Highlights of the week:
February is Heart Month; Wear Red Day: Friday, Feb. 3
We look forward to celebrating our incredible Duke Heart team throughout the month of February, also known as Heart Month. Please join us in celebrating National Wear Red Day on Friday, Feb. 3. Organization around the U.S. — including the National Heart Lung and Blood Institute (NHLBI), The Heart Truth®, and the American Heart Association (AHA) — celebrate National Wear Red Day annually on the first Friday in February to bring greater attention to heart disease as a leading cause of death for Americans.
On Wednesday, Feb. 1 we have a recruitment/hiring event in partnership with Duke Health HR for our adult heart step-down units. If you know someone who would be a great addition to our team, please let them know about this! Registration is required. Here is the link: Registration is via Qualtrics. The event runs from 8 a.m. to 2 p.m.
Friday, Feb. 3: National Wear Red Day. Send us photos of you and/or your teams sporting some red. We’ll share photos across the month in Pulse and on Twitter.
Feb. 12-18: Cardiac Rehabilitation Week & Cardiovascular Professionals Week
On Feb. 22, we’ll join our local AHA affiliate in offering DUHS staff the opportunity to join a one-hour virtual Hands-Only CPR Awareness Class. Stay tuned for more information on this to share with any Duke team member, especially those without a BLS requirement, who are interested in learning about compression-only CPR.
As we head into February, we thank you for all you do to help in the prevention and treatment of cardiovascular and thoracic diseases in our community, and as thought-leaders in the field. Our work is important – let’s keep up the momentum!
Recognizing Duke Heart’s Exercise Professionals
A belated happy Exercise Professionals Week to the Exercise Physiologist and Exercise Scientists in Duke Heart! We are proud to work with each of you every day. You provide excellent care to the patients in Duke Heart and they reap great benefits from your expertise! The CDU would not be as successful without you — thank you!
Shown here are the Heart CDU Exercise Physiologists celebrating last week at Full Steam in Durham (L-R: Jeff Mikitka, Ashley Swavely, Olivia Dobbin, Erin Young, Anna Gray, Matt Razdom, Jacque Fee).
Trailblazer: Starks Flies High with Promising AED Drone Delivery Network
The sudden cardiac arrest of the NFL’s Damar Hamlin on the playing field has stirred intense public interest in critical, life-saving interventions such as the rapid application of automated external defibrillators (AEDs). But Hamlin’s celebrated recovery is atypical. Survival probability for the 350,000 people who annually experience out-of-hospital cardiac arrest (OHCA) in the U.S. is just 10%, where it has stubbornly remained for more than 30 years.
Duke cardiology researcher Monique Starks, MD, MHS, is working to change that. Starks is the first investigator in the U.S. to be funded by the National Institutes of Health to explore development of a drone network that is capable of delivering AEDs to OHCA bystanders, and she’s flying high with some promising early observations.
Building on her work to improve OHCA emergency response times as a co-investigator in the ongoing RACE-CARs trial, Starks and her team have created mathematical simulation models to evaluate the impact of a drone-deployed AED network on treatment of OHCA. Early results show that response times can be reduced enough to meet the critical five-minute resuscitation window required to preserve good neurological function in survivors.
Optimizing Survival Probability
Historical RACE-CARS cardiac arrest data from 48 North Carolina counties shows median response time (from 911 call to AED arrival) can be improved from eight to seven minutes by equipping all first responders with AEDs. But by adding a drone network on top of that, Starks has shown that the median response time could fall to 4.8 minutes, meeting the critical five-minute resuscitation window.
“With a drone network that’s optimized for placement in strategic areas within each county, we believe that we can reduce the medium response time for most cardiac arrests to less than 5 minutes, which is tremendous,” says Starks, associate professor in the division of Cardiology and a member of the Duke Clinical Research Institute. Starks and a team of Duke researchers and engineers from the University of Toronto recently presented the data at the 2022 American Heart Association Scientific Sessions.
