VASCULAR PROGRAM

A modern approach to treating peripheral vascular disease Cardiologists with Baptist Heart Specialists do more than just clean coronary arteries and fix blockages in the heart. They can also fix blockages in veins, arteries and lymph vessels that cause pain and poor circulation known as Peripheral Vascular Disease (PVD).

The treatment procedures for PVD at Baptist Health encompass all vascular systems in the body, including:

Similar to Coronary Artery Disease (CAD), PVD is a slow, progressive circulatory disorder caused by a clogged or narrowed artery or blood vessel, often due to a buildup of plaque, known as atherosclerosis.

• Renal artery (kidney) angioplasty and stenting for difficult-to-control blood pressure

The legs and feet are most commonly affected.

Risk factors include smoking, diabetes, hyperlipidemia and hypertension. PVD is very common in men over age 50 and affects more than 8 million people in the United States.

Baptist has several cardiologists who specialize in peripheral vascular interventions, including Nayan Agarwal, MD; Bharat Gummadi, MD; Ankur Jain, MD; Nehu Patel, MD; Salil Patel, MD, FACC; and Siddharth Wayangankar, MD, FACC. “The field of Interventional Cardiology has really exploded into areas beyond the heart,” said Dr. Wayangankar, medical director of the Peripheral Vascular Program. “With extensive experience with wires and catheters, cardiologists are spearheading treatments concerning arteries and veins across the entire body. We at Baptist Health currently offer treatment from neck to toe – from carotid artery stenting in the neck to angioplasty in the toes.”

Dr. Wayangankar serves on several national cardiovascular committees and editorial boards and is also an investigator for the CREST-2 trial which compares medical therapy versus carotid artery stenting in patients with more than 70% blockage in the carotid arteries.

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• Carotid arteries stenting for patients with a history of stroke, transient loss of vision and abnormal carotid duplex

• Lower extremity arterial endovascular procedures (angioplasty, stenting, atherectomy – removal of plaque/calcium using devices) for poor wound healing in legs/non-healing ulcer and gangrene or “claudication” defined as discomfort in calf, thighs and buttocks on exertion • Erectile dysfunction • Subclavian artery stenting for left arm pain or blood pressure differences in both arms • Thrombectomy – removal of fresh clot using devices that act like vacuum cleaners within arteries of the body • Venous procedures (superficial and deep)

Offering the latest technology In 2021, cardiologists with Baptist Heart Specialists began performing minimally invasive procedures to remove blood clots in veins and arteries that can cause life-threatening conditions, such as pulmonary embolism.

“We take pride in offering all the latest device treatments in the pulmonary thrombectomy space.

Many of the devices that we use currently do not even need the assistance of clot busters – hence can be used in all patients regardless of age and comorbidities,” said Dr. Wayangankar.

Dr. Wayangankar and Dr. Salil Patel have been involved in performing clot removal procedures for patients with pulmonary artery embolism.

than 25 years of experience, who was also the first cardiologist in Jacksonville to perform radiofrequency ablation.

“These procedures involve aspirating clots or masses by inserting a large suction catheter into a blood vessel to remove the blockage and restore blood flow to the lungs,” Dr. Salil Patel explained.

“They are performed in our catheterization lab.”

“I’ve been doing this since 2007, and while the technology is basically the same, the procedures are a lot more efficient and with fewer complications,” said Dr. Nehu Patel.

Recently, Dr. Wayangankar and Dr. Salil Patel performed the first right atrial vegetation extraction using these devices in a patient who could not have open-heart surgery.

“Current technology allows innovative solutions to arcane problems, and we at Baptist Health are always striving to be on the forefront of this change,” explained Dr. Wayangankar.

Vein Clinic at Baptist Health Venous reflux disease damages valves and restricts blood flow, leading to an elevation of venous pressure and problematic symptoms like: • Leg pain • Swollen limbs • Leg heaviness and fatigue • Skin changes (color and texture) • Varicose veins Dr. Nehu Patel has been performing venous procedures to help patients with venous reflux disease for more than 15 years in Jacksonville, all in the comfort and convenience of a traditional office setting.

