Electrophysiology
2023 OUTCOMES REPORT
In this podcast, Erica Engelstein, MD, discusses the ways RUSH electrophysiologists treat patients with atrial fibrillation through a number of pharmacologic, non-surgical and surgical approaches, while also helping patients modify risk factors to slow down progression of this chronic disease.
“Some patients are best managed with rate control and anticoagulation so that we don't expose those patients unnecessarily to an invasive procedure. However, if the chances of restoring and maintaining a normal heart rhythm are good--and a lot of patients fit that profile--then they may be better managed with a more aggressive approach including catheter ablation.”
Rounding at
RUSH Podcast
Erica Engelstein, MD
Henry Huang, MD
Director,
Electrophysiology Fellowship
Timothy Larsen, DO
Edward Lipman, MD
Caitlin Boyak, NP
Paula Dunskis, CNS
Liya Lukose, PA-C
Alexander Mazur, MD
Providers
Clinical Site
Reach and Expansion
of patients discharged in atrial or sinus rhythm post-procedure
99.4%
Afib Ablations
This data comes from two different National Cardiovascular Data Registries (NCDR) sponsored by the American College of Cardiology (ACC). Hospitals are required to participate in the LAAO registry and may opt into the Afib Ablation registry. These metrics help identify our quality outcomes and showcase our areas for opportunities to improve patient care. Using both national and regional benchmarks allow us to compare ourselves to hospitals with similar patient populations. Benchmarks are the median (or 50th percentile) unless otherwise noted.
October 2022 – September 2023 (same timeframe used for the below)
National is all hospitals participating in Afib Ablation registry (n=165)
Regional is all urban/suburban hospitals in Illinois & Indiana (n=7)
Volume: 363 procedures
Mortality Rate
0%
(4) Major adverse event intra or post procedure prior to DC
((includes stroke, PE, cardiac surgery, MI, cardiac arrest, TIA, and access site complications)
1.1%
of patients are discharged in 1 day or less
88.7%
of patients discharge same day (with proven results of no greater complications or hospital visits post DC)
48%
Major complications
(including bleeding, stroke
& conversion to surgery)
0%
(3) non-device
related readmissions
7.3%
(6) ANY events from the procedure through 59 days post procedure
(includes any bleeding, stroke or all cause readmission)
14.6%
of procedures successful
(excluding canceled procedures).
97.7%
Mortality Rate
0%
Initial surgery
Left Atrial Appendage Occlusion
(3) bleeding related events
7.3%
(n=45 because July 2022-June 2023)
Rhett Burgess had a feeling something wasn’t quite right. Even getting out of bed in the morning left the normally active, athletic baseball player short of breath.
“I did not understand it and just felt so out of shape,” he recalls.
The Rome, Georgia, nursing student’s suspicions were confirmed at his doctor’s office, where he learned that something was amiss in the lower left chamber of his heart. Tests showed his ejection fraction — a measurement of how much blood the left ventricle pumps with each heartbeat — had dropped by 20%.
Heart issues weren’t new to Rhett. He already had a pacemaker due to complications from previous treatment for an abnormally fast heartbeat. And he was aware that traditional pacing, which involved placing a lead in the right ventricle, could eventually cause side effects like his weakened left ventricle.
Rhett's Story
RUSH Stories
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October 2022 – September 2023 (same timeframe used for the below)
National is all hospitals participating in LAAO registry (n=168)
Regional is all urban teaching hospitals in Illinois (n=14)
Volume: 44 procedures
Follow-up events
Ablations
EP Study
Extractions
ICD Implants
ILR/ICM
Other
Pacemaker Implants
Total Procedures
FY19 Final
FY20 Final
FY21 Final
FY22 Final
FY23 Projected
800
750
700
650
600
550
500
450
400
350
300
250
200
150
100
50
25
0
Ablation (Afib)
1,700
1,600
1,500
1,400
1,300
1,200
1,100
1,000
900
800
700
600
500
400
300
200
100
0
1,353
1,180
1,408
1,614
190
201
166
171
226
340
320
300
280
260
240
220
200
180
160
140
120
100
80
60
40
20
0
340
320
300
280
260
240
220
200
180
160
140
120
100
80
60
40
20
0
252
213
253
295
342
340
320
300
280
260
240
220
200
180
160
140
120
100
80
60
40
20
0
99
116
172
176
160
340
320
300
280
260
240
220
200
180
160
140
120
100
80
60
40
20
0
274
194
193
221
144
170
160
150
140
130
120
110
100
90
80
70
60
50
40
30
20
10
0
91
81
91
130
78
170
160
150
140
130
120
110
100
90
80
70
60
50
40
30
20
10
0
35
28
18
24
22
170
160
150
140
130
120
110
100
90
80
70
60
50
40
30
20
10
0
40
25
9
18
6
170
160
150
140
130
120
110
100
90
80
70
60
50
40
30
20
10
0
40
39
66
61
70
210
200
180
160
140
120
110
100
90
80
70
60
50
40
30
20
10
0
182
156
172
159
180
500
470
440
410
380
350
320
290
260
230
200
170
140
110
80
60
30
0
139
162
263
304
424
401
382
510
542
680
Ablation (SVT)
Ablation (AV)
Ablation (VT)
Ablations
Ablation (Afib)
Ablation (SVT)
Ablation (VT)
Ablation (AV)
EP Study
Extractions
ICD Implants
ILR/ICM
Other
Pacemaker Implants
Total Procedures
1,616
FY23 Lab Volumes
The RUSH electrophysiology (EP) team sees patients in seven clinics across Chicago, and while the majority of them come from Chicago and the surrounding communities, patients from 20 other states also come to RUSH to receive care.
