Outcomes 2019 - Baylor Scott & White Heart and Vascular Hospital BSWHHVH_646_2019 Outcomes JOOMAG MOD | Page 53

Cardiac electrophysiology
As a part of the comprehensive cardiovascular
services on the Fort Worth campus,
electrophysiology (EP) program and the
associated electrophysiologists on the medical
staff are known for their expertise in treating all
types of heart rhythm disorders from arrhythmia
to atrial fibrillation and ventricular tachycardia.
>500
Pacemakers/ICDs implanted
(FY19)
LAAOs performed
>2,029
>1,040
(FY19)
(FY19)
Highlights for the department include:
• MRI compatible ICDs are routinely used,
allowing patients and their physicians to use
this modality for diagnostic imaging even after
ICD implantation.
24
(FY18)
63
(FY19)
83
As a part of the EP program, in fiscal year 2019
electrophysiologists became increasingly
known throughout Tarrant County for left atrial
appendage closure device (LAAO) implantation.
Implanted in patients with atrial fibrillation using
a minimally invasive technique, over time, patients
were able to decrease the amount of blood
thinner medication taken as prescribed by the
patient’s provider.
The LAAO device is suitable for patients with
nonvalvular AFib who:
• Are at increased risk for stroke and systemic
embolism based on CHADS2 or CHADS2-
VASc scores and are recommended for
anticoagulation therapy
•
Have an appropriate rationale to seek a
non-pharmacologic alternative to oral
anticoagulation, taking into account the safety
and effectiveness of the device compared
to Warfarin
Electrophysiologists on the medical staff
received patient referrals from throughout the
region for precise diagnosis and treatment using
ablation therapy. The use of advanced mapping
systems for signal analysis coupled with the
electrophysiologists’ experience results in a more
accurate identification of the abnormal rhythm
circuit and eliminating it both safely and effectively.
Baylor Scott & White Heart and Vascular Hospital
– Fort Worth also realized strong volumes in fiscal
year 2019 for implantable cardioverter defibrillators
(ICDs) and cardiac resynchronization therapy (CRT).
• Available CRT devices provide multipoint
pacing, a “next generation” form of CRT that
pace the ventricles from three sites instead
of two. This form of pacing has been shown
to increase the clinical response rate of heart
failure patients in early clinical trials.
• Treatment options include leadless
pacemakers that are implanted using femoral
access and are entirely contained within the
heart itself.
The electrophysiology area of Baylor Scott
& Heart and Vascular Hospital - Fort Worth
participates in the ICD Registry.
(FY17)
EP cases
EP procedures
53
Generator
procedures/
adverse events
US
Hospitals
BSW-
HVH-
FW
Better,
same or
worse
Intra- or post-procedure events
Incidence of any
adverse event
(excluding death) 1.6% 1.4%
Incidence of death
or any adverse event
(implant procedures) 1.8% 1.4%
Cardiac arrest 0.3% 0.0%
Cardiac perforation 0.1% 0.0%
Cardiac tamponade 0.1% 0.0%
Hematoma (requiring a
reoperation, evacuation
or transfusion) 0.2% 0.0%
Infection requiring
antibiotics 0.1% 0.0%
Better
Post-procedure event(s)
Lead dislodgement
0.5%
0.0%
Source: ICD Registry, NCDR, rolling four quarters ending Q4 2018.
Better