Category Archives: Cardiology

Cardiology

The benefits of implementing FFR-CT in clinical practice – Cardiovascular Business

He said the integration of FFR-CT not only informs medical decisions, but also profoundly impacts patient care. Gupta said the images can be shown to patients to help explain their condition to empower them with a deeper comprehension of their condition. Sharing FFR-CT results and images with referring providers and patients also fosters a collaborative approach, ensuring everyone involved comprehends the nuances of the diagnosis and treatment strategy.

Valley Health System sends about 25-29% of patients undergoing coronary CT exams to also undergo a HeartFlow analysis. Rather than employing FFR-CT universally, Gupta's team judiciously selects patients falling within the intermediate category, typically encompassing those with coronary disease that appears to block from 40% to 90% of a vessel. This selective approach allows for a nuanced assessment of patients who stand to benefit most from FFR information. It is not merely about determining who needs a catheterization procedure, but understanding the physiology of the disease for appropriate decision-making.

"We make sure that the referring providers, who are many times interventionalists, understand what the disease is, the severity of disease and if the patient is going to benefit form an invasive procedure. Alternatively, we would do FFR and we will find disease, which in some cases may not necessarily need invasive angiogram, despite knowing that there is significant disease. This is partly because we know from medical literature that medical management is equally good if not better, especially in a lower risk population. So we are trying to stratify the patient population. Thirdly, I think it provides a peace of mind to the patients, because they understand their disease better," Gupta explained.

Efficiency is paramount in cardiac care, and Gupta underscored the fast turnaround times for FFR-CT results. Reports are usually available within a day, he said, and it can be even quicker in emergency cases.

Implementing FFR-CT as a gatekeeper has impacted cath lab utilization. While diagnostic catheterizations may see a reduction, the precision of FFR-CT aids interventionalists in planning procedures more efficiently. Guta said this can help reduce radiation exposure and optimize contrast use. Also, the 3D FFR-CT images can serve as a clear roadmap for interventions, contributing to enhanced patient safety and procedural efficacy.

"I believe that it is actually helping the interventionalist plan the procedure in which we are finding frequently, at least at our center, they would either take very limited pictures of the coronary arteries or use special kinds of catheters where they can directly go for intervention based on what the study results shows on the CT and the FFR. They also know upfront exactly what to fix and what not to fix," Gupta explained.

One unique factor about Valley Health System is it uses a collaborative model for reading cardiac exams, combining the expertise of both radiologists and cardiologists. Gupta said their joint efforts, coupled with robust quality control processes, ensure the optimal integration of FFR-CT into clinical practice.

"We basically thrive on each other's strength. So we have a couple of very high-quality radiologists working with a couple of high-quality cardiologists and we are continually expanding our team," Gupta said.

Beyond its conventional use in coronary artery stenosis, Gupta's team is exploring other novel applications of FFR-CT. This includes evaluating anomalous coronary artery physiology, studying gender-based differences in chest pain presentations and evaluating patients during transcatheter aortic valve replacement (TAVR) pre-procedural workups.

"We are able to do a CT angiogram at the same time of a TAVR evaluation for the coronary arteries. We combine it with FFR data to try to risk prognosticate what is the risk of any event during the TAVR procedure and determine if they need an invasive angiogram or any kind of interventional procedure. So it really helps optimize high-risk, frail patients in terms of more optimal outcome," Gupta said.

FFR-CT was included as a recommendation in the 2021 ACC/AHA chest pain guidelines to evaluate chest pain. It was the first clinical artificial intelligence (AI) algorithm to be included in any U.S. cardiology guidelines.

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The benefits of implementing FFR-CT in clinical practice - Cardiovascular Business

Cardiology

Hybrid coronary revascularization vs. CABG for multivessel CAD: New meta-analysis tracks long-term outcomes – Cardiovascular Business

Hybrid coronary revascularization (HCR) and coronary artery bypass grafting (CABG) are associated with comparable long-term mortality rates among patients with multivessel coronary artery disease (MVCAD), according to new data published in the American Journal of Cardiology.[1] However, HCR patients were more likely to experience certain adverse events.

HCR, as the name suggests, is a combination of two different revascularization techniques. It includes both minimally invasive for the left anterior descending (LAD) coronary artery and traditional percutaneous coronary intervention (PCI) for non-LAD lesions.

