THROUGH SCREENING AND regular checkups, early diagnosis of heart conditions and risk factors can reduce the occurrence of heart attacks, which happen at the alarming rate of one every 34 seconds. Using state-of-the-art advances in cardiac care,
cardiologists are saving lives and improving the quality of life for survivors and their families. Experts from the following top New Jersey hospitals and medical centers are featured in this special section:
- AtlantiCare Regional Medical Center;
- Cooper University Health Care;
- Englewood Hospital and Medical Center;Hackensack University Medical Center (Hackensack Meridian Health);
- Holy Name Medical Center;
- Jersey Shore University Medical Center (Hackensack Meridian Health);
- Monmouth Medical Center (RWJBarnabas Health);
- Morristown Medical Center (Atlantic Health System);
- St. Joseph’s University Medical Center;
- The Valley Hospital (Valley Health System);
- Trinitas Regional Medical Center.
AtlantiCare Regional Medical Center
By Sanjay Shetty, M.D., Chairman, Division of Cardiology, AtlantiCare Physician Group, Cardiology
New Jersey designates AtlantiCare Regional Medical Center (ARMC) Mainland Campus, a member of Geisinger, as a STEMI Center, that provides the highest level of emergency cardiac care 24 hours a day. The Heart Institute at ARMC Mainland Campus, through its Catheterization & Rhythm Center, is the only provider in southeastern New Jersey of 24/7/365 emergency catheterization with angioplasty and/or stent placement. AtlantiCare treatments include transcatheter aortic valve replacement (TAVR); thoracic endovascular aortic repair (TEVAR); transcarotid artery revascularization (TCAR); convergent (radio frequency) atrial fibrillation treatment; non-surgical clamp closure of congenital heart holes; left main coronary artery stenting; and ventricular- assisted percutaneous intervention. Through Geisinger ProvenCare®,
AtlantiCare uses evidence-based protocols aimed at reducing mortality rates, improving outcomes and reducing costly readmissions for cardiac surgery and heart failure patients. AtlantiCare also offers patients who have experienced heart attack, heart surgery and/or heart disease, comprehensive intensive outpatient rehabilitation. Lesser-known causes of heart disease include stress; cardiac asthma or heart failure in elderly diagnosed with asthma or COPD; undertreatment of atrial fibrillation; and under-diagnosis/lack of symptom awareness of heart disease among women and African Americans.
Cooper University Health Care
By Phillip A. Koren, M.D., FACC, FSCAI, Medical Director-Cooper Heart Institute, Associate Chief Medical Officer for Ambulatory Services, Clinical and Interventional Cardiologist, Assistant Professor, Cooper Medical School of Rowan University
The Cooper Heart Institute (CHI) at Cooper University Health Care is the most comprehensive heart care center in southern New Jersey, providing world-class cardiac care. Cooper has been a leader in bringing new technology and procedures, such as TAVR and Watchman, to patients in the region. The program has received top quality awards for cardiac surgery including 3-Star Ratings for Coronary Artery Bypass Graft (CABG) and Aortic Valve Replacement (AVR), placing Cooper in the top 13 percent of programs nationwide. Cooper has internationally recognized electrophysiologist physicians specializing in all forms of cardiac arrhythmias. The team is expert in advanced coronary intervention and hybrid procedures, which combines procedures to avoid sternotomy whenever possible (major, open chest procedures) and is widely recognized for its expertise in mitral valve repair. Cooper also has the largest women’s heart program with five fulltime female cardiologists. In addition, the CHI provides advanced treatment of cardiac arrhythmia, including leadless pacemakers, and techniques to remove pacemaker wires. Most people are aware that smoking, high blood pressure, obesity, diabetes, family history and lack of exercise are risk factors for heart disease. But, there are other lesser known risks factors. Also, those with rheumatoid arthritis, lupus and any other inflammatory diseases are at risk for cardiac issues. Sleep apnea, chronic stress or excessive alcohol consumption are associated with hypertension and other heart conditions. Most people do not realize that the leading killer for women in the United States is heart disease. At Cooper, given our association with the MD Anderson Cooper Center, we do commonly see patients receiving treatments that may affect the heart.
