2020 UAB Cardiovascular Institute Annual Report CVI Annual Report 2019-2020 6

ISCHEMIC HEART DISEASE The Electrophysiology (EP) Section at UAB is the largest and most experienced program of its kind in Alabama. UAB’s electrophysiologists are leaders in the diagnosis and treatment of heart rhythm disorders such as atrial fibrillation/flutter, premature ventricular contractions (PVC), ventricular tachycardia, Wolff-Parkinson-White Syndrome, and atrioventricular re-entrant tachycardia. These internationally acclaimed physicians work within a multidisciplinary group of scientists and with other UAB departments, such as Biomedical Engineering, to provide extensive diagnostic and therapeutic care to patients with complex arrhythmias. Approximately 2,400 rhythm- related procedures are performed in the four EP suites in the UAB Heart and Vascular Center every year, with well-documented success. UAB Cardiothoracic Surgery continues to enjoy a high and stable annual volume of treatments for ischemic heart disease. UAB surgeons perform a variety of procedures, including coronary revascularization, ventricular aneurysm resection, complete arterial revascularization, off-pump revascularization, and myocardial revascularization in advanced heart failure patients with poor ventricular function. UAB also offers total arterial revascularization with utilization of bilateral internal thoracic and radial arteries. PROGRAM HIGHLIGHTS • History of innovation with scientific and clinical contributions to the field of catheter ablation • Current mapping technology allows for limiting the use of contrast and fluoroscopy with atrial fibrillation ablation, making procedures safer for patients • Advanced mapping technology allows for successful ablation of complex tachycardia • First in Alabama to implant the leadless pacemaker • Early experience with subcutaneous ICD implantation • Major referral center for pacemaker and ICD lead extraction, with approximately 80 procedures performed annually. All procedures are performed with the CV Surgery team on standby, in case surgical intervention is required • Watchman device procedures are performed to close the left atrial appendage to help reduce the incidence of stroke in patients with atrial fibrillation ELECTROPHYSIOLOGY PROCEDURES 2014–2019 (N=14,381) UAB again received the highest overall composite quality rating of 3 stars for isolated CABG, as reported in the STS 2019 Harvest #3 Report. This was accomplished through the diligent efforts of the entire staff and faculty working together to achieve patient-centric care and excellent outcomes. Various multidisciplinary subcommittees meet regularly to review quality metrics, develop strategic methods to improve care, monitor results, and report quarterly to the Cardiovascular Institute Executive Committee. We are a national leader in cardiothoracic surgery with a long history of excellence and perform over 1,000 open heart procedures each year. CARDIAC RHYTHM DISORDERS UAB cardiac surgeons performed more than 5,600 coronary artery bypass graft surgeries from 2009 to 2019, including more than 3,900 isolated coronary artery bypass procedures. HIGHLIGHT UAB’s overall isolated CABG operative mortality rate for 2014 through June 2019 of 2.0% is below the *STS Benchmark of 2.2%. UAB’S STS ISOLATED CABG OVERALL COMPOSITE QUALITY RATING July 2018–June 2019 Overall STS Isolated CABG Composite Quality Rating n A-Fib Ablation. . . . . . . . 19.0% n Cardioversion. . . . . . . . 15.1% n SVT Ablation. . . . . . . . . 13.0% n Pacemaker. . . . . . . . . . . 10.8% n VT/PVC Ablation . . . . . . 8.6% n Diagnostic EPS. . . . . . . . 6.7% n Other . . . . . . . . . . . . . . . . 6.4% n Extraction . . . . . . . . . . . . 3.3% n Loop Recorder . . . . . . . . 1.2% n ICD. . . . . . . . . . . . . . . . . . 0.6% n LAAO . . . . . . . . . . . . . . . . 0.6% HHH UAB SCORE *STS MEAN PARTICIPANT SCORE STS COMPOSITE QUALITY RATING 98.2% 96.8% Significantly higher than the STS Mean Source: STS 2019 Harvest #3 Report period ended 6/30/19 SELECTED PUBLICATIONS • Shah RR, Pillai A, Schafer P, Meggo D, McElderry T, Plumb V, Yamada T, Kumar V, Doppalapudi H, Gunter A, Pentecost E, Maddox WR. Am J Cardiol. Safety and Efficacy of Uninterrupted Apixaban Therapy Versus Warfarin during Atrial Fibrillation Ablation. 2017 Aug 1; 120(3):404-407. doi: 10.1016/j. amjcard.2017.04.041. Epub 2017 May 10. PMID: 28595862 https://www.ncbi.nlm. nih.gov/pubmed/28595862 • Shah RR, Pillai A, Schafer P, Meggo D, McElderry T, Plumb V, Yamada T, Kumar V, Doppalapudi H, Gunter A, Pentecost E, Maddox WR. J Cardiovasc Electrophysiol. Significant Discrepancy between Estimated and Actual Longevity in St. Jude Medical Implantable Cardioverter-Defibrillators. 2017 May; 28(5):552-558. doi: 10.1111/ jce.13178. Epub 2017 Mar 7. PMID: 28181727. https://www.ncbi.nlm. nih.gov/pubmed/28181727 • Watts TE, McElderry HT, Kay GN. An Irregular Wide Complex Tachycardia. Circulation. 2017 Aug 22; 136(8):773- 775. doi: 0.1161/CIRCULATIONAHA.117.029974.https://www.ncbi.nlm.nih.gov/pubmed/28827222 • Hindricks G, Weiner S, McElderry T, Jaïs P, Maddox W, Garcia-Bolao JI, Ji SY, Sacher F, Willems S, Mounsey J, Maury P, Bollmann A, Duffy E, Raciti G, Tung, R, Wong T. Acute Safety, Effectiveness, and Real-World Clinical Usage of Ultra-High Density Mapping for Ablation of Cardiac Arrhythmias: Results of the TRUE HD Study. EP Europace, 2019: 0, 1-7, https://doi.org/10.1093/ europace/euy191 4 UAB Cardiovascular Institute Annual Report uabmedicine.org 5

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