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Duke Heart – March 1st 2020 – Updates

Chief’s message:

It’s increasingly difficult to keep things in perspective as the world rapidly changes around us.  The Coronavirus disease 2019 COVID-19 news and daily information from the CDC, WHO and local authorities keeps our utmost attention.  Yet we are all working to balance and continue our ongoing care for patients and each other.  The latest information from a scientific perspective can be found @ JAMA Current.

The JAMA resource center has interviews with CDC, NIH, and Chinese officials including an interactive map.  The case reports of the first 72,314 cases from China can also be found here.   https://jamanetwork.com/journals/jama/pages/coronavirus-alert

Over the upcoming days, weeks, and likely months we will all be following and working together to help manage and provide care/support to those in need.

As with all crises, we balance this with our ongoing lives which we attempt to keep moving as much as possible.  This week for Duke Heart our highlights included the AHA Heart Ball, discoveries and publications, expanding and partnering around EP lead extraction management, and continued recognition of several of our faculty and fellows.  Thanks to all of the members of the Duke Heart group that work to help us carry out our missions.

Highlights of the week:

U.S. News/Best Hospitals Voting is Open

Voting is open in Doximity for U.S. News & World Report “Best Hospitals”. Please visit your Doximity account and enter your vote. Thank you!

Lead Extraction Program Expands to Wake Med/HCP+

Congratulations go out to the Duke Electrophysiology (EP) team for the expansion of their lead extraction program to include patients at Wake Med. As part of our HeartCarePlus+ partnership, Sean Pokorney is conducting laser lead extractions at Wake Med with Judson Williams, executive medical director of the Wake Med Heart & Vascular program and an adjunct faculty member in Duke’s Department of Surgery; Williams completed his cardiothoracic surgery training here at Duke.

Pokorney is providing his expertise in lead extraction as well as Duke’s model of care, which utilizes a combined lead extraction team with an EP, a cardiothoracic surgeon and a cardiac anesthesiologist working alongside a highly skilled support team of APPs and imaging technicians. Pokorney’s team performed their first laser lead extraction at Wake Med on Feb. 21 and is currently the only team in Wake County using a laser during lead extractions and the only one using the combined team approach.

Duke EP is a regional referral center for lead extractions. For those of you who may be unfamiliar with this patient population, these are patients with implanted pacemakers or defibrillators who have an electrical lead that has either become infected or who require one or more leads to be removed for other medical reasons. Patients with lead infections must be treated. Often, patients with lead infections will receive antibiotics, but this isn’t a viable long-term solution as it will not cure the underlying problem and patients will need repeated courses of antibiotic therapy. Without extraction, patients with infections have a significant one-year mortality rate compared to those who do have the lead removed.

Removal of the leads is complicated process. Scar tissue commonly develops around leads, making them difficult to remove without causing tears or punctures to the delicate heart tissue – complications of which can be catastrophic — which is why the skill level of practitioners is critically important. Lead extractions done by highly skilled EPs have become very safe with good outcomes.

There are approximately 30,000 pacemaker lead infections annually in the U.S. and an estimated 12,000 lead extractions done per year. Duke has one of the highest volume lead extraction programs in the world. In 2019, Duke’s EP team performed 120 lead extractions, its highest volume to date. With high patient volumes and the strongest safety protocols in place, Duke’s program offers access to the most technically skilled electrophysiologists in the U.S., partnering with highly experienced cardiothoracic surgeons and anesthesiologists who are ready for any type of complication that could arise.

The Duke team has been performing both laser and mechanical approaches to lead extraction and is highly skilled in both methods. The team plans to expand again soon when Rob Lewis begins taking on cases later this year with a combined team at the Durham Veterans Affairs Medical Center.

Richard Palma Joins Duke Heart

We are pleased to welcome Richard Palma, BS, RDCS, RCS, ACS, FSDMS, FASE, to the Duke Heart team. Palma joined us in January as director and clinical coordinator of the Duke Cardiac Ultrasound Certificate Program (see below).

Palma comes to Duke from St. Francis Hospital & Medical Center in Hartford, CT where he served as the director and clinical coordinator of the School of Cardiac Ultrasound at the Hoffman Heart and Vascular Institute.

He brings a wealth of experience to Duke not only as a cardiac imaging specialist, but as a program director with the skills to build a program from scratch, having built the program at St. Francis.

He has worked in the field of cardiac imaging since 1990 and was one of the first in the U.S. to earn the Advanced Cardiac Sonographer (ACS) credential and one of the first to become a fellow of the American Society of Echocardiography. In 2011, he received the Distinguished Educator award from the Society of Diagnostic Medical Sonography (SDMS); he was induced as a fellow of the SDMS in 2016.

An author or co-author of numerous papers and educational materials, Palma lectures nationally and internationally on adult echocardiography and contrast.

He holds a BS in Education from Northeastern University with a concentration in cardiovascular health and exercise. He and his wife, Terri, reside in Durham. Terri is a physical therapist here at Duke. They have three adult children: Chloe, a physician assistant; Lucas, a manager at Oracle, and Sydney, who is in her third year of nursing school in Philadelphia.

Please offer him a warm welcome when you see him!


Duke Heart Launches Cardiac Ultrasound Certificate Program

We are excited to announce that Duke Heart is partnering with the Duke University School of Medicine to offer a Cardiac Ultrasound Certificate Program. The program will be led by Anita Kelsey, medical director and Richard Palma, director.

