Review of the Cardiac Electrophysiology program at the Minneapolis Heart Institute at

Abbott Northwestern Hospital

Raed H. Abdelhadi, MD, FACC

Cardiac Electrophysiology

Director, Genetic Arrhythmia Clinic

Minneapolis Heart Institute at Abbott Northwestern Hospital

Highlights of the EP program

• More than 2000 procedures in 2013, one of the largest in the country

• Complex ablation procedures:- Epicardial Ventricular tachycardia ablation

- Ischemic VT ablation

- Ablation procedure in patient with ventricular assist devices

- Complex atrial fibrillation and atypical atrial flutter ablations

• High volume extraction program with out of state referral base

Safety and Excellence

• MHI recently participated in a landmark ablation study for treatment of atrial fibrillation. This study included 20 major academic and high volume ablation centers. The ablation success achieved at MHI was the highest of all these prestigious centers

• Unparalleled safety: No deaths directly related to extraction with hundreds of extractions performed

• Data previously presented at HRS showed no major complications with Fidelis lead extractions at the Minneapolis

Case

• 34 year old presented to ER with dizziness, fatigue and frequent palpitations (lasting for 30-60 seconds on occasions)

• No prior cardiac history

• No FH od SCD

ECG

Overnight

Case follow up

• Low EF on echo

• Normal MRI

• Ablation of RVOT VT with resolution of symptoms and normalization of left ventricular function

Unique Programs

• Genetic Arrhythmia Center (GAC)• Provides comprehensive consolidated care and screening for patients AND families with

genetic/familial cardiac

• Helps Identify genetic/familial causes for unexplained sudden death in order to screen family members

• In collaboration with the Jesse E. Edwards registry of Cardiovascular disease and the local medical examiners, we created a sudden cardiac death network that aims to identify potential genetic/familial causes of unexplained sudden cardiac death and subsequently provide appropriate screening and workup for family members

• More than 500 patients/family members have been seem at the GAC clinic

• Multiple families with rare genetic/familial causes of sudden cardiac death were identified and treated

• - Database resulted in multiple national presentations

Patient and data flow within the Sudden Cardiac Arrest Network

Unique Programs

• Midwest Adult Congenital Heart Clinic (MACC):

• In collaboration with Children's Hospital and Heart Clinic we have developed a comprehensive program including electrophysiologic care for adults with treated congenial heart disease

• This is a multidisciplinary program that involves adult electrophysiology, cardiology and advanced imaging.

Unique Programs

• Minneapolis Heart Institute®’s Pacemaker and ICD Clinic

• Provides ongoing care and monitoring for patients with pacemakers and ICDs at 25 locations across the state.

• In 2013, these clinics performed nearly 20,000 device evaluations.

• Unlike some device clinics that contract with device manufacturer representatives to provide device follow-up:

- Staffed by nurses with specialized training in device management. - Most are experienced telemetry or cardiac intensive care nurses.- They meet with patients in person or retrieve device data via telephone.

- Their ability to provide skilled nursing assessments along with their expertise in device management ensures that patients receive expert care

Leading the way…• The world's smallest pacemaker (the Medtronic Micra™ Transcatheter Pacing

System) was implanted by Dr. Charles Gornick here at the MHI as part of a global clinical trial. The procedure was the first of its kind in the United States Midwest. MHI continues to offer the pacemaker for appropriate candidates

• We were early adopters of the subcutaneous implantable cardioverter defibrillator (ICD), which, for some patients, can eliminate some or the complications associated with traditional ICDs

• We also participated in the Watchman™ left atrial appendage closure device trials,

which has shown to be effective in preventing stroke in patients with atrial fibrillation

Thank you!

• Questions?