Previous studies showed the short-term benefits of HCR, including comparable mortality, reduced lengths of intubation and hospital stay, and less transfusion than CABG, wrote first author Junichi Shimamura, MD, with the division of cardiothoracic surgery at Westchester Medical Center in New York, and colleagues. However, the current guidelines do not recommend HCR as a routine procedure. This is partly because the previous analyses were based on retrospective data, and there is a lack of randomized controlled trials and meta-analyses in a large population with a long-term outcome.

Shimamura et al. tracked data from 13 different studies comparing the two techniques. The mean patient age was 64.3 years old, and the mean follow-up period was 5.1 years.

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Hybrid coronary revascularization vs. CABG for multivessel CAD: New meta-analysis tracks long-term outcomes - Cardiovascular Business

Cardiology

5 Things Not to Do at Your Cardiologist Appointment – Livestrong

Lying to your cardiologist about your symptoms could be harmful to your health.

Image Credit: SDI Productions/E+/GettyImages

Before we dive into the things you shouldn't do at the cardiologist, let's start by saying it's great you're seeing a cardiologist in the first place. Taking care of your heart is important especially as you age.

Heart disease is responsible for one out of every five deaths in the U.S., according to the Centers for Disease Control and Prevention, but catching it early (or its risk factors like high blood pressure and elevated cholesterol) gives you enough time to treat it properly.

While seeing your cardiologist is a great first step, there are some things you may unintentionally do to sabotage these appointments, like withholding information or lying to your doctor.

Here, learn habits that cardiologists wish their patients would stop doing at checkups.

No, this doesn't mean dressing in your best outfit, but rather, telling your cardiologist what you think they want to hear, says Elizabeth Klodas, MD, FACC, a preventive cardiologist in Edina, MN and creator of Step One Foods.

For example, you might say you never eat fast food (when you do), or that you eat fruits and vegetables every day (when you don't). The thing is, this information may change the course of your treatment, if a condition is uncovered at an appointment.

"A statin [cholesterol-lowering medication] is much more likely to be prescribed to someone with high cholesterol who also reports eating a healthy diet and not drinking too much," Dr. Klodas says.

On the other hand, if you have high cholesterol but admit to a not-so-great diet, your doctor may suggest trying diet and lifestyle changes first before medication, if that makes sense with your health history, Dr. Klodas says.

"Physicians are not mind readers. They can only rely on what you tell them," Dr. Klodas says. "They've also seen and heard it all, so you don't have to worry that you will shock or disappoint them," she adds.

The internet can be a scary place, especially if you're worried about a certain health symptom and you recruit Google to get answers.

"Sometimes a patient has been Googling their symptoms and without proper context, pressures their doctor to order or prescribe certain things," says Mary Greene, MD, a cardiologist with Manhattan Cardiology in NYC and contributor to LabFinder.

The problem is that this can lead to "unnecessary and expensive" testing, she says.

While it's absolutely important to be an informed patient and advocate for yourself (especially if you feel your doctor's not listening to you), try to approach your appointment with a collaborative mindset, Dr. Greene says.

This means, it's OK to ask, "what do you think about this?" or "I read this online, does it apply to me?" and being open to what your doctor has to say. This will lead to a much more helpful discussion about what's best for you, Dr. Greene says.

Maybe you've found it difficult to walk up the stairs lately. Or, you've started circling the parking lot to find a parking space closest to the grocery store entrance. Dr. Klodas wants you to pay attention to those symptoms and report them to your cardiologist.

"No doubt our bodies become less cooperative as we age. But a lot of symptoms that people don't bother reporting (because they think they're a normal part of aging) can be clues to potentially reversible underlying health issues," she adds.

For instance, being short of breath during normal activities is a potential sign of cardiovascular disease not just a sign that you're out of shape or getting older.

Another interesting example? Erectile dysfunction can also be a "first clue" you have atherosclerosis, Dr. Klodas says. Even when you think it isn't related, it might be, so don't be afraid to speak up.

Similar to wanting to "look good" for your cardiologist, there's a specific tendency to hide how much alcohol you drink, whether you smoke cigarettes and whether you use recreational drugs, says Allan Stewart, MD, a cardiac surgeon in Miami, FL.

These things are important to disclose at checkups, especially if you need heart surgery in the future. Why? Because it can affect your post-op recovery.

