The document summarizes initiatives at the Minneapolis Heart Institute to improve cardiac emergency services through regional collaboration and protocol-based care. It discusses programs for ST-elevation myocardial infarction (STEMI), non-STEMI, unstable angina, aortic dissection, therapeutic hypothermia, and abdominal aortic aneurysm that standardize protocols to streamline processes and improve outcomes. It also describes efforts to close gender gaps in women's heart health through research, education, and clinical care programs.
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MHI Quarterly
1. MHI ™
FALL 2009
A quarterly report from the
Minneapolis Heart Institute®
Comprehensive Cardiac Emergency Services
Volume 5, Number 2
Enhanced by Regional System of Protocol-based Care
The Level One Heart Attack Program launched to a country like Denmark, which has a small
by the Minneapolis Heart Institute® in 2003 has population and an organized transfer system.”
demonstrated that a statewide program using a
standardized protocol ensures timely access to According to Barb Unger, RN, director of Cardiac
care and improved outcomes among patients with Emergency Services, the success of the Level One
ST-elevation myocardial infarction (STEMI). Heart Attack Program is due to collaboration among In ThIs Issue
Emergency Medical System (EMS) staff, referring
Now, lessons learned in the development of the hospitals, the Emergency Department at Abbott
Level One Heart Attack Program have been applied Northwestern Hospital and the Minneapolis Heart PAGE 1
to other cardiac emergencies and adapted to ensure Institute®. Working as partners, they have made
Comprehensive Cardiac
access to other time-sensitive treatments. accessing services easier, hastened patient transport
Emergency Services
and streamlined care.
At the beginning of this decade, it was clear that Enhanced by Regional System
percutaneous coronary intervention (PCI) was “When you need to access a large tertiary center, of Protocol-based Care
the preferred treatment for STEMI – but few the first hurdle is figuring out who to call and who
hospitals had catheterization labs, and the process does what, while at the same time taking care of the PAGE 4
of transferring patients and initiating treatment was patient. So we created one phone number, one set of Closing the Gender Gap in
complicated and inefficient. orders and a standardized protocol,” Unger said. Women’s Heart Health
“We felt it was our responsibility to referring To address patient transport barriers, Unger said it PAGE 5
physicians to develop a standard protocol that was was important to make plans that were hospital-
Women’s Heart Health Program
effective and efficient,” said Tim Henry, MD, who led specific. “Every hospital has its nuances. We needed
Current Research
the team that developed the Level One Heart Attack to go to the outstate hospitals and understand their
Program. “It has succeeded beyond what we ever challenges and strengths.” The Summit: Eliminating
imagined – we have cut mortality by 50 percent, and Untimely Deaths of Women
the transfer times we have achieved are equivalent A Level One paging system helped to streamline from Heart Disease
Continued on Page 2
PAGE 6
Genetic Arrhythmia Center
Offers Systematic Approach
to Treat Rare Conditions
Get Timely Clinical Updates
Via Email
PAGE 7
Cardiac Device Registry
Expanding Its Scope
New Physicians at
Minneapolis Heart Institute®
www.mplsheart.com
612-863-3900
2. (see MHI™ Quarterly, May 2009). There are Aortic Dissection Program. Because aortic
twice as many Emergency Department visits dissection is relatively rare, it may not be an
for these conditions as there are for STEMI. immediate consideration for a patient who
But while the mortality rate from STEMI presents with chest pain. “But if a patient
has decreased, it has remained unchanged for presents with chest pain and it doesn’t quite
non-STEMI. add up to MI, you need to be thinking about
aortic dissection.”
“By reducing practice variations and
creating a more efficient way to treat these Important clues include chest pain without
patients, we hope to see a similar reduction EKG changes, and sudden, severe chest
in mortality for non-STEMI,” said Nicholas or back pain that may radiate to the head,
Burke, MD, director of the Chest Pain abdomen and legs.
Program.