“We can do everything in the office, including vein mapping, without sedation,” said Dr. Nehu Patel, a fellowship-trained cardiologist with more

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI Interventional Cardiologist; Medical Director, Peripheral Vascular Program

Nayan Agarwal, MD, FACC, RPVI

Interventional Cardiologist, Pheripheral Vascular Intervention

Bharat Gummadi, MD

Interventional Cardiologist, Director, Cardiac Cath Lab at Baptist South

Cardiologist Dr. Salil Patel also specializes in a number of vein therapies, including deep venous stenting, pulmonary artery thrombectomy and right atrial mass thrombectomy. He was also the first cardiologist at Baptist Heart Specialists to perform the deep venous stent procedure.

Venous stents are metal mesh tubes that expand against blocked or narrowed vein walls and function as a scaffold to keep veins open. During a thrombectomy, a catheter is inserted into a blood vessel to remove the blockage and restore blood flow.

“Anyone with problems of a vascular nature can feel comfortable being referred to Baptist Heart Specialists because we can treat superficial venous disease in our office as well as deep vein issues that may require an intervention in our catheterization lab,” said Dr. Salil Patel.

Since establishing the Vein Clinic five years ago, Baptist Health has experienced a 300% growth rate in the venous space. A second Vein Clinic will soon be located at Baptist Medical Center South.

Ongoing health care management is another differentiator of the venous specialists at Baptist Heart Specialists. “After their intervention, we have regular and ongoing follow-ups with the patients in our clinic,” Dr. Salil Patel added. “Continuity of care is one of the benefits of seeing a cardiologist in our group.”

Ankur Jain, MD, FACP, FACC, RPVI

Interventional Cardiologist, Pheripheral Vascular Intervention

Nehu Patel, MD, FACC Cardiologist, Director, Venous Program

Salil Patel, MD, FACC

Interventional Cardiologist, Peripheral Vascular Intervention, Chief of Cardiology at Baptist Jacksonville

27

INTERVENTIONAL CARDIOLOGY

Enabling innovation

Using the latest tools and techniques in our "cath lab of tomorrow."

The number of interventional cardiology technologies and techniques is growing by leaps and bounds and many of innovative treatment options are now available for the patient’s benefit.

“Interventional cardiology has changed dramatically in the past 10 years. We are now treating many patients in the catherization lab with interventional procedures who would not have been candidates in the past," said Salvatore DiLoreto, MD, FACC, peripheral interventionalist and director of the cardiac catheterization lab at Baptist Medical Center Jacksonville.

Miniaturized ventricular assist device Among the innovations driving the catheterization lab of tomorrow are miniature heart pumps to inflate and deflate the heart

Nayan Agarwal, MD, FACC, RPVI

Salvatore DiLoreto, MD, FACC

Interventional Cardiologist, Pheripheral Vascular Intervention

Interventional Cardiologist, Pheripheral Vascular Intervention, Director, Cardiac Cath Lab at Baptist Jacksonville

Ruby Satpathy, MD, FACC, FSCAI

Russell Stapleton, III, MD, FACC

Interventional Cardiologist, Medical Director, Baptist Structural Heart Program, Chair, Cardiology Board

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Interventional Cardiologist, Director, Congestive Heart Failure Clinic

during minimally invasive procedures. Radial interventions are particularly helpful for patients at high risk for bleeding complications.

In 2017, the FDA approved the use of a miniaturized ventricular assist device for patients with severe coronary artery disease requiring Percutaneous Coronary Intervention (PCI) or protected stenting.

Known as the world’s smallest heart pump, the transcatheter axial flow device is inserted into the heart through a tube inserted in the femoral artery.

With the Impella® pump in place during a PCI procedure, physicians are able to relieve the blockage while maintaining circulatory support.