For example, if you drink every day and then go into surgery, you may have symptoms of alcohol withdrawal during recovery, and these symptoms can mimic a stroke, Dr. Stewart says. You may then be prescribed lots of expensive testing, which will also delay alcohol withdrawal treatment.

Dr. Stewart also says that smoking affects your recovery, while recreational drug use may affect the heart's response to medications and anesthesia.

"Surgeons are not judgmental people. We just want to know all of the possible issues we may face, so we can properly plan for your safe recovery," Dr. Stewart says.

The best time to talk about these things is during an in-office visit, when that planning can be done.

Not all of your concerns can or will be resolved in one office visit, Dr. Greene says. "Whenever you see any doctor, expect there to be some follow up," she says.

When it comes to specific heart issues, it may take time (and often multiple tests) to figure out what's going on. After these tests are complete, your cardiologist can come up with a personalized treatment plan.

Try to schedule any follow-up appointments at the end of your initial visit. And aim to see the same cardiologist each time, so they can continue the conversation about your specific needs.

"Building this doctor-patient relationship takes time, but can be helpful in getting the best treatment possible," Dr. Greene says.

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5 Things Not to Do at Your Cardiologist Appointment - Livestrong

Cardiology

BLOG: Combining Local Impedance with Contact Force to Perform RF Ablation – Diagnostic and Interventional Cardiology

When performing radiofrequency (RF) ablation to treat cardiac arrhythmia, medical professionals must balance the safety of the patient with the efficacy of the procedure. Several important safety considerations are at play.

Physicians want to avoid mechanical perforation of the cardiac tissue, which can be caused by applying too much force in positioning the catheter. They also want to avoid unintentional damage to tissue or nontargeted structures during RF delivery.

Among the rare but serious complications associated with RF ablation are steam pops, which occur when ablated tissue is heated above 100 C, causing an explosion of steam to be released and unwanted damage to the tissue. In a worst-case scenario, a steam pop can tear a hole in the wall of the cardiac tissue allowing blood to leak into the pericardium. This can lead to cardiac tamponade, when the pressure from the blood surrounding the heart prevents it from beating.

Since the introduction of RF ablation as a cardiac arrhythmia therapy, advances have been made in the technologies and methods of delivering RF. These include the introduction of advanced mapping, multi-electrode and irrigated catheters, contact force, and the use of measures of tissue resistivity, or impedance, as a means to track RF delivery and lesion development.1

Boston Scientific offers RF ablation catheters with technology that enables capture of impedance metrics nearer the tissue to be treated. With the DIRECTSENSE Technology-enabled catheters, impedance can be measured around the tip of the catheter, avoiding the interference of far-field signals and capturing insights on cardiac tissue resistivity.

Local impedance has been demonstrated to more accurately indicate subsurface tissue temperature and lesion formation than does surface temperature. In tissue tests with embedded thermocouples, local impedance drop followed the rate and magnitude of the rise in intra-lesion temperature, demonstrating a correlation between the metric and volumetric heating as it occurs.2 Local impedance has also been found to respond with greater specificity and sensitivity in identifying abnormal substrate all valuable feedback in helping inform optimal delivery of ablation therapy.

Boston Scientific has now incorporated contact force capabilities into their DIRECTSENSE-enabled ablation catheters.

The investigational device INTELLANAV STABLEPOINT Ablation Catheter brings together the handling and inputs of contact force catheters with the ablation feedback offered by DIRECTSENSE local impedance. Available with RHYTHMIA HDx Mapping System (pictured above), the STABLEPOINT catheter is designed to help physicians verify contact, discern tissue characteristics, monitor subsurface tissue heating for predictable and controlled delivery of RF.

With the addition of force technology, the STABLEPOINT catheter can help confirm tissue contact and catheter-tip stability for the duration of RF delivery. In one study, force readings enabled two independent users to maintain a stable average force of +/- 5 grams, compared to starting force, for the full duration of >90 percent of point-by-point PVI applications.3

Using local impedance, physicians gain insights into tissue characteristics and resistivity, input that can help guide the ablation strategy. Changes in local impedance during ablation offer information on lesion development and feedback that can help safeguard against tissue overheating.