“If we have a patient in Alexandria who has
The program has been welcomed by referring atypical chest pain, all it takes is for someone
hospitals and physicians because it spells out to think of AD as a possibility,” said Frazier
exactly which patients need to be transferred Eales, MD, cardiovascular surgeon at the
and which can remain in the community for Minneapolis Heart Institute®. The diagnosis
testing and follow-up. can be made with a computed tomography
(CT) scan. The AD protocol specifies how
While hospitals nation-wide are adopting the CT should be done and includes a process
similar treatment protocols for acute coronary to ensure immediate interpretation. If needed,
syndrome, the Chest Pain Program is one of CT scans are transmitted to the surgeon in
the first multi-hospital initiatives to do so. Minneapolis before the patient arrives.
aoRTIc dIssecTIon: When chesT The protocol also establishes blood pressure
PaIn doesn’T add uP To MI parameters, specifies which medications to
The key to treating aortic dissection is use and streamlines the processes required
the ability to quickly distinguish it from to prepare for AD surgery. “Instead of a
myocardial infarction (MI). The two longitudinal decision-making process,
conditions may present similarly, but the everything is defined by the protocol,” said
treatment is quite different. Then it’s a matter Eales. “Having all those steps set up in
of getting the patient to the operating room advance so it can proceed automatically is a
processes at Abbott Northwestern Hospital. without delay. huge benefit.”
“There was nothing new that had to be built
or created. It was just streamlining all the The Minneapolis Heart Institute® introduced A study by the Minneapolis Heart Institute
steps from the helipad to the cath lab. Once its aortic dissection protocol in 2005. “Our Foundation showed that since implementing
our team gets the page, everyone jumps into first priority was education for the Level One the protocol, the mortality rate has decreased
action and knows exactly what to do,” said regional network,” said Kevin Harris, MD, by more than 50 percent. Other key quality
Unger. cardiologist and director of the Ascending measures are shown in Table 1.
This regional, protocol-based approach
has been replicated to care for patients
with non-STEMI, unstable angina, aortic Table 1 | RegIonal aoRTIc dIssecTIon: Key QualITy MeasuRes
dissection, critical limb ischemia and
abdominal aortic aneurism and to ensure that, 2003-July 2005 August 2005-present
when needed, therapeutic hypothermia for (pre-implementation) (post-implementation)
patients suffering cardiac arrest is delivered as
Average time to
effectively as possible. make AD diagnosis 279 minutes 158 minutes
non-sTeMI and unsTable Average time from AD
angIna: ReducIng PRacTIce diagnosis to operating room 112 minutes 56 minutes
VaRIaTIons
Earlier this year, the Minneapolis Heart Percentage of AD cases in which
Institute® launched its Chest Pain Program, betablockers were used 46 percent 96 percent
which applies protocol-based care to the AD mortality rate 35 percent 16 percent
treatment of non-STEMI and unstable angina
Source: Strauss CE, Eales F, Hirsch AT, Kroshus TJ, Duval S, Kebede TD, Adolphson GM, Inampudi S, Mitchell, PA,
Cohen JD, Unger BT, Orlandi QG, Streckenbach S, Kapsner C, Flavin TF, Kshettry VR, Henry TD, Graham KJ, Harris
KM. Improving the process of care for the management of acute aortic dissection. J Am Cardiol Coll 2009;53:A400
2 MHI™ Quarterly
3. the region. “That’s where it has to begin in
Table 2 | abdoMInal aoRTIc aneuRysM suRVIVal order for the therapy to be effective,” he said.
October 2005-July 2008 August 2008-August 2009 The Intensive Care service at Abbott
(pre-implementation) (post-impementation) Northwestern is also critical to the program.
“This treatment involves complex multi-
Total number of patients 15 22 system failure in patients with metabolic
derangement that goes beyond what most
Number of survivors at discharge 11 17 cardiologists treat. That’s one of the unique
aspects of our program. Very few places in the
Survival rate 73 percent 77 percent state have 24/7 intensivist coverage, which
these patients very clearly need,” said Mooney.