Englewood Hospital and Medical Center
By Samuel Suede, M.D., Chief of Cardiology
Englewood Hospital and Medical Center has once again been nationally recognized as a leader in providing exceptional and safe cardiac care by Healthgrades, The Leapfrog Group and Carechex®. Over the past year, the medical center has greatly expanded its cardiac services through community-based practices in Bergen, Essex, Hudson, Morris, Passaic and Rockland (New York) counties. Among the most recent clinical innovations offered to cardiac patients are the Impella® program to support those with severe heart failure; the WATCHMAN™ device for left appendage closures, as well as stroke risk reduction in people with atrial fibrillation; and MitraClip® procedures for managing inoperable mitral valve disease. Englewood Hospital’s TAVR (transcatheter aortic valve replacement) program remains a leader in the state, treating severe aortic stenosis—narrowing of the aortic valve—using minimally invasive techniques. In addition, the Micra™ Transcatheter Pacing System, the world’s smallest wireless pacemaker, is being used to treat patients with bradycardia. While many people are aware of the common causes for heart disease, some may not know that lack of exercise (sedentary lifestyle), obesity, sleep apnea and depression are quickly becoming major risk factors for life-threatening cardiac episodes. Regular appointments with your physician are imperative to mitigating these risks and preventing emergencies.
Hackensack University Medical Center, Hackensack Meridian Health
By Joseph E. Parrillo, M.D., Chair, Heart and Vascular Hospital
Cardiovascular disease is a problem of extraordinary magnitude and is the most common cause of death in the United States. New technologies in use at the Heart and Vascular Hospital at Hackensack University Medical Center are revolutionizing our ability to treat heart disease and further reduce morbidity. One revolutionary technique is Transcatheter Aortic Valve Replacement (TAVR), which is used to replace the aortic valve in patients who are not healthy enough to undergo traditional open-heart surgery. The Hackensack Structural Heart Disease program also performs transcatheter closure of para-valvular leaks (PVLs) in previously placed artificial valves. Our Structural Heart team has one of the largest experiences in the world in successfully closing PVLs.
Another groundbreaking technology is the Left Atrial Appendage Occluder Device (LAAOD) for patients who suffer from atrial fibrillation, and are likely to develop small blood clots in their atrial heart chamber. These blood clots can travel to the brain causing a stroke. Using a catheter-based approach, a small parachute-like device can be permanently implanted into the left atrial appendage, occluding the appendage over several months. Patients with this device in place are protected from clots and stroke, and no longer require anticoagulants. One of the major challenges is treatment of a patient with heart failure who is no longer responding to conventional medications. Ventricular Assist Devices (VADs), mechanical heart support devices, are highly effective short-and long-term heart assists for patients with severe heart failure. VADs can be implanted to improve quality of life and long-term survival. These devices are
lifesaving in appropriate heart failure patients.
Holy Name Medical Center
By Zankhana Raval, M.D, Board-Certified Interventional Cardiologist
At Holy Name Medical Center, our world-class, technically skilled cardiologists are compassionate and comprehensive in our approach to providing holistic, patient-centered heart care utilizing state-of-the-art technology and advanced techniques. We thoroughly investigate the structure, blood supply and electrical system of each patient’s heart, while considering not only the well-known risk factors of heart disease—such as family history, hypertension, high cholesterol and smoking— but also lesser-known risk factors. These include advanced liver or kidney disease, a history of chest radiation or certain types of chemotherapy (required and life-saving), sleep apnea, significant
alcohol or drug abuse, and certain infections. Early identification of cardiac issues; streamlined protocols, such as “chest pain fast track” starting in the Emergency Care Center; and thorough cardiovascular evaluations utilizing state-of-the-art diagnostic technology (including SPECT imaging, 64-slice CT angiography and transesophageal echocardiograms) enable our board-certified cardiologists to make accurate diagnoses. Our cardiac team has expertise in interventional cardiology; electrophysiology; peripheral and endovascular interventions for peripheral arterial disease; and non-invasive diagnostic testing. Easy scheduling, evidence-based guidelines for best practices in cardiac care, and advanced interventional devices and treatment modalities—such as transradial cardiac catheterization, which minimizes bleeding and maximizes an easier recovery, and angioplasty using medicated dissolving stents—often lead to safer, better outcomes.