In 2022, RUSH opened new clinic locations in Lincoln Park and Oakbrook, Illinois, and Northwest Indiana. We also opened a newly renovated EP clinic in the RUSH Professional Building, Suite 358.
RUSH Oak Park opened a new EP lab in 2023 that further expanded RUSH’s capacity for these types of procedures to provide a system-wide approach to arrhythmia care.
RUSH’s Coordinated EP Care Team Model
As one of the only coordinated electrophysiology (EP) care teams in the Midwest, RUSH’s EP care team delivers outstanding patient care and satisfaction, while also playing an integral role in supporting RUSH’s superior results.
The care team provides a formal structure to guide patients through their time with RUSH from education to scheduling procedures. The EP team consists of patient navigators, nurses and clinic coordinators who work together with RUSH physicians, advanced practice providers and EP lab staff to ensure that patients are supported through every step of their care.
RUSH’s patient navigators specialize in case creation, coordination, patient scheduling and obtaining pre-authorizations. They also are in touch with patients about procedure times and for appointment reminders, providing them with smooth transitions throughout their EP care.
The EP nurses at RUSH are responsible for providing patients with education before the procedure and answering their calls afterward. They also communicate test and lab results and provide a medication review at each patient touchpoint. The EP nurses also manage referrals, staff and MyChart messages while providing clinical support.
The EP clinic coordinator completes medical record collection for all new patients, checks patients in and then checks on them after and assists with appointment scheduling, reminding patients about them and then calling if they do not arrive as scheduled.
A RUSH cardiology team presented two posters at the American College of Cardiology (ACC) Quality Summit that took place Sept. 14 to 16, 2022, and had over 1,000 attendees. The summit highlighted initiatives to tackle the most common and pressing problems improving the quality of cardiology care. Overall, of the 100 posters submitted for publications from all attendees, only six were selected for presentation.
Sonal Patel, PA-C, presented on the safety of same-day discharges for patients undergoing catheter ablation for atrial fibrillation. She showcased how the RUSH electrophysiology (EP) team decreased the length of stay for patients discharging the same day while not increasing complication rates. The work by the EP team earned it second place at the conference.
Julie Merz, Cardiology’s clinical quality manager, who represented the heart failure (HF) team, presented on the decrease in HF readmissions after implementing the Readmission Engagement and Care Transitions (REACT) program. The REACT team consists of cardiologists, advanced practice providers, a doctor of Pharmacy, a heart failure nurse care manager and a heart failure social worker who provide wraparound care services for high-risk patients needing more support. The REACT team earned an honorable mention at the conference.
ACC Quality Summit
Patient Satisfaction
4,648
5,297
7,141
7,618
9,000
8.000
7,000
6,000
5,000
4,000
3,000
2,000
1,000
0
FY20
FY21
FY22
FY19
14%
Outpatient Visits
Increase
35%
Increase
7%
Increase
FY20
FY21
FY22
FY19
1,355
1,179
1,462
1,586
1,700
1,600
1,400
1,200
1,000
800
600
400
200
0
Procedure Volumes
Increase
8%
Increase
24%
Decrease
13%
Programmatic Areas
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© Copyright 2023 RUSH University Medical Center, RUSH Copley Medical Center or RUSH Oak Park Hospital.
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RUSH Arrhythmia Center
Conduction System Pacing
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Atrial fibrillation clinic
Learn more
For FY 2023, Press Ganey presented their outpatient survey data for RUSH’s EP program, which included the following highlights:
National Performance:
0.8%
(50th; 0.0 75th)
Regional Performance:
0.8%
Physicians
Advanced Practice Providers
Parik Sharma, MD
Section Chief, Electrophysiology Director, Electrophysiology Lab
2
in
quality.
#
Providers
A RUSH cardiology team took part in the Vizient Connections Summit, Sept. 18 to 21. This summit brought together over 4,000 attendees and representatives from over 1,000 hospitals to discuss topics that included health equity and quality improvements.
Parik Sharma, MD, MPH*, Hannah Cooper, MBA**, and Anne Krukowski, MHA***, were part of a panel that presented “The RUSH Arrhythmia Center: Patient-Centered Care Focused on Operational Excellence.” They discussed how RUSH remains focused on providing high-quality care and keeping the patient at the center of workflows and complex care coordination, while responding to increases in clinic and procedure volumes, patient access and internal referrals.