Despite the low survival probability for OHCA, survival rates of 40 to 60% can be achieved if defibrillation occurs within the first five minutes of collapse. However, defibrillation within this threshold is rare as 70% of cardiac arrests occur in the home. When a cardiac arrest occurs in public, it is rare to know whether an AED is nearby and a significant percentage of first responders do not carry an AED despite arrival to the scene of OHCA before paramedics. In North Carolina, the current rate of bystander defibrillation is 2% while nationally the rate is 4%.
Across the 48 North Carolina counties evaluated, only 16% of cardiac arrests have a response time (from 911 call to AED arrival) of less than five minutes. When a first responder AED intervention is added, the percentage increased to 22.3%. Starks found that further implementation of a drone network increased the percentage of OHCA receiving defibrillation within five minutes to 63%.
“We think equipping all first responders with AEDs is the low-hanging fruit but what we show with our mathematical study is that’s a drop in the bucket compared with what drone technology could do,” says Starks.
“The idea of using drones to deliver AEDs within a few minutes of a 911 call is almost 10 years old now and we are still years and a lot of research work away from being ready to do large scale community-based tests of this. But we think it’s worth the effort because in theory, we could get survival rates up to 30-40% or higher and from where we are now that would be a massive breakthrough,” says Starks’s research colleague and clinical cardiologist, Daniel Mark, MD, MPH, professor in the division of Cardiology and Director of Outcomes Research at the Duke Clinical Research Institute. “Dr. Starks is one of the leading investigators in the world working on this incredibly difficult and challenging opportunity.”
“At Duke, we have a history of innovative thinking around ways to increase survival for heart attacks and cardiac arrest,” adds Manesh Patel, MD, Richard S. Stack Distinguished Professor and chief of the division of Cardiology at Duke. “For example, the RACE-AMI pilot study we conducted around getting people to hospitals that can provide coronary intervention and care as soon as possible. Work led by Drs. (Christopher) Granger and (James) Jollis and many interventionalists helped build that network in NC, which was then adopted across the country by the American Heart Association as ‘Mission: Lifeline’. One can imagine this type of research for cardiac arrest survival — with innovations such as drone delivery for AED use — could also become a national standard if we can show this works.”
New Directions
Starks estimates that five to eight drones would be needed for most counties in North Carolina to achieve five-minute arrival times for most cardiac arrest patients.
“We really need to move from a static AED delivery model such as the traditional public access defibrillation (AEDs placed in businesses and government institutions) to dynamic delivery (on-demand AED delivery to bystanders),” she adds. “This is where we hope to go in the U.S.”
The next step for Starks is testing over the next three months and pursuit of further funding for pilot programs with some of the 48 North Carolina counties she is working with.
“We’ve done the math now to show where they the drones are going to go and what the impact will be,” Starks says. “Now we need to work out some of the needed infrastructure and operational aspects of drone AED delivery because it’s not just a matter of flying a drone. Fully functional emergency drone networks are several years off, but we have a role to play now in establishing the effectiveness of this technology.”
This story originally ran in This Week in Medicine on Jan. 24. This is important and exciting work – well done!
STS Lillehei Lecture Given by Smith
Peter K. Smith, MD, gave the C. Walton Lillehei Plenary Lecture on Monday, Jan. 23 at STS 2023 in San Diego. The title of his lecture was Treatment Selection for Coronary Artery Disease: The Collision of a Belief System with Evidence. Dr. Smith recognized his many teachers over the years, including Drs. David C. Sabiston, Jr., Walter Wolfe, and Robert H. Jones — as well as his mentees – during his presentation. On Twitter, CT surgery trainee Dr. Julie Doberne wrote, “Dr. Smith, you have embodied the unwavering pursuit of truth in the field of cardiac surgery for the last several decades. Thank you for your lasting gifts to our profession. It is an honor to know you.”
We feel the same way. Your patients and our team have all been blessed to learn from you!
