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2009

Virginia's First Acute Myocardial Infarction Center in Response to Research

Responding to new heart research, Centra Health has launched Virginia's first Acute Myocardial Infarction Center. The Stroobants Heart Center now offers a streamlined process for transferring patients rapidly from distant emergency rooms to Lynchburg for immediate treatment to re-open blocked vessels via catheterization, angioplasty or open heart surgery.

The Acute MI Center was launched based on results from the Danami-2 clinical trial published in 2002. The national study showed moderate reductions in mortality and significant reductions in recurrent events and complications when heart attack victims receive primary angioplasty immediately as compared to clot-busting drugs administered in the emergency department.

In the Danami-2 study, mortality was 15% lower for patients who underwent immediate angioplasty, rather than receiving clot-busting thrombolytics. Recurrent heart attacks dropped from 6.6% of those receiving thrombolytics to 1.6% for those undergoing angioplasty.

"Research is redefining state-of-the-art for cardiac care," said Tom Nygaard, MD, medical director of the Acute MI Center at Lynchburg General Hospital. "For years a wait and see approach was standard. Clot-dissolving drugs would be administered in the Emergency Room and the patient's progress would be monitored. Follow-up interventions – catheterization and stents - might not come until hours or days later."

Today the Stroobants Heart Center moves quickly to intervene to open blocked vessels. The American College of Cardiology standard is to get blood flow restored within 90 minutes of arrival in the ED. Nationally, the average time is a substandard 114 minutes, but the interventional cardiologists at Stroobants average just 75 minutes, one of the best times in the nation.

Physicians in outlying facilities access the Acute MI Center using a toll-free telephone line to arrange a patient transfer. The Stroobants Heart Center will dispatch a helicopter or use ground transport to bring heart attack victims in for treatment.

Air transport is provided by Med Flight III, a helicopter service jointly operated by the Virginia State Police and Centra Health. Medical personnel aboard the helicopter include a nurse and a registered paramedic. Ambulances have also been used. Doctors at both Southside Community Hospital in Farmville, and Bedford Memorial Hospital have referred patients from their emergency rooms to the Acute MI Center.

"Time is muscle when dealing with heart attacks," said Skip Meador, director of cardiac services at Centra Health. "The longer a vessel is blocked, the greater the damage to heart tissue. We've long felt that rapid reprofusion was the best approach, and the Danami research confirmed our belief."

A dozen cardiologists and cardiac surgeons participate in the Acute MI Center program. Centra Health performs more than 3,000 major cardiac procedures each year and earns some of the highest patient satisfaction scores in the country.

For more information, call Tom Urtz at (434) 947-4732.