Vizient ranked RUSH University Medical Center No. 2 in its 2023 quality and accountability study.
U.S. News & World Report ranked RUSH University Medical Center among the best in the nation for cardiology and heart surgery care.
National Performance: 96.7%
(50th; 98.7% 75th)
Regional Performance:
94.6%
National Performance:
0.9%
(50th; 0% 75th)
Regional Performance:
0%
National Performance: 12% (50th percentile; 7.4% 75th)
Regional Performance: 14.8%
Procedures by Type
Among the nation's best, again.
Clinicians in the RUSH Arrhythmia Center offer patients with heart arrhythmias the full spectrum of innovative treatments that include medications, ablation and cardiac implantable devices, such as conduction system pacing.
RUSH was one of the early adopters of His-bundle pacing in the United States. As leaders in this space, RUSH providers have published more than 80 studies on His-bundle and left bundle branch pacing and are investigators for some of the latest clinical trials.
Electrophysiologists in the RUSH atrial fibrillation clinic treat patients with newly diagnosed, paroxysmal, persistent and permanent atrial fibrillation and help them modify risk factors and slow down progression of this chronic disease.
Heartlight Endoscopic Ablation System clinical trial
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This study is designed to assess the continued safety and effectiveness of the HeartLight System in patients who are being treated for drug refractory, symptomatic and paroxysmal atrial fibrillation.
of patients were satisfied
with their care at RUSH
95%
of patients would recommend the RUSH
EP program
95%
Clinical Trials
This study investigates the correlation between two commonly prescribed antiarrhythmic medications, Flecainide and Sotalol, which are used in the treatment of atrial fibrillation.
AAD Crossover Study
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Hagai Yavin, MD
* Parik Sharma, MD, MPH, Electrophysiology Section Chief and Director, Electrophysiology Lab at RUSH
** Hannah Cooper, MBA, Program Manager for Heart and Vascular Care at RUSH
*** Anne Krukowski, MHA, Director of RUMG Practice Operations for Heart and Vascular Care at RUSH
National Performance:
98.4.0%
(50th percentile;
99.2% 75th percentile)
Regional Performance:
98.7%
Claim CME Credit
FY23
1,742
FY23
9,357
Learn more
This study investigates the correlation between two commonly prescribed antiarrhythmic medications, Flecainide and Sotalol,
which are used in the treatment of atrial fibrillation.
AAD Crossover Study
Learn more
This study conducts a prospective evaluation of the effectiveness and the mechanisms contributing to the benefits of HIS-CRT compared to Biventricular CRT (BIV-CRT) in patients with Right Bundle Branch Block (RBBB).
HIS-BUNDLE Corrective Pacing
in Heart Failure
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This study assesses the comparative effectiveness of His/LBBP concerning patient-centered outcomes, including quality of life, physical activity, heart failure hospitalization and mortality. Additionally, the study aims to evaluate the comparative safety of His/LBBP in terms of device-related complications and re-interventions (such as lead dislodgement and infection) compared to the standard of care biventricular pacing.
Left vs Left
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This trial assesses the safety and effectiveness of the Amulet Left Atrial Appendage (LAA) occluder in comparison to Non-Vitamin K Antagonist Oral Anticoagulant (NOAC) therapy. This evaluation specifically targets patients with non-valvular atrial fibrillation who are at an elevated risk for ischemic stroke and are recommended to undergo long-term NOAC therapy.
CATALYST Trial
Hagai Yavin, MD
HIS-BUNDLE Corrective Pacing in Heart Failure
Learn more
This study conducts a prospective evaluation of the effectiveness and the mechanisms contributing to the benefits of HIS-CRT compared to Biventricular CRT (BIV-CRT) in patients with Right Bundle Branch Block (RBBB).
This study assesses the comparative effectiveness of His/LBBP concerning patient-centered outcomes, including quality of life, physical activity, heart failure hospitalization and mortality. Additionally, the study aims to evaluate the comparative safety of His/LBBP in terms of device-related complications and re-interventions (such as lead dislodgement and infection) compared to the standard of care biventricular pacing.
Learn more
Left vs Left
CATALYST Trial
Learn more
This trial assesses the safety and effectiveness of the Amulet Left Atrial Appendage (LAA) occluder in comparison to Non-Vitamin K Antagonist Oral Anticoagulant (NOAC) therapy. This evaluation specifically targets patients with non-valvular atrial fibrillation who are at an elevated risk for ischemic stroke and are recommended to undergo long-term NOAC therapy.
Claim CME Credit
FY23
1,742
FY22
9,357
FY23
National Performance:
98.4%
(50th percentile; 99.2% 75th percentile)
Regional Performance:
98.7%
National Performance:
0.8%
(50th percentile; 0.0 75th)
Regional Performance:
0.8%
National Performance:
96.7%
(50th percentile; 98.7% 75th)
Regional Performance:
94.6%
National Performance:
0.9%
(50th; 0% 75th)
Regional Performance:
0%