The one-year, full-time, allied health certificate program will train post-Bachelors students to become knowledgeable cardiovascular professionals who perform adult cardiac ultrasound procedures.

The program will matriculate its first class of eight students this year in September. Applications are now available online and will be accepted through June 1. To learn more, please visit: https://medicine.duke.edu/divisions/cardiology/education-and-training/duke-cardiac-ultrasound-certificate-program.


Terrific write-up on Svati Shah late last week (see News, below, or click here). Nancy Brown, CEO of the American Heart Association, authored the piece which appeared on Thrive Global.

CRT 2020

Duke was well represented at the Cardiovascular Research Technologies (CRT) 2020 interventional conference held Feb. 22-25 at Gaylord National Convention Center, National Harbor, MD.

Shown here are Marc Samsky, Rajesh Swaminathan, Tracy Wang, Mitch Krucoff, David Kong and Sunil Rao.

Thanks to Sunil for the photo!


Out & About

Marat Fudim was able to have dinner and attend a Duke men’s basketball game last weekend with none other than Richard Schatz, interventional cardiologist at Scripps Clinic. Schatz is the 2019 recipient of the Fritz J. and Dolores H. Russ Prize, presented by the National Academy of Engineering and Ohio University for his seminal role in the development of heart stents. Fudim said they both enjoyed the game, adding, “how could one not with those seats?”

Good Catch, Hutter!

The Duke Heart leadership team recognized Kimberly Hutter of 7 East with a Good Catch award. Hutter identified a medication safety issue for a Duke Heart patient.

The team wrote, “Your dedication and commitment to your team and Duke Heart patients and families enables us as an organization to deliver on our Core Value and strive towards Zero Harm. Please take time to celebrate your personal and professional accomplishments today.

Thank you again for all you do each and every day to make Duke Heart a great place for our patients, their loved ones, and each of our staff!”

Way to go, Kimberly!

Heart Stepdown Units Celebrate Quality Milestones

Special recognition to the 3100 and 7300 on reaching significant quality milestones!

Congratulations to team 3100 for 814 days since their last Catheter Associated Urinary Tract Infection! We appreciate the measures staff, Hospital Acquired Infection Champions (Taylor Smith, Missy Sturdivant, Tyler Adcock), and 3100 nursing leadership (Heather McKinney, Beth McChesney, Sarah Tucker) have implemented to provide quality care to our patients. Shown here are members of 3100. Nice job! Keep up the great work!

Congratulations to the 7300 team for 372 days since their last Pressure Injury and 309 days since their last Central Line Associated Blood Stream Infection!  We appreciate measures staff, Skin Care Champions (Danielle Rogers, Erin Reilly, Leah Shannon), Kelly Smith (WOC), Hospital Acquired Infection Champions (Emily Towery, Salome Williams, Tiffany Gibson), and 7300 nursing leadership (Monica Harper, Abby Ratliff, Leah Shannon) have implemented to provide quality care to our patients. Shown here are members of 7300. Way to go!

ACC Scientific Sessions

Are you presenting at the ACC 2020 Scientific Sessions in Chicago? Please drop a note to Tracey Koepke, director of communications so that she can track your work. If you are on a late-breaker and you think there may be some press coverage, give her a head’s up. Thanks!


Upcoming Opportunities/Save the Date:

Cardiology Grand Rounds

This week we welcome Duke cardiology fellow Anthony Carnicelli who will present Clinical Reasoning Conference. Please join us on Tuesday, March 3 at 7:15 a.m., DN 2003.

Upcoming Grand Rounds:

  • March 10: Heart Center Grand Rounds
  • March 17: Faculty Meeting at 5 p.m.
  • March 24: Carolyn Lam, Duke-NUS
  • April 14: Ryan Tedford, MUSC
  • May 12: Michelle Kittleson, Cedars Sinai

Update: ACC DCRI/Duke Heart Annual Reception

We are looking forward to seeing the Duke team at the upcoming ACC Scientific Sessions in Chicago! The location of the DCRI/Duke Heart annual reception has changed. It will be held in the Regency A Ballroom. Please make sure you update your calendar! Also, gentle reminder, this is a Duke-only event.


Have news to share?

If you have news to share with the Pulse readership, please contact Tracey Koepke, director of communications for Duke Heart at tracey.koepke@duke.edu. We would love to hear about your latest accomplishments, professional news, cool happenings, and any events or opportunities that may be of interest to our Duke Heart family. Please call with any questions: 919-681-2868. Feedback on Pulse is welcome and encouraged.


Duke Heart in the News:


February 21 — Manesh Patel


FDA approves drug that lowers cholesterol in a new way



February 24 — Tazeen Jafar (Duke Global Health Institute)


Community Health Worker Home Visits Cut Blood Pressure



February 25 — Renato Lopes

Healio/Cardiology Today

SECURE-PCI: Atorvastatin loading in planned PCI fails to reduce 12-month MACE



February 25 — Sunil Rao

tctMD/the heart beat

PCI-Related MIs Not Linked to Mortality at 1 Year: Onyx ONE



February 26 — Duke is mentioned


After heart attack, mini-stroke and stroke, survivor has some advice



February 27 — DCRI is mentioned

tctMD/the heart beat

Positive Early Data for TAVR in Low-Risk Patients With Bicuspid Valves



February 28 — Svati Shah

Thrive Global

Her parents taught her grit, caring for others. She’s using those traits to fight heart disease.



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