Bharat Gummadi, MD Interventional Cardiologist, Director, Cardiac Cath Lab at Baptist South

Bernie Utset, MD, FACC

Interventional Cardiologist

Ankur Jain, MD, FACP, FACC, RPVI Interventional Cardiologist, Pheripheral Vascular Intervention

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI Interventional Cardiologist, Medical Director, Peripheral Vascular Program

Salil Patel, MD, FACC

Interventional Cardiologist, Peripheral Vascular Intervention, Chief of Cardiology at Baptist Jacksonville

The device is commonly removed after a PCI procedure but can stay implanted for longer periods, according to Salil Patel, MD, FACC, an interventional cardiologist with Baptist Heart Specialists.

The radial artery in the wrist is smaller than the femoral artery in the groin, making it much easier to apply direct pressure to the puncture site to stop bleeding.

“It’s usually a planned procedure, but we do put them in emergently when a patient is in cardiogenic shock,” said Dr. Patel. “This device has allowed us to do more complex procedures and to treat sicker patients.” Many patients are back up and walking within a few hours, leading to faster recoveries and better outcomes.

• Less discomfort

Interventional cardiologists and other members of Baptist Heart Specialists are taking part in the Door-to-Unload (DTU) Trial, a national trial using the Impella® device to try to minimize damage to the heart during heart attacks. Baptist Health is the only health system in Northeast Florida involved in the study.

Dr. Patel recently used the device for two individuals ages 89 and older, both of whom were turned down for surgery.

“We use this innovative solutions on a weekly basis for complex heart stent procedures and in some high-risk cardiothoracic surgeries,” he said.

“We are proud to offer the latest breakthrough technologies and procedures for our patients."

Radial-first approach Since joining Baptist Heart Specialists in 2013, Bharat Gummadi, MD, a fellowship-trained interventional cardiologist and director of the cardiac catheterization lab at Baptist Medical Center South, has been a proponent of radial artery catheterization. An alternative to the more traditional femoral artery approach, transradial artery access (TRA) involves gently threading a thin catheter through the radial artery of the wrist and eventually up into the heart.

Other benefits of radial artery access: • Earlier mobility • Lower infection rates • Decreased length of hospital stay To be a candidate for radial artery access, patients must have good blood supply to their hands through both the radial artery in the wrist and the ulnar artery in the forearm. To assist the physician during intravenous cannulation, ultrasound is used.

Another advantage of the radial approach: patients do not have to be taken off anticoagulants. According to a 2018 study, 71% of coronary patients who have experienced both transradial and transfemoral procedures preferred the radial approach.

Dr. Gummadi recently used a rare transradial approach to clear a blocked artery in a patient whose peripheral artery disease was so severe he could no longer walk. “The approach through the wrist decreases vascular complications and allows for quicker recovery,” said Dr. Gummadi. “The procedure requires only local, rather than general anesthesia.”

“Patients who have had radial cath rarely have entry site complications and get out of the hospital in just a few hours,” he added. “I believe a large majority of patients would be candidates for the radial approach if it were an option for them.”

“We utilize a team approach with the collaboration of all the interventional cardiologists and the cardiac surgeons in order to offer the patient the best option for their individual situation,” added Dr. DiLoreto. “We, at Baptist Health, are proud to offer our patients these life-saving procedures with excellent quality and outcomes.”

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CLINICAL TRIALS

On the leading edge To ensure patients in our community have access to the most advanced heart treatments, Baptist Health is active in clinical trials.

Clinical trials at Baptist Heart Specialists By the numbers

112

January – December 2021

patients enrolled in clinical trials

27

7 research staff

open trials

2

trials as a top enroller in the U.S.

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Baptist Health strives to provide patients with the latest evidencebased treatments and preventive therapies and to foster medical advancements through clinical trials under the direction of the Baptist Health Research Institute. Clinical Research Director Smitha Gubbi, MBBS, CCRC (left), featured here with Doran Cassidy, certified clinical research coordinator (right).

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CLINICAL TRIALS

General Cardiology Enrolling studies ADI CPM (2021)

“We are privileged to work with colleagues around the world in clinical studies that help advance health care for our patients.”

Carlos Sotolongo, MD, FACC

Cardiologist, Chief of Cardiology at Baptist Beaches

Performance assessment of the ADI Cardio Pulmonary Monitoring System (CPM), an at-home heart failure management device.