Jersey Shore University Medical Center, Hackensack Meridian Health
By Richard M. Neibart, M.D., Chief, Cardiac Surgery
The cutting-edge advancements that are taking place at Jersey Shore University Medical Center are transforming treatment options and improving the quality of life for patients. Advanced procedures such as TransCarotid Artery Revascularization (TCAR), robotic-assisted Coronary Artery Bypass Graft (CABG), Transcatheter Aortic Valve Replacement (TAVR) and CentriMag™ technology are some of the latest innovations. Jersey Shore University Medical Center is one of the few hospitals in the country and one of only two hospitals in the state to offer TCAR, the most advanced minimally invasive procedure that dramatically reduces the risk of stroke in patients being treated for carotid artery disease. It is also one of the only hospitals in the state to perform groundbreaking robotic-assisted minimally invasive CABG surgery using the da Vinci® Xi Surgical System, the most advanced surgical robot available. This innovative technology allows complex cardiovascular surgeries to be performed through smaller
incisions and precise motion control, offering patients improved outcomes in comparison to the conventional approaches. Jersey Shore University Medical Center has also performed more than 500 TAVR procedures, giving new hope to patients with critical aortic stenosis who are at an increased risk for conventional surgery. Most recently, the medical center introduced the CentriMag™, which is a ventricular assist
device (VAD) used in patients for the treatment of heart failure. These are among the many comprehensive offerings that place Jersey Shore University Medical Center on the forefront of cardiovascular care.
Monmouth Medical Center, RWJBarnabas Health
By Isaac Tawfik, M.D., Chief of Cardiology, Member, Barnabas Health Medical Group
Our team of cardiac specialists offers advanced cardiac care for patients with the support of the vast network of cardiac services available throughout New Jersey by RWJBarnabas Health. Monmouth Medical Center offers comprehensive diagnostic testing—including coronary CTA; echocardiography, including transesophageal echo (TEE) with 3D techniques; coronary and peripheral angiography; stress testing using nuclear myocardial perfusion imaging; and stress echocardiography. For those who require a more advanced level of heart care, we facilitate a seamless transition to one of our system’s four cardiac surgery centers, where our team is performing and perfecting the latest in minimally invasive, percutaneous procedures; valve replacements and repairs; electrophysiology studies, including arrhythmia detection and ablation and device implants; ventricular assist devices; pediatric cardiac surgery; and cardiac transplantation. While most people recognize the common causes of heart disease, including advanced age, diabetes, tobacco use, high blood pressure and high cholesterol, it is important to also recognize the less commonly known causes of heart disease. These include stress, congenital heart disease, excessive alcohol or caffeine intake, drug abuse, obesity, lack of physical activity and poor oral hygiene. It is also essential to remember that family history and genetics play a major role and should be discussed with your physician.
Morristown Medical Center, Atlantic Health System
By Linda D. Gillam, M.D., MPH, FACC, FAHA, FASE, the Dorothy and Lloyd Huck Chair
of Cardiovascular Medicine
The Gagnon Cardiovascular Institute/Morristown Medical Center offers advanced cardiac care for all forms of heart disease. In addition to being the first and highest-volume program in New Jersey for transcatheter aortic valve replacement (TAVR),
Morristown Medical Center offers catheter-based interventions for mitral and tricuspid valve disease not offered at any other center in New Jersey, and few in the nation. The Gagnon Cardiovascular Institute offers advanced cardiovascular imaging, including positron emission tomography (PET) scanning, a more sensitive lower radiation form of nuclear stress testing, computed tomography and magnetic resonance imaging. It is widely recognized for its Mechanical Circulatory Support Program, which provides patients with advanced heart failure permanent left ventricular assist devices. Morristown Medical Center also has nationally and internationally known programs for less recognized, but important forms of heart disease. The Chanin T. Mast Center for Hypertrophic Cardiomyopathy (HCM) offers patients a supportive, multidisciplinary approach to the diagnosis and treatment of HCM. This is a common genetically transmitted condition of the heart muscle that affects 1 in 500 Americans. While it is the most common cause of sudden death in athletes, it is frequently underdiagnosed. Additionally, our cardio-oncology program provides care for patients with heart damage due to cancer treatment, with patients with breast cancer being at highest risk.
The Valley Hospital
By Suneet Mittal, M.D., Director of Electrophysiology, Medical Director, the Snyder Center for Comprehensive Atrial Fibrillation
Atrial fibrillation (AFib) is the most common irregular or abnormal heart rhythm disorder, affecting more than 3 million Americans. If untreated, AFib can cause serious complications. At Valley’s Snyder Center for Comprehensive Atrial Fibrillation, we practice an integrative, total patient management approach to the treatment of AFib. The emphasis is on overall health, not simply treating AFib. Patients seen at the Snyder Center receive individualized evaluation and treatment by a multidisciplinary team, including electrophysiologists, plus specialists in imaging, cardiology, sleep medicine, nutrition and weight loss management, diabetes and stress management. The goal is to identify health issues that are contributing to the patient’s AFib—such as stress, hypertension, sleep apnea and obesity. Navigators and coordinators guide patients through the entire care continuum. Some individuals don’t notice any symptoms of AFib. Others feel palpitations or a galloping or sluggish heartbeat, shortness of breath, chest pain or discomfort, fatigue or weakness, dizziness, unexplained falls or fainting. Treatment may include lifestyle measures, medications, implantable devices, cardioversion treatment and catheter ablation or surgery.
