Grandview Electrophysiology Lab, continued from page 4 blood thinners. “A lot of patients cannot take thinners because of contraindications, leaving them unprotected,” Osorio says. “The LAA closure is designed for these patients.” The 30 to 60-minute procedure walls off the blood pooled inside a little pouch, called the appendage, inside the atria. That blood can clot, dislodge and cause life-altering or fatal strokes. The LAA closure dams up that pouch. The procedure starts by threading a tiny device through the major blood vessel in the groin up to the heart. “It looks like a little umbrella. We open that in the mouth of the appendage and leave it there,” Osorio says. Within a few weeks, the heart tissue grows over the umbrella and completely occludes the opening. The thousands of procedures by Grandview’s EP lab reflect the area’s need. “Alabama lies in the buckle of the Stroke Belt. We have a high incidence of atrial fibrillation,” Osorio says. “But a large part of our patients are not coming from Birmingham.” He estimates about 70 percent treated in the lab travel from Mississippi, Tennessee, Georgia and Florida. Osorio says that although other EP programs in the region are capable of doing the same procedures, it is Grandview’s quest for quality based on meticulous data collection that produces efficacious outcomes. “We have success rates as good as any other center in the country, if not better,” he says. Their success in treating early-stage (paroxysmal) atrial fibrillation in a single procedure is 85 percent. When adding in the success from those who may need a second procedure, the success rate for
make patients feel better. Osorio disagrees with that approach. “20 percent of strokes are because of atrial fibrillation,” he says. “Decreasing the risk of stroke should be the focus, along with making patients feel better.” Osorio says it wasn’t long ago that patients with early-stage arterial fibrillation were told they could live with the condition and no treatment. “But we have more data now, and it shows this affects a lot of patients,” he says, adding that only about 50 percent of the patients they see in the lab are in the early stages of AFib, which is usually progressive. “So we’re not appreciating the degree for which this can affect patients, their quality of life, and overall mobility—and risk for strokes. The right treatment for a patient can absolutely decrease the risk of stroke.”
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The EP Lab team.
treating early-state AFib rises even higher. The rates drop for treating more complex AFib, such as persistent or permanent which, according to Osorio, shows that patients need to be seen sooner. The value of seeing an EP may be underestimated by patients and the medical community alike, especially in the early
stages of AFib. But a 2014 study published by the National Institutes of Health on AFib treatment patterns of cardiologists and electrophysiologists, showed the approach by EPs differed significantly and resulted in half the mortalities. Treatment for AFib often focuses primarily on mitigating the symptoms to
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than with their patients and the number of ‘clicks’ it takes to perform a task are well-documented and concerning.” Richardson said the first goal of releasing the report was to put the organizations’ ideas and agenda ‘out into the world’ to foster broader conversations among stakeholders about how best to move forward. “It’s also a way for us to examine and engage with what others in the private sector, as well as at a federal level – CMS & ONC, are doing to advance interoperability. It gives us a foundation to determine how those efforts line up with the areas we’ve identified,” she explained. By addressing barriers and adopting industrywide standards to safely, securely transmit and receive usable data, the hospital associations believe improved interoperability should advance high-quality, patient-centered care and have a positive impact on outcomes. At its best, interoperability should provide a fuller picture of an individual’s health by utilizing information from disparate sources capturing both medical and social determinants data and allowing that information to flow seamlessly across care settings. Furthermore, the hope is that by aggregating and deidentifying data, clinicians should gain a clearer picture of population health issues and workable innovations. A link to the full report is available online at NashvilleMedicalNews.com.
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16 • FEBRUARY 2019
Birmingham Medical News
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Birmingham Medical News February 2019