Recent studies have examined the STABLEPOINT catheters use in clinical settings. In a multicenter, prospective study conducted across Europe, Asia, and the United States, 299 patients treated for de novo atrial fibrillation (AF) underwent pulmonary vein isolation with the STABLEPOINT catheter guided by RHYTHMIA HDx Mapping System. STABLEPOINT in the NEwTON AF Study met the 30-day and 12-month primary safety endpoints as well as the acute, 6-month and 12-month primary effectiveness performance criteria for the use of the catheter in this patient population.4 At 12 months, data indicated a 4 percent incidence of adverse events. Freedom from atrial flutter and atrial tachycardia in the study group was 90.2 and 97.6 percent, respectively.4

A separate, multicenter study of 212 consecutive patients treated for AF with the STABLEPOINTcatheter assessed results across 13,891 RF applications of a 3 second duration. High-power, short-duration ablation with contact force and local impedance resulted in a 93.3 percent rate of successful first-pass isolation with no reported steam pops or major complications. Researchers also noted that the combination of local impedance drop with good contact led to a reduction in the duration of RF.5

Editor's note: This is the conclusion of a three-part series on cardiac ablation technology.Part one,Pulsed Field Ablation: A New Ablation Method,addressed pulsed field ablation; Part two, Cryoablation Gets New Tech," covers next-generation cryoballoon technology.

1. Habibi M, Berger RD, Calkins, H. Radiofrequency ablation: technological trends, challenges, and opportunities. EP Europace. 2021;23(4): 511519. doi.org/10.1093/europace/euaa328

2. Garrott KE, et al. Intra-lesion temperature rise and local impedance drop predictive of lesion growth on RF ablation catheter with mini electrodes. Abstract. Heart Rhythm Annual Meeting. May 2020.

3. Internal BSC Report 92464384.

4. NEwTON AF: Clinical Evaluation of the STABLEPOINTTM Catheter and Force Sensing System for Paroxysmal Atrial Fibrillation. NEwTON AF Study (NCT04580914) presented at AHA, November 2023.

5. Lepillier A, Maggio R, De Sanctis V, et al. Insight into contact force local impedance technology for predicting effective pulmonary vein isolation. Front Cardiovasc Med. 2023;10. doi.org/10.3389/fcvm.2023.1169037

Caution: Investigational device. Limited by Federal (or U.S.) law to investigational use only. Not available for sale. 2023 Boston Scientific Corporation or its affiliates. All rights reserved. All trademarks are the property of their respective owners. EP-1755903-AA

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BLOG: Combining Local Impedance with Contact Force to Perform RF Ablation - Diagnostic and Interventional Cardiology

Cardiology

Heart attack breakthrough: New protocol saves 71% of patients with deadly complication – News-Medical.Net

Published results of a large, national heart attack study show that patients with a life-threatening complication known as cardiogenic shock survived at a significantly higher rate when treated with a protocol developed by cardiologists at Henry Ford Health, in collaboration with 80 hospitals nationwide.

Cardiogenic shock is a critical condition in which the heart is unable to pump enough blood to sustain the body's needs, depriving vital organs of blood supply. This can cause those organs to eventually stop functioning. The typical survival rate of this deadly complication during a heart attack has historically hovered around 50%.

Led by a cardiology research team based at Henry Ford Hospital in Detroit, the National Cardiogenic Shock Initiative (NCSI) results demonstrate a survival rate of 71% in patients whose heart attack was complicated by cardiogenic shock and were treated with the protocol. Final results from the national study published in the Journal of the American Heart Association were achieved from looking at 406 patients from hospitals across 29 states.

The National Cardiogenic Shock Initiative is the largest prospective study of therapy for severe heart attack cardiogenic shock done in the United States in the past two decades. The impressive results from our study in the U.S. have also prompted the use of our protocol in Japan where they are experiencing similar great outcomes."

William O'Neill, M.D., medical director emeritus of Henry Ford's Center for Structural Heart Disease and principal investigator of the study

The treatment algorithm, available at henryford.com/cardiogenicshock, emphasizes quick recognition of the condition, then inserting a temporary straw-sized pump into the heart to keep blood flowing throughout the body. The Impella heart pump, an FDA-approved device, is inserted through a catheter in the groin as soon as the patient arrives at the hospital. Doctors then treat the cause of the heart attack, either inserting a stent, removing a clot or taking other necessary action.

The NCSI study involved cardiologists at both community hospitals, where many patients with heart attack first present, and large academic centers. Of the more than 1,100 patients who were screened, 406 were enrolled into the study. The study also isolated predictive markers that indicate a patient's condition, an invaluable tool in determining treatment.