Turek, DeBlasio to Receive 2022-2023 Duke Presidential Award
Congratulations to Duke Heart chief of pediatric cardiothoracic surgery, Joe Turek, and to former Duke CTICU nurse Joe DeBlasio – this week we learned they have been named recipients of Duke University’s highest possible honor for faculty and staff: The Duke Presidential Award.
Turek and DeBlasio are two of eight individuals and five teams selected for the honor, which will be presented during a 4 p.m. ceremony on Tuesday, Feb. 28 in Page Auditorium. The awards are organized by the Office of the President in partnership with Duke Human Resources and honor teams and individuals who best demonstrate Duke’s core values of respect, trust, inclusion, discovery and excellence.
Congratulations Joe and Joe!
To read more about the 2022-2023 Presidential Award winners, please see Duke Today.
Krasuski is New Chair of ACHA Medical Advisory Board
Congratulations to Richard Krasuski! On January 22, he began a 3-year term as the Chair of the Medical Advisory Board of the Adult Congenital Heart Association (ACHA). This group of top physicians and healthcare providers in the congenital heart disease (CHD) field provides expert input and advice for all ACHA activities involving medical, scientific and/or medical profession-related content. They offer expert opinions on research and medical developments in CHD and the needs of the CHD population, and assure that ACHA policies meet the highest standards of scientific need and accuracy.
Krasuski says he is most looking forward to contributing more on a national policy level. He says the ACHA has been instrumental in bringing awareness to the plight of the over 2 million adults with CHD and the specialized care they require – and that evolving legislation will help to further procure the resources necessary to grow this rapidly growing and evolving specialty.
“Duke was one of the original medical centers to recognize the future needs of this complex patient population and has a rich history of training the current leaders in the field,” says Krasuski. “I think this is another accolade demonstrating the important role that Duke is playing in the evolution of the field. Internally at Duke, we have tremendous collaboration with several specialty programs including Pediatric Cardiology, Adult and Pediatric Cardiothoracic Surgery, Hepatology, and Heart Failure and Transplantation just to name a few. The Duke program has been a national leader in the three-core elements of an academic medical program – clinical care, research, and education – and I see a great future ahead of us.”
The ACHA was founded in 1998 as a national nonprofit organization with the mission to improve and extend the lives of millions born with congenital heart disease, through education, advocacy, and the promotion of research. Currently, ACHA has a membership of more than 14,000 patients and professionals and is the largest worldwide patient and professional organization representing Adult Congenital Heart Disease.
Congratulations, Rich!
Jackson Selected for 2023 Duke Clinical Leadership Program
Congratulations to Larry Jackson, MD! He is one of 28 School of Medicine faculty members selected for the 2023 Clinical Leadership Program cohort. The Duke Clinical Leadership Program (DCLP) was founded by the Chancellor for Health Affairs in 2010 to help expand leadership capacity within Duke Health. The program provides faculty with an opportunity to deepen their awareness of healthcare operations and to develop relevant leadership skills. The program is run by the School of Medicine Office for Faculty.
Congratulations, Larry!
Jacqueline Fee named Clinical Operations Supervisor, CDU
Duke Heart is pleased to announce that Jacque Fee, BS, MS ACSM-RCEP, will become Clinical Operations Supervisor for the DUH Cardiac Diagnostic Unit (CDU) effective Wednesday, Feb. 1. As Clinical Operations Supervisor she will have shared oversight of the CDU sonographers, cardiac technicians and exercise physiologists with Ashlee Davis for the management of clinical operations.
Jacque earned a Bachelor of Science in Sports Biology in 2012, followed by a Master of Science in Clinical Exercise Physiology at Springfield College in 2015. Her credentials include American College of Sports Medicine Registered Clinical Exercise Physiologist.
She began her career as a Clinical Exercise Physiologist at Beth Israel Deaconess Medical Center (BIDMC) in Boston, MA in 2014, advancing to Senior Clinical Exercise Physiologist while there. While at BIDMC she assisted in managing their student internship program and managed the emergency equipment and procedures for the Stress Lab.