PrincipaI investigator: Ruple Galani, MD

Novo 4665 & Novo 4773 (2021) Investigate how well semaglutide, an antidiabetic medication, works in people living with heart failure and obesity. The Novo 4773 study includes patients with diabetes.

PrincipaI investigator: Ashwini Davuluri, MD

Alleviate (pre-2021) The study will utilize the market-released Reveal LINQ™ Insertable Cardiac Monitor with an investigational ALLEVIATE-HF RAMware download for collection of data from which a heart failure risk status can be derived, enabling clinicians to take action before patients’ conditions worsen.

PrincipaI investigator: Russell Stapleton, MD

Florida TS (pre-2021) Data registry of feasibility and long-term outcomes of past and future Takotsubo syndrome patients.

PrincipaI investigator: Andre Macedo Dias, MD

WARRIOR (pre-2021) Determine whether intensive medication treatment to modify risk factors and vascular function in female patients with coronary arteries showing no flow limit obstruction but with cardiac symptoms (i.e., chest pain, shortness of breath) will reduce the patient's likelihood of dying, having a heart attack, stroke/TIA or being hospitalized for cardiac reasons.

PrincipaI investigator: Ruple Galani, MD

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Open studies in follow up Vesalius (2021) Assess the effect of lowering low-density lipoprotein cholesterol (LDL-C) with evolocumab on major cardiovascular events in adults without a prior myocardial infarction or stroke who are at high risk of a cardiovascular event.

PrincipaI investigator: Carlos Sotolongo, MD

NOVO 4388-SELECT (pre-2021) Two separate studies

Determine if semaglutide may reduce the risk of having cardiovascular events in patients with obesity and prior cardiovascular disease.

PrincipaI investigators: Ashwini Davuluri, MD (Baptist South) and Carlos Sotolongo, MD (Baptist Beaches)

Perspective (pre-2021) Evaluation of Valsartan vs. Entresto on cognitive function in patients with chronic heart failure.

PrincipaI investigator: Carlos Sotolongo, MD

COORDINATE (pre-2021) Test the effectiveness of an innovative, clinic-level educational intervention, including cardiology and endocrinology partnerships and guidelinerecommended care pathways, to improve the management of patients with Type-II diabetes mellitus and cardiovascular disease.

Interventional Cardiology Enrolling studies DTU (pre-2021) Demonstrate the safety and effectiveness of primary left ventricular unloading and a 30-minute delay to reperfusion vs. current standard of care in reducing infarct size and heart failure-related clinical events in patients with anterior ST-Elevation Myocardial Infarction.

PrincipaI investigator: Siddharth Wayangankar, MD

Open studies in follow up Spyral HTN-OFF MED (pre-2021) Test the hypothesis that renal denervation decreases blood pressure and is safe in absence of antihypertensive medications.

PrincipaI investigator: Bharat Gummadi, MD

PrincipaI investigators: Ashwini Davulri, MD and Alan Cleland, MD (endocrinology)

33

CLINICAL TRIALS

Electrophysiology Enrolling studies

Open studies in follow up

HEAL (2021)

EV_ICD (pre-2021)

Gather information on participants returning at time of CIED change-out or revision who underwent a device implantation with either a CanGaroo® envelope, Tyrx™ envelope, or no envelope.

Demonstrate safety and efficacy of the Extravascular Implantable Cardioverter Defibrillator System.

PrincipaI investigator: Aaditya Vora, MD

Medtronic PAN PSR Registry (pre-2021) Provide continuing evaluation and periodic reporting of safety and effectiveness of Medtronic market-released products.

PrincipaI investigator: Venkata Sagi, MD

Aveir DR i2i (2022) Prospective, multicenter, international, single-arm pivotal investigational study to evaluate the safety and effectiveness of the Aveir atrial LP. PrincipaI investigator: Venkati Sagi, MD

PrincipaI investigator: Venkati Sagi, MD

Upcoming studies AdMIRE (2022) Assess safety and effectiveness of treatment management of atrial fibrillation with the BWI IRE Ablation System.