The NCSI participating hospitals agreed to treat patients who presented with acute myocardial infarction and cardiogenic shock using a standard protocol, which involved rapid initiation of mechanical circulatory support (MCS) with an Impella 2.5 or Impella CP heart pump, along with right heart catheterization to assess status of right and left ventricular heart function. Patients were enrolled between July 2016 and December 2020.

"The study results show remarkable survival, the highest we've seen in any study so far," said Babar Basir, D.O., Director of Acute Mechanical Circulatory Support at Henry Ford Health and principal investigator of the study. "The results show that we now have therapy that can save lives and improve outcomes for people who've had severe heart attacks and we haven't had results like these in 20 years. The protocol has already saved many lives and will continue to do so as more hospitals adopt its principles."

In the U.S., approximately 80,000 people are diagnosed with cardiogenic shock as a result from a heart attack each year according to data from a published study that looked at a 15-year trend from 2004 to 2018.

Dr. O'Neill will continue to lead research in the next NCSI phase in an upcoming study titled Recover IV Trial.

"Implementing this protocol has truly been a joint effort with hospitals that have experienced the devastating burden of cardiogenic shock," said Sarah Gorgis, M.D., a cardiologist at Henry Ford Health and co-researcher for the study. "Our work has just begun, but this protocol gives us hope since we have seen first-hand the impact it can make on survival."

"The NCSI initiative was critically important. It changed how we approach the management of patients with cardiogenic shock, and with those changes, we witnessed improvements in survival , for the first time in decades," said Herb Aronow, M.D., medical director of Heart & Vascular Services at Henry Ford Health.

"Bringing together 80 different sites to investigate an innovative treatment protocol for Acute myocardial infarction complicated by cardiogenic shock is an incredible accomplishment by our NCSI team and heralds highly promising new approaches to improving outcomes in this challenging patient population," said Henry Kim, M.D., Division Head of Cardiology at Henry Ford Health.

Source:

Journal reference:

Basir, M. B., et al. (2023) Early Utilization of Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock: The National Cardiogenic Shock Initiative. Journal of the American Heart Association. doi.org/10.1161/JAHA.123.031401.

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Heart attack breakthrough: New protocol saves 71% of patients with deadly complication - News-Medical.Net

Cardiology

Saint Mary’s sues Renown Health again over alleged cardiology monopoly – Reno Gazette Journal

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Cardiology

Michelle Bloom, MD, Named System Director of Cardio-Oncology at NYU Langone Health – NYU Langone Health

A renowned expert in cardio-oncology and heart failure, Michelle Bloom, MD, has joined NYU Langone Health as system director of the Cardio-Oncology Program, which provides specialized care to protect patients heart health throughout cancer treatment and survivorship.

Dr. Bloom is a professor in the Department of Medicine and a member of the Division of Cardiology at NYU Grossman Long Island School of Medicine. She has a secondary appointment as clinical professor in the Department of Medicine and is a member of the Leon H. Charney Division of Cardiology at NYU Grossman School of Medicine. Before joining the institution December 1, she was at Stony Brook University Hospital, where she served as co-director of the Cardio-Oncology Program, director of outpatient services for the Heart Failure and Cardiomyopathy Center, and associate professor in the Department of Medicine at Stony Brook School of Medicine.

We are thrilled to welcome Dr. Bloom to NYU Langone Heart, where she will provide valuable expertise as we expand our cardio-oncology program, said Glenn I. Fishman, MD, the William Goldring Professor of Medicine in the Department of Medicine and director of the Leon H. Charney Division of Cardiology. Her experience as a clinician, educator, and researcher will further enhance the NYU Langone community. We look forward to a phase of significant clinical and academic advancement under her leadership in our program.

As a well-recognized and accomplished heart failure specialist, Dr. Bloom will also continue a robust heart failure practice at several NYU Langone locations on Long Island, including NYU Langone Cardiology AssociatesMineola.

As a specialist in the field of cardio-oncology, Dr. Bloom focuses on early prevention, detection, treatment, and management of the potential cardiac effects of cancer treatments, so that patients can safely continue their therapies. She will lead the system-wide program, which unites cardiologists, oncologists, immunologists, and researchers from both NYU Langone Heart and NYU Langones Perlmutter Cancer Center to coordinate personalized cardiac care designed with our patients with cancer in mind. Dr. Bloom and the team also offer specialized treatment to cancer survivors so that their risk of cardiovascular disease can be recognized early and minimized. Dr. Bloom has been a pioneer in the field, publishing in peer-reviewed journals on how to best provide cardio-oncology care.