Source: Minneapolis Heart Institute database®
In addition to beginning treatment before
patients are transferred, the Cool It
abdoMInal aoRTIc aneuRysM: are resuscitated following a cardiac arrest. In Program has not used rigorous exclusions in
neW PRoTocol, neW TReaTMenT 2006, Abbott Northwestern Hospital and the determining which patients to treat. “The
oPTIon Minneapolis Heart Institute® helped pioneer magnitude of the clinical benefit is so great,
Treatment for abdominal aortic aneurysm therapeutic hypothermia in Minnesota and we did not want to withhold treatment
(AAA) has been enhanced through the use the treatment has become a standard of care from anyone. As a result, we’ve treated a
of a new protocol as well as the development across the state. higher risk group than are included in some
of a new treatment option: endovascular previously published studies.”
stenting. “We chose to implement the Cool It
Program using a state-wide strategy from The results have been remarkable, both in
Many aneurysms can be treated with a the very beginning,” said Michael Mooney, terms of the scientific data and individual
stent, which is less invasive and has fewer MD, cardiologist and lead on the Cool It patient experiences. “Our survival rates are 70
complications, shorter hospitalizations and a development team. He credits nursing percent when patients have a simultaneous
lower mortality rate than open surgical repair. colleagues for helping to bring the program to full cardiac arrest with brain injury. And there
a variety of community settings and educating have been spectacular saves – people who
Before the protocol was implemented, EMS and Emergency Department staffs across were not expected to survive,” said Mooney.
emergency AAA repair using endovascular
stents was a process “that on a good day TRacKIng ouTcoMes
required dozens of calls in a short time The importance of tracking quality measures
period,” said Alex Tretinyak, MD, vascular and patient outcomes and reporting back to
surgeon. “Our challenge was to whittle referring hospitals and physicians is another
down the process so more of it could happen lesson from the Level One Heart Attack
automatically. We worked off the scaffolding Program. “You have to pay attention to the
of the Level One Heart Attack Program and details,” said Unger. “You can’t just set up a
translated it to do endovascular triple-A system and walk away.”
repairs.”
The Minneapolis Heart Institute® provides
As a result, the time required to diagnose immediate follow-up to physicians and nurses
AAA has been reduced by more than 30 from referring hospitals whenever patients
minutes, and the time from diagnosis to are transferred. In addition, data collected
making the incision in the operating room on cardiac emergency services helps Abbott
has been reduced by more than an hour. “If Northwestern and the Minneapolis Heart
you can gain an hour in repairing triple-A, Institute® improve services and is made
you greatly increase the likelihood that available to regional hospitals for their quality
the patient will survive,” said Tretinyak. improvement efforts.
The survival rate for AAA patients at the
Minneapolis Heart Institute® has increased “It’s clear that if you can standardize care, you
since the protocol was implemented, as can improve outcomes. Working with our
shown in Table 2. regional system allows us to take this a step
further,” said Henry. “Our approach to these
cool IT: TReaTMenT begIns problems is to have a comprehensive system.
befoRe TRansfeR It’s not just having the best stents or the best
One of the most important recent technology. We want to make every part of
developments in emergency cardiac care has the care we deliver better for patients.”
been the use of therapeutic hypothermia to
reduce the risk of brain injury in patients who
MHI™ Quarterly 3
4. Closing the Gender Gap in Women’s Heart Health
While women’s heart health has received to educate the public about women and
more attention in recent years, American heart disease and to focus more research on
Heart Association statistics published in women,” said Grey.
Circulation (2009; 119:e21-e181) confirm
that disparities remain in recognizing and Through its association with the
treating women’s heart disease. Minneapolis Heart Institute Foundation,
the Women’s Heart Health Program is
At the Minneapolis Heart Institute®, participating in several national studies and
cardiologists are closing the gender gap in local protocols that focus on women (see
providing emergency cardiovascular care to page 5).
women.
coMMITMenT To educaTIon
“Because of the Level One Heart Attack The Women’s Heart Health Program also
Program, the treatment gap has closed. Once sponsors a variety of educational sessions
women arrive in an emergency department around the region for women and health
they are receiving treatment about as care providers. “We feel that educating
quickly as men,” said Elizabeth Grey, MD, people about women’s heart health is one of
cardiologist and director of the Women’s the most important services we can provide,”
Heart Health Program at the Minneapolis said Grey. This year, seminars focusing on
Heart Institute®. women’s heart health have been held in
12 locations throughout Minnesota and
Yet, outcomes for women who have had a Wisconsin.
heart attack continue to lag behind men’s.