Principal investigator: Venkati Sagi, MD

EVICD-CA (2022) Provide continued access to the Extravascular Implantable Cardioveter Defibrillator (EV ICD) System.

Principal investigator: Venkati Sagi, MD

“The research we do centers around providing something new to our patients with key goals in mind: the new technology or treatment has to be safer and more effective than an existing technology or treatment, and the patient’s satisfaction, experience and quality of life has to be improved beyond what we currently offer. Every trial or study is valuable for our patients.”

Venkati Sagi, MD Electrophysiologist

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Structural Heart Enrolling studies

WATCH-TAVR (pre-2021)

Evaluate the effectiveness of the Amulet™ LAA occlude compared to novel oral anticoagulants (NOACs), a new class of anticoagulant drug.

Evaluate the safety and effectiveness of the left atrial appendage occlusion with WATCHMAN Device in prevention of stroke and bleeding in patients with atrial fibrillation undergoing transcatheter aortic valve replacement (TAVR).

PrincipaI investigator: Ruby Satpathy, MD

PrincipaI investigator: Ruby Satpathy, MD

Catalyst (pre-2021)

PFO-PAS (pre-2021) Evaluate the safety and effectiveness of the AMPLATZER PFO Occluder in patients with a confirmed patent foramen ovale (PFO).

PrincipaI investigator: Ruby Satpathy, MD

Open studies in follow up Amulet (pre-2021) The Amulet™ device will be evaluated for safety and efficacy by demonstrating its performance is non-inferior to the commercially available WATCHMAN® left atrial appendage closure device in patients with non-valvular atrial fibrillation.

PrincipaI investigator: Ruby Satpathy, MD

Upcoming studies Complete TAVR (2022) Compare effectiveness of staged complete revascularization with percutaneous coronary intervention to treat coronary artery disease versus medical management alone in patients with symptomatic aortic valve stenosis undergoing elective transfemoral transcatheter aortic valve replacement.

Principal investigator: Siddarth Wayangankar, MD

The Progress Trial (2022) Assess the management of moderate aortic stenosis by clinical surveillance or transcatheter aortic valve replacement.

Principal investigator: Ruby Satpathy, MD

Apollo Trial (2022)* Evaluate the safety and efficacy of Medtronic Intrepid™ TMVR System in patients with moderateto-severe or severe symptomatic mitral regurgitation who are unsuitable for treatment with approved transcatheter repair or surgical mitral valve intervention. *Anticipated clinical trial.

Baptist Health is the first health system in the southeast United States to use the Amplatzer™ Amulet™ Left Atrial Appendage Occluder post-FDA approval.

Principal investigators: Ruby Satpathy, MD and independent physician Nathan Bates, MD

35

“Caring for your heart can’t be paused. We are determined to stay connected with our patients so they recieve the care they need.”

Pamela Rama, MD, FACC Cardiologist

PREVENTIVE CARDIOLOGY

Facing COVID-19 The arrival of COVID-19 changed the health care landscape in many ways. Because individuals with comorbidities, such as cardiovascular disease, are at higher risk for complications and mortality if infected with COVID-19, the necessity to provide preventive cardiology became more imperative.

“If you have heart disease, you are at a higher risk for both catching the virus and having a very bad outcome if you get sick,” explained Chetan Hampole, MD, FACC, cardiologist with Baptist Heart Specialists.

Working with patients in new ways As patients increasingly are comfortable with either in-person or virtual appointments, cardiologists have been challenged to remotely provide quality, preventive medical care.

36

Of course, cardiologists make in-person appointments when the patient's comfort level or condition doesn’t allow for telemedicine.

As COVID-19 prevalence ebbs and flows, cardiologists have encouraged patients to do their part in staying healthy by focusing on active, healthy lifestyles – no easy feat when routines are disrupted.

“Every heart is unique, and we treat each patient with an individualized approach, stressing the importance of a diligent heart-healthy lifestyle,” said Dr. Hampole.

