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Published on: April 21, 2013
Mobile cardiac catheterization registry: report of the first 1,001 patients
R M Bersin1, C M Elliott, A V Elliott
1Sanger Clinic, Charlotte, NC.
Insights
This study assessed the safety and effectiveness of mobile cardiac catheterization, finding it to be a viable option for patients needing cardiac angiography. The registry data supports its clinical utility for diagnosing coronary artery disease.
Area of Science:
- Cardiology
- Medical Technology
Background:
- Mobile cardiac catheterization was introduced in 1989 but lacked systematic performance and safety evaluations.
- A registry was established to monitor outcomes of this innovative cardiac diagnostic procedure.
Purpose of the Study:
- To prospectively evaluate the efficacy and safety of mobile cardiac catheterization.
- To systematically assess the performance and safety of mobile cardiac catheterization since its inception.
Main Methods:
- A registry monitored outcomes of 1,001 consecutive patients undergoing mobile cardiac catheterization over 20 months.
- Patients were screened using AHA/ACC outpatient angiography criteria.
- Data collected included indications, findings, dispositions, and complications via checklist, follow-up, and chart review.
Main Results:
- Catheterization was successful in 99.9% of patients.
- The most frequent indications were angina (46.4%) and atypical chest pain (36.9%).
- Angiographically normal studies occurred in 22.8%, and mild coronary artery disease in 13.6%.
Conclusions:
- Mobile cardiac catheterization is a safe and effective procedure for diagnosing cardiac conditions.
- The registry data demonstrates the clinical utility and feasibility of mobile cardiac catheterization services.
Abstract:
The purpose of this study was to evaluate prospectively the efficacy and safety of mobile cardiac catheterization. Mobile cardiac catheterization was introduced into clinical practice in 1989, but there has been no systematic study of its performance and safety. A registry was established in 1989 to monitor outcomes with mobile cardiac catheterization and is reported here. Patients were screened for eligibility for mobile cardiac catheterization using the joint AHA/ACC criteria for outpatient angiography. Eligible patients underwent mobile catheterization at eight hospitals within 120 miles of the base tertiary center. Helicopter evacuation services were available at each mobile site. The indications, findings, dispositions, and complications of mobile cardiac catheterization were recorded by means of a checklist, telephone follow-up and chart review. A total of 1,001 consecutive patients were entered into the registry in the first 20 months of operation, including 436 females and 565 males aged 22 to 84 years. Angina (Canadian Classes II-IV) was the most frequent primary indication for catheterization (46.4%), followed by atypical chest pain (36.9%), or a positive exercise stress test (25.6%). Infrequent indications for catheterization included a history of myocardial infarction (5.6%), congestive heart failure (7.1%), arrhythmias (4.1%), and valvular heart disease (0.7%). Catheterization was accomplished in 99.9% of patients. Angiographically normal studies were observed in 22.8%, and mild (< or = 50%) coronary artery disease in 13.6% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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