Jacque joined the Duke Heart team in 2021 as an Exercise Physiologist in the DUH CDU. During her time at Duke, she has advanced to Exercise Physiologist, Level II, led efforts to evaluate cardiopulmonary reporting procedures, facilitated a switch from sterile processing to high level disinfectant for cardiopulmonary equipment and has led educational initiatives for staff and is a member of the Orientation Committee in the CDU. She is also an active member of the American College of Sports Medicine.
When she is not at Duke you can find her out on the trails for a run, reading a book or journal article, or cooking!
Congratulations, Jacque!
SOM Faculty Achievement Award Nominations due this Week
Nominations and Applications for the 2023 School of Medicine Faculty Awards are now open.
The Faculty Awards are a wonderful opportunity to highlight the outstanding work conducted at Duke. The Office for Faculty is now accepting nominations and applications for the following 2023 faculty awards:
- Leonard Palumbo Jr., MD Faculty Achievement Award – Nomination Deadline: January 31, 2023
- Leonard B. Tow Humanism in Medicine Award – Nomination Deadline has passed
- Excellence in Professionalism Award – Nomination Deadline: February 10, 2023
- Research Mentoring Awards – Nomination Deadline: February 20, 2023
- Ruth and A. Morris Williams Faculty Research Prize – Application Deadline: February 28, 2023
To learn more, visit https://duke.is/4hqkb. Questions? Please contact Jennifer Meyer Dare, jennifer.meyer-dare@duke.edu. Nominations and applications should be submitted via email to facdev@dm.duke.edu.
Upcoming Events & Opportunities
Cardiology Grand Rounds
Jan. 31: Branched-Chain Amino Acids and Cardiometabolic Disease: Biomarkers and Beyond with Robert McGarrah. 5 p.m., Zoom.
Medicine Grand Rounds
Feb.17: Topic TBD with Hyung (Harry) Jin Cho of NYU Langone Health, a 2023 Joseph C. Greenfield Visiting Professor. 8 a.m. via Zoom or in person, Duke North 2002.
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. Submissions by Noon, Wednesdays, to be considered for weekend inclusion.
Duke Heart in the News:
January 20 — Katherine Collins (Duke Molecular Physiology Institute)
Healio/Endocrinology
Weight loss of 10% significantly affects insulin resistance, cardiometabolic biomarkers
https://duke.is/2vupd
January 23 — Nandini Abburi (Neurology)
CBS17.com/WNCN (Raleigh-Durham)
Stroke symptoms require emergency treatment even if symptoms go away quickly, new report says
https://duke.is/vxhkx
January 24 — Michael Pencina
Healio/Cardiology
Risk scores, algorithms less accurate in stroke prediction in Black vs. white adults
https://duke.is/z9med
January 24 — Michael Pencina
Neurology Live
Assessing Stroke Risk With Algorithms and Modeling Health Discrimination
https://duke.is/bjryq
January 24 — Robert Mentz
HealthDay
Mortality Similar With Torsemide, Furosemide for Patients Hospitalized With Heart Failure
https://duke.is/nmspa
*carried by 78 additional news outlets including in Buffalo, Miami & Washington, DC
January 24 — Reid Chamberlain (pediatric cardiology)
WFMY-2/CBS News (Greensboro, NC)
https://duke.is/czgku
January 25 — Michael Pencina
WUNC-FM/NC Public Radio
AI Models Fail Black Americans in Stroke Assessment
https://duke.is/rxu23
*news clip begins @ 10:04:51
January 25 — Richard Shannon
Becker’s Hospital Review
6 clinical leaders on hospital accreditation visit prep: Act now, don’t react later
https://duke.is/prgzm
January 26 — Michael Pencina
Reuters
Health Rounds: Stroke prediction tools failing Black patients
https://duke.is/bkgzd
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