Cardiologist Mona Shah, MD, works with patients on the connection between their lifestyle and heart health. As the only physician in Northeast Florida who is board certified in both cardiology and holistic medicine, she believes in treating the whole patient. She encourages them to Mona Shah, MD Cardiologist take control of what they can. “With all the uncontrollable factors in the world, do your best to exercise, eat healthy and be grateful for the parts of your life that are bringing you joy,” she tells her patients.

“Every heart is unique and we treat each patient with an individualized approach, stressing the importance of a diligent heart-healthy lifestyle.”

Chetan Hampole, MD, FACC

Cardiologist, Chief of Cardiology at Baptist Clay

Emphasis on the whole patient experience Despite the challenges, team members and physicians at Baptist Heart Specialists have continued to focus on the patient experience – and our patients took notice.

“The medical office staff is welcoming, extremely courteous and efficient, and the physical office space, including the lobby and examining rooms, are meticulously clean and all COVID-19 precautions are followed scrupulously,” raved one grateful patient.

“All of the staff I dealt with were very polite and seemed to care about my condition,” said another. “I really am glad that I went to Baptist Heart Specialists.”

“Caring for your heart can’t be paused. We are determined to stay connected with our patients so they recieve the care they need,” said Pamela Rama, MD, FACC, cardiologist with Baptist Heart Specialists.

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Our physicians DIAGNOSTIC AND PREVENTIVE CARDIOLOGY

Ken Adams, MD, FACC

Cardiologist

Geetanjali Dang, MD, MS, FACC

Paul Dillahunt, II, MD, FACC

Emiliana Franco, MD

Ruple Galani, MD, FACC

Thomas Hilton, MD, FACC

Praveen Kanaparti, MD, FACC, RPVI

Cardiologist

Cardiologist

Cardiologist, Co-Director, Echo Program

J. H. “Houston” Mooney, MD Cardiologist

Marcus Cox, MD, FACC

Cardiologist

Cardiologist, Director, Advanced Cardiac Imaging

Simone Nader, MD, FACC Cardiologist

Cardiologist

Ashwini Davuluri, MD, FACC

Andre Macedo Dias, MD

Cardiologist, Chief of Cardiology at Baptist South

Shreya Ghetiya, MD

Cardiologist

Chetan Hampole, MD, FACC

Cardiologist

Cardiologist, Co-Director, Echo Program

Cardiologist, Chief of Cardiology at Baptist Clay

George Le-Bert, DO

Shannon Leu, MD

Raymond Mai, DO

Nehu Patel, MD, FACC

Alejandro Pena, MD

Pamela Rama, MD, FACC

Cardiologist, Chief of Cardiology at Baptist Nassau

Cardiologist, Director, Venous Program

Cardiologist

Cardiologist

Cardiologist

Cardiologist

PHYSICIANS JOINING

BY EARLY 2023 Raghav Gupta, MD

Interventional Cardiologist

Vamsi Kodumuri, MD

Mona Shah, MD Cardiologist

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Girish Shroff, MD, FACC Cardiologist

Carlos Sotolongo, MD, FACC

Cardiologist, Chief of Cardiology at Baptist Beaches

Interventional Cardiologist

Kabir Yousuf, MD, FACC Cardiologist

INTERVENTIONAL CARDIOLOGY

Nayan Agarwal, MD, FACC, RPVI

Salvatore DiLoreto, MD, FACC

Bharat Gummadi, MD

Interventional Cardiologist, Pheripheral Vascular Intervention

Interventional Cardiologist, Pheripheral Vascular Intervention, Director, Cardiac Cath Lab at Baptist Jacksonville

Interventional Cardiologist, Director, Cardiac Cath Lab at Baptist South

Ruby Satpathy, MD, FACC, FSCAI

Russell Stapleton, III, MD, FACC

Bernie Utset, MD, FACC

Matthew McKillop, MD, FACC, FHRS

Christopher Ruisi, MD

Interventional Cardiologist, Medical Director, Baptist Structural Heart Program, Chair, Cardiology Board

