The HRJ paper notes that the majority of EP doctors describe being on their limit for their work capacity. (Don’t worry, I will not drone on, in yet another diatribe on the maladies of healthcare reform, you all know them well, but suffice to say that that recently enacted policies will have a major effect on our workload.) In parallel with the explosion in therapeutic options available to heart rhythm specialists, and an aging population with way more atrial fibrillation, we also have the new healthcare system to contend with. Workload increases because patients with heart failure and coronary artery disease keep on trucking. The device population that needs follow-up grows. That’s the idea, isn’t it? Patients are protected from sudden death, and those that stay on the plan, live on and on. Once these devices are implanted, patients do better. The BiV (CRT) device has three leads, and implanting the third lead (a coronary sinus lead for LV pacing) often doubles the degree of difficulty of surgery. Now more than half my device implants are bi-ventricular devices. There used to be one and two lead pacemakers and ICDs. So, like in the early days of squishing blockages, where one angioplasty frequently lead to another, signing up for one AF ablation means there may need to be another.Īnd it is not just AF ablation that contributes to the increase workload for EP doctors, it is cardiac devices as well. This leads to recurrent electrical conduction. Also, each one of those hundred red-dots can be impermanent.
When one substitutes half their ablation volume for procedures that take three times longer, workload increases. Here is a picture of a common SVT ablation. They are longer, more dangerous and less effective than other ablations. The recent EP workforce study reveals that an increased demand for ablation procedures is a root cause for the increased workload.īut ablating AF is not like any other ablation. Now, we have new drugs (more coming), catheter ablation and even open heart surgery as available tools. In AF, it used to be digoxin, warfarin, and sorry, live with it. AF isn’t fun, but sometimes the therapy is far worse. It is complicated to explain the problem, it is difficult for patients to understand the many issues, and most of all, it is difficult walking the tightrope of not making the treatment worse than the disease. Everything about this disease is complicated. Atrial fibrillation is the primary driver. It is what I have experienced the past decade. In this month’s Heart Rhythm journal, a survey of 700 arrhythmia professionals revealed that there is a marked increase in demand for heart rhythm doctoring. So it is with no surprise that I read this recent study on increased electrophysiology workforce demand. At the end the day, I am done.” The spouse may often add, “he is so short-winded, even little things.”ĭoc, I thought it was just my age, or stress, or that I am not sleeping well.”
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