2009-01-02 / Community

PHC Becomes Heart Attack Hospital

Innovative Treatment Now Available
By Miriam Rosenberg

It was once the conventional wisdom that the time it took for a heart attack victim to get to the hospital was the one crucial element for his or her survival. Now, however, New York City is joining several other municipalities across the country that believe that a low body temperature is just as crucial as time in saving the lives of cardiac arrest victims.

For that reason, beginning this week, city EMS ambulances will transport heart attack victims directly to hospitals that utilize a new hypothermia therapy which, studies show, increases the patient's survival rate. For those on the Rockaway peninsula, that means Peninsula Hospital Center will become the hospital of choice for ambulances transporting heart patients rather than St. John's Episcopal Hospital in Far Rockaway, which has not yet moved towards the new treatment.

"We will be one of the receiving hospitals. We have the equipment already," said Liz Sulik, the facility's director of external affairs. "It's not that complicated. We have staff."

St. John's Episcopal Hospital is still involved in discussing whether or not to move to the new cooling therapy.

"We have already spoken to New York City EMS and are now meeting internally," said John Gupta, the chief executive officer of St. John's in a December 17 statement to The Wave. "We are committed to doing what is most appropriate for the patients in our community."

Cooling a patient's body tempera- ture to approximately eight degrees below normal, within six hours of the heart attack, is critical, as is keeping the body at that temperature for at least 24 hours. Studies show that those activities increase the survival rate. In addition, the new therapy prevents or limits loss of oxygen to the brain, which reduces the chance of brain damage.

According to the New York Times, the new treatment would be limited to patients who have regained "a pulse within 30 minutes of the start of resuscitation but remain neurologically compromised."

In December 2007, The Greater New York Hospital Association and United Hospital Fund hosted a conference called 'Project Hypothermia,' at which was discussed the cooling therapy and standardizing the training for it.

A summary of the conference appears on the GNYHA's website. It reads in part, "The outcomes for victims of cardiac arrest out of the hospital setting are poor. Brain injury claims the lives of over 85 percent of patients who have been successfully resuscitated after cardiac arrest in the field. Studies have found that cooling patients who suffer certain types of cardiac arrest can dramatically improve survival rates and the patient's functional outcome."

Long Island hospitals are also currently working on plans to offer the treatment. Earlier this month, St. Francis in Roslyn became the first hospital on the Island to offer hypothermia treatment. According to Newsday, Dr. Syed Hasan Naqvi, of North Shore Hospital, has become an unexpected backer of the new treatment since experiencing a heart attack in October. After he fell into a coma, his wife contacted Dr. Stephen Mayer, the chief of neurological intensive care for New York-Presbyterian Hospital Columbia University Medical Center. Mayer has been a leader in advocating for the use of the treatment.

"I was on a ventilator," Naqvi, who was originally taken to North Shore University Hospital, told Newsday.

Mayer advised that Naqvi be transported to New York-Presbyterian Hospital where he underwent the cooling therapy for 24 hours. Dr. Naqvi is now back to work at North Shore University Hospital just a month and a half after the heart attack that almost killed him.

According to the city's Department of Health and Mental Hygiene, heart disease is the number one cause of death, regardless of race or ethnicity, for both men and women in New York City.

In the New York City Department of Health and Mental Hygiene's 2006 health profile, the death rate for those dying of heart disease in Rockaway was 85 percent higher than the rates in Queens and New York City overall. In the 2003 health profile, heart disease was the number one cause of death in the Rockaways.

New York joins Seattle, Boston and Miami in mandating the transport of cardiac victims directly to hospitals that offer therapeutic hypothermia. Overseas, Vienna and London also require these patients be sent to facilities with the cooling systems.

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