Interventional Cardiologist, Director, Congestive Heart Failure Clinic

Ankur Jain, MD, FACP, FACC, RPVI

Interventional Cardiologist, Pheripheral Vascular Intervention

Salil Patel, MD, FACC

Interventional Cardiologist, Peripheral Vascular Intervention, Chief of Cardiology at Baptist Jacksonville

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI

Interventional Cardiologist

Interventional Cardiologist, Medical Director, Peripheral Vascular Program

ELECTROPHYSIOLOGY

Christopher Austin, MD, FACC Electrophysiologist

Medical Director, Electrophysiology Program

SLEEP MEDICINE

Nura Festic, MD Sleep Medicine

Venkata Sagi, MD

Electrophysiologist

Aaditya Vora, MD

Electrophysiologist

Electrophysiologist

ADVANCED PRACTICE PROVIDERS

Peter Nassar, MD, FAASM, FCCP Sleep Medicine

Devon Anthony, PA Peyton Bailey, PA

Daniela Harirchi, APRN Stephanie Hembach, APRN

Wagma Qazizada, PA Judith Rewis, APRN

Jaclyn Bowden, APRN Kelly Bumgarner, PA

Ashley Hill, PA Kristin Hostetler, ARNP

Jessica Saliba, APRN Ryan Shrode, ARNP

Sara Chance, PA Max Courtney, PA Meagan Dellilo, APRN Jenna Effron, PA

Allison Huffman, PA Allison S. Kavanagh, ARNP Morgan Koch, PA Marissa Lynch, PA

Taylor Sousa, APRN Laura Spear, APRN Elizabeth Thomas, PA Daisy Tu, APRN

Michele Foeks, PA Katie Geyer, APRN

Brent Mickley, PA Boski Patel, APRN

Katherine Uy, APRN Michael Walker, APRN

Eric Poovey, APRN

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Office locations 1 BAPTIST JACKSONVILLE – Pavilion

St. Marys Hilliard

Fernandina Beach

17

NASSAU COUNTY

836 Prudential Drive, Suite 1700 Jacksonville, FL 32207 904.398.0125 • FAX 904.376.3206

200

5

Yulee

Callahan

A1A

301

1

6

9A 105

Jacksonville

10

1

10

Atlantic Beach

8

2 202

10 9A

DUVAL COUNTY

4

Orange Park

CLAY COUNTY

Jacksonville Beach

3

7

Fruit Cove

1

ST JOHNS COUNTY

9

17

Ponte Vedra Beach A1A

Ken Adams, MD, FACC Christopher Austin, MD, FACC Geetanjali Dang, MD, FACC Paul Dillahunt, II, MD, FACC Salvatore D. DiLoreto, MD, FACC Shreya Ghetiya, MD Raymond Mai, DO Matthew McKillop, MD, FACC, FHRS Salil Patel, MD, FACC Alejandro Pena, MD Chris Ruisi, MD Venkata Sagi, MD Ruby Satpathy, MD, FSCAI, FACC Girish Shroff, MD, FACC Russell Stapleton, III, MD, FACC Aaditya Vora, MD Siddharth Wayangankar, MD, FACC, FSCAI, RPVI

2 BAPTIST BEACHES

1361 13th Avenue South, Suite 270 Jacksonville Beach, FL 32250 904.241.7147 • FAX 904.376.3213 Christopher Austin, MD, FACC Marcus Cox, MD, FACC Ruple Galani, MD, FACC Thomas Hilton, MD, FACC Matthew McKillop, MD, FACC, FHRS Pamela Rama, MD, FACC Mona Shah, MD Carlos Sotolongo, MD, FACC Bernie Utset, MD, FACC

3 BAPTIST CLAY St. Augustine

1747 Baptist Clay Drive, Suite 320 Fleming Island, FL 32003 904.224.5185 • FAX 904.376.3202 Christopher Austin, MD, FACC Emiliana Franco, MD Chetan Hampole, MD, FACC Aaditya Vora, MD