I take care of people for years beyond their cancer treatment and cherish these relationships, loving my patients like they are my own family, said Dr. Bloom. After spending more than a decade managing the heart health of thousands of patients on Long Island, Im honored to join the NYU Langone community, where theres a strong culture of innovation and patient-centeredness. With the dedication of our team, I know we can make further significant advancements in the field that will result in improved outcomes for our patients.

We are very fortunate to have Dr. Bloom, with her background and expertise, join our faculty and patient care operations, said Joseph J. Greco, MD, senior vice president and chief of hospital operations at NYU Langone HospitalLong Island. The combination of her personal experiences and training translates to exceptional, personalized patient care for our Long Island community and beyond.

An alumna of Rutgers Robert Wood Johnson Medical School, Dr. Bloom completed her residency in internal medicine at Montefiore Medical Center. She went on to complete a fellowship in cardiology and advanced training in heart failure, mechanical device support, and cardiac transplant at the Icahn School of Medicine at Mount Sinai before joining the faculty at Stony Brook in 2011.

Katie Ullman Phone: 646-483-3984 Kathryn.Ullman@NYULangone.org

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Michelle Bloom, MD, Named System Director of Cardio-Oncology at NYU Langone Health - NYU Langone Health

Cardiology

Northwest Health La Porte Among Nation’s Top Performing Hospitals for Treatment of Heart Attack Patients – NWI.Life

Northwest Health La Porte has received the American College of Cardiologys NCDR Chest Pain- MI Registry Platinum Performance Achievement Award for 2023. This is the highest honor awarded by the American College of Cardiology for the treatment of heart attack patients and Northwest Health La Porte is one of only 262 hospitals nationwide, and the only hospital in Northwest Indiana to receive the honor.

This achievement is due to the expertise of the cardiologists, emergency room physicians, nurses, and other caregivers on staff at the hospital, said Jami Jackson, BSN, RN, chest pain coordinator for Northwest Health La Porte. The Chest Pain - MI Registry empowers our health care team to consistently treat heart attack patients according to the most current, science-based guidelines. This establishes a national standard for understanding and improving the quality, safety and outcomes of care provided for our patients with coronary artery disease.

According to the American College of Cardiology, the award recognizes Northwest Health La Portes commitment and success in implementing a higher standard of care for heart attack patients and signifies that Northwest Health La Porte has reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations.

To receive the Chest Pain-MI Registry Platinum Performance Achievement Award, Northwest Health La Porte has demonstrated sustained achievement in the Chest Pain- MI Registry for two consecutive years (2021 and 2022), and performed at the highest level for specific performance measures. Full participation in the registry engages hospitals in a robust quality improvement process using data to drive improvements in adherence to guideline recommendations and overall quality of care provided to heart attack patients.

It is an honor to award Northwest Health La Porte with the Platinum Performance Award for their valuable national leadership and dedication to meeting comprehensive performance measures in patient care, said Michael C. Kontos, MD, FACC, chair of the NCDR Chest Pain MI Registry Steering Subcommittee, and cardiologist at Virginia Commonwealth University Medical Center. The receipt of this award indicates that Northwest Health La Porte remains committed to providing top quality, guideline-driven care for heart attack patients. Their success ensures patients are receiving the highest quality cardiovascular care.

The Centers for Disease Control estimates that over 800,000 Americans suffer a heart attack each year. A heart attack occurs when a blood clot in a coronary artery partially or completely blocks blood flow to the heart muscle. Treatment guidelines include administering aspirin upon arrival and discharge, timely restoration of blood flow to the blocked artery, smoking cessation counseling and cardiac rehabilitation, among others.

About Northwest Health

Northwest Health is a comprehensive healthcare system committed to providing communities in Northwest Indiana with high-quality, accessible healthcarefrom highly specialized care and surgical services to more routine primary care. The system of more than 60 access points includes three hospitals, five emergency departments, urgent care centers, outpatient surgery centers, an ambulance service, and physician offices. A team of more than 3,000 employees work together with the more than 700 physicians on its medical staffs. For more information, visit NWHealthIN.com.

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its more than 56,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.

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