Keeping the beat: cardiac care in North Carolina is improving, thanks to better treatments and expanded services.



David Fitzgerald and Zan Tyson want patients to go to the hospital only when it's necessary. A screening tool developed through a study conducted by the two cardiologists at High Point Regional Medical Center makes sure that happens.

Patients experiencing atrial fibrillation, the most common type of erratic heart rhythms, took part in the study. Emergency-department doctors and nurses evaluated 233 AFib patients with the risk-factor-based screening tool, Fitzgerald says, and sent 73 to outpatient management--a High Point Regional practitioner or private-practice cardiologist--instead of a hospital bed. During the week following their emergency-department visits, none of them reported complications or were admitted for further care.

While the study results will make more patients happy, they'll put smiles on the faces of health-system and insurance executives, too. The costs to treat low-risk patients as outpatients, according to the study, were significantly less than sending them to the hospital: $1,287 vs. $5,666 per patient on average. Fitzgerald and Tyson presented their results at the American College of Cardiology symposium in April.


Heart disease is the No. 1 cause of death in the U.S., and it killed more than 17,500 North Carolinians in 2014, according to Atlanta-based Centers for Disease Control and Prevention. Raleigh-based N.C. Department of Health and Human Services says hospitals charged $4.1 billion for heart-disease care in 2012. North Carolina doctors and hospitals are working to reduce the cardiac deaths by developing and implementing better technology and techniques, collaboration among medical specialties and new hospitals that feature increased capacity.

Better diagnoses are one way to keep cardiac patients from spending unnecessary time in a hospital. Minimally invasive procedures are one more. Take percutaneous coronary intervention, for example. It's better known as angioplasty, an outpatient procedure. Cardiologists insert a catheter that controls a small balloon-like device that, once in the proper spot, expands a stent that props open a plaque-clogged artery.

Until recently, angioplasty was available only to patients with partial blockages. About 14% of patients with atherosclerosis--accumulation of plaque inside arteries--have a complete blockage, and the procedure has historically been considered too difficult and risky for them. And with only one artery affected...

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