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4 BAPTIST HEALTHPLACE AT NOCATEE 400 Colonnade Drive, Suite 230 Ponte Vedra, FL 32081 904.271.7540 • FAX 904.376.3204 Ashwini Davuluri, MD, FACC Thomas Hilton, MD, FACC Matthew McKillop, MD, FACC, FHRS Alejandro Pena, MD Mona Shah, MD Carlos Sotolongo, MD, FACC

5 BAPTIST NASSAU

1348 S. 18th Street, Suite 200, Bldg. B Fernandina Beach, FL 32034 904.261.9786 • FAX 904.376.3203 Paul Dillahunt, II, MD, FACC Salvatore DiLoreto, MD, FACC George Le-Bert, DO J. H. Houston Mooney, MD Chris Ruisi, MD Venkata Sagi, MD Russell Stapleton, III, MD, FACC

6 BAPTIST NORTH

11236 Baptist Health Drive, Suite 310 Jacksonville, FL 32218 904.224.9303 • FAX 904.376.3205 Andre Macedo Dias, MD Raymond Mai, DO Matthew McKillop, MD, FACC, FHRS Salil Patel, MD, FACC Chris Ruisi, MD Russell Stapleton, III, MD, FACC

7 BAPTIST SOUTH

14534 Old St. Augustine Road Medical Office Building #3, Suite 3420 Jacksonville, FL 32258 904.493.8001 • FAX 904.376.3207 Ken Adams, MD, FACC Nayan Agarwal, MD, FACC, RPVI Christopher Austin, MD, FACC Ashwini Davuluri, MD, FACC Emiliana Franco, MD Bharat Gummadi, MD Ankur Jain, MD, FACC Praveen Kanaparti, MBBS, MD, FACC Shannon Leu, MD, FACC Simone Nader, MD, FACC Nehu Patel, MD, FACC Chris Ruisi, MD Venkata Sagi, MD Aaditya Vora, MD

8 UNIVERSITY

3225 University Blvd South, Suite 104 Jacksonville, FL 32216 904.399.1171 • FAX 904.376.3208 Geetanjali Dang, MD, FACC Shreya Ghetiya, MD Nehu Patel, MD, FACC Salil Patel, MD, FACC Venkata Sagi, MD Girish Shroff, MD, FACC

9 WORLD GOLF VILLAGE

533 West Twincourt Trail, Suite 701 St. Augustine, FL 32095 904.493.8383 • FAX 904.376.3209 Shannon Leu, MD, FACC Matthew McKillop, MD, FACC, FHRS Simone Nader, MD, FACC Aaditya Vora, MD

10 JACKSONVILLE SLEEP CENTER

6930 Bonneval Road, Suite 2 Jacksonville, FL 32216 904.854.6899 • FAX 904.376.3210 Nura Festic, MD Peter Nassar, MD, FAASM, FCCP

41

Connect with us Patients To make an appointment, call 904.720.0799 or visit BaptistHeartSpecialists.com.

Providers Referrals within the Baptist Health network

information stored in our EHR for referred and

Referring to Baptist Heart Specialists is easy:

To learn more about EpicCare Link or request

• Call 904.720.0799 • Fax 904.720.5225 • Send orders electronically via Epic

enrollment for your practice or providers,

admitted patients.

please visit baptistjax.com/EpicCareLink or email us at EpicCareLink@bmcjax.com.

A scheduler will contact your patient to create an appointment at the most convenient location.

Annual Cardiovascular Symposiums

Referrals outside the Baptist Health network

Nationally renowned cardiologists take the

Referring to Baptist Heart Specialists is easy:

technologies and innovations in cardiovascular

• Call 904.720.0799 • Fax 904.720.5225 • Send orders electronically via EpicCare Link

care at Baptist Health's Annual Cardiovascular

What is EpicCare Link?

stage to deliver education on the most advanced

Symposium.

To learn more, visit BaptistHeartSpecialists.com or email BaptistHeart@bmcjax.com.

EpicCare Link is a secure, web-based portal that connects independent physicians to patient

BaptistHeartSpecialists.com

The talented group of physicians at Baptist Heart Specialists, and other physicians providing care at our Baptist Health hospitals, are independent professionals and not employees or agents of our hospitals.