St. Joseph’s University Medical Center Offers the World’s Smallest Pacemaker
St. Joseph’s University Medical Center, part of St. Joseph’s Health, announced
that it is among the first hospitals in New Jersey to offer the world’s smallest pacemaker for patients with bradycardia, a slow or irregular heart rhythm. The Micra® Transcatheter Pacing System (TPS) is a new type of heart device that provides patients with the most advanced pacing technology at one-tenth the size of a traditional pacemaker.
Bradycardia is a condition characterized by a slow or irregular heart rhythm, usually fewer than 60 beats per minute. At this rate, the heart is unable to pump enough oxygen-rich blood to the body during normal activity or exercise, causing dizziness, fatigue, shortness of breath or fainting spells. Pacemakers are the most common way to treat bradycardia to help restore the heart’s normal rhythm and relieve symptoms by sending electrical impulses to the heart to increase the heart rate.
Comparable in size to a large vitamin, the Micra TPS does not require cardiac wires or leads or a surgical “pocket” created under the skin to deliver a pacing therapy. Instead, the device is delivered through a catheter and implanted directly into the heart with small tines, providing a safe alternative to conventional pacemakers without the complications associated with leads, all while being cosmetically invisible. The Micra
TPS is designed to automatically adjust pacing therapy based on a patient’s activity levels.
The Micra TPS also incorporates a retrieval feature to enable retrieval of the device when possible; however, the device is designed to be left in the body. For patients who need more than one heart device, the Micra TPS was designed with a unique feature that enables it to be permanently turned off, so it can remain in the body and a new
device can be implanted without risk of electrical interaction.
Trinitas Regional Medical Center Implements AHA Standards
“It is important to strengthen the chain of survival in our community,” says Trinitas Regional Medical Center President and CEO Gary S. Horan, FACHE. “The AHA toolkit brings the chain full circle by incorporating healthy dietary guidelines for Trinitas to implement and share with the community.”
The American Heart Association (AHA) recently honored Trinitas Regional Medical Center for its impact in increasing standards in food and nutrition among healthcare systems in New Jersey. Trinitas was the first hospital in the state to use AHA’s new Healthy Workplace Food and Beverage Toolkit, which was designed to help organizations improve their food environment and promote a culture of health. The toolkit provides practical action steps and suggestions that are easy to understand and apply.
“The use of this toolkit was essential to our mission as a healthcare provider,” explains Nancy DiLiegro, Ph.D., FACHE, chief clinical officer, vice president of Clinical Operations and Physician Services. “We pride ourselves on providing quality, nutritious options to our patients and guests. We want to be the example of healthy living from the food we eat to the lifestyles we lead.”
Dr. DiLiegro is a board member for the Northern New Jersey Chapter of the American Heart Association and a board member for the American Heart Association Founders Affiliate for eight states.
Combined with the internal expertise and resources of the Food & Nutrition Department, Trinitas was able to achieve a positive impact through offering healthier vending machine options, catering at special events and presenting nutrition seminars. The American Heart Association acknowledged Trinitas for its leadership and commitment to building a healthier environment for employees, patients, visitors and the community.
Delta Dental: Good Oral Health Can Lessen Heart Disease Risks
According to a study in the American Journal of Medicine, “people who use plaque-targeting toothpaste brush their teeth more thoroughly, lowering their levels of heart-attack triggering inflammation.” This 2016 study suggests that a thorough brushing habit can decrease the future risk of heart attacks.
According to Delta Dental, maintaining oral health is also important for those who already have coronary heart disease.
“While additional study is needed, research indicates that oral health could play a role in improving overall health and lowering the risk of serious conditions,” explains Kevin Sheu, DDS, director of professional services for Delta Dental. “Research like this is a good reminder that a healthy lifestyle, including a strong oral health component,
supports better overall wellness.”
Another study found that tooth loss is associated with an increased risk of death
and stroke in heart disease patients. Compared to individuals who still had all their own teeth, those with no teeth showed greater overall health risk; for example, 27 percent higher risk of major cardiovascular events; 85 percent higher risk of cardiovascular death; 67 percent higher risk of stroke; 81 percent higher risk of all causes of death; and patients who had lost only some teeth experienced a steadily increased risk, rising
roughly 6 percent for every tooth lost.