“One of the big questions is ‘Why do women A weekly women’s-only cardiac support Elizabeth Grey, MD
with myocardial infarction have a higher group is held at the Minneapolis Heart
incidence of cardiogenic shock and death Institute® to provide information,
for women with heart disease occur in the
than men?’” said Grey. “We suspect that encouragement, camaraderie and support to
primary care setting. “One thing we and
one reason is they may be waiting at home women with heart disease. “As treatment
others have noticed is that the typical risk
longer before going to the ED, but that’s a advancements have trimmed the hospital
profile – the Framingham Risk Score – does
hard thing to pin down.” length of stay, there is less time for education
not always accurately identify risk levels in
and support in the hospital. It also takes
women,” she said. “The greatest challenge
In addition to providing clinical care time to assimilate information and adopt
is deciding who is at risk before an event
for women, the Women’s Heart Health new behaviors that will alter coronary risk
occurs, and this remains an important
Program is dedicated to gaining a better factors,” said Grey. The support group helps
issue for primary care physicians as well as
understanding of this and other aspects of to address these needs.
cardiologists.”
women’s heart disease.
The Women’s Heart Health Program
Also, because women with heart disease
Through research, education and clinical at the Minneapolis Heart Institute® in
have atypical symptoms more often than
care, the program is working to raise conjunction with the Mayo Clinic and the
men, they may not notice or bother to report
awareness of the risks of heart disease University of Minnesota is also hosting
symptoms that may be significant. “People
in women, support women and families a summit conference on April 29, 2010:
think they are supposed to be feeling pain
in creating lifestyles which strengthen Eliminating Untimely Deaths of Women
before they worry about their hearts. I ask
heart health, nurture and care for women from Heart Disease. The summit is designed
about exertional shortness of breath and
with heart disease, and add to the body to help chart the next steps in addressing
whether there has been a sudden change in
of research specific to women and the needs of women with heart disease
exercise tolerance. Another symptom might
cardiovascular disease. and improving women’s cardiac care (see
be chest pressure or heaviness with exertion.
sidebar).
Often women will say, ‘It’s just an ache that
Historically, cardiac research has been
I hardly notice.’ But these are indications
hindered by the gender gap, leaving women challenges foR PRIMaRy caRe
that further tests may be needed,” said Grey.
under-represented in many cardiac studies. Grey believes that involving primary care
“Often it is what people don’t report or pay
But in recent years, “there’s been a huge physicians in finding solutions is critical
much attention to that is important in terms
push by the American Heart Association because many of the challenges in caring
of heart disease.”
4 MHI™ Quarterly
5. Women’s Heart Health Program Current Research
Lite HEARTEN Study (plaque and stenosis) on a risk-adjusted basis
Psychosocial stress is a significant risk factor with age and risk-matched controls from
for coronary artery disease (CAD). This study both sedentary and fitness activity groups
examines the effects of two interventions on who have never been significant runners.
the stress responses and vascular functioning Multi-slice CT will be used to characterize the
of women with documented heart disease as amount, severity and type of atherosclerotic
well as on other subclinical markers of CAD. lesions. The study is currently enrolling
Subjects will be randomly assigned to one participants.
of three intervention groups: mindfulness-
based stress reduction, aerobic exercise or VIRGO Study
the control group. The study is currently The Minneapolis Heart Institute Foundation is
enrolling patients. (Ruth Lindquist, PhD, a participating center for this Yale University
principal investigator). study: Variation In Recovery: Role of Gender
on Outcomes in Young AMI Patients.
Stress Cardiomyopathy Despite perceptions that young women are
Broken heart syndrome, or Tako-tsubo protected from heart disease, it is one of
cardiomyopathy, is characterized by acute the leading causes of death in women 55
reversible left ventricular systolic dysfunction years and younger. Building on more than a
triggered by an emotionally or physically decade of work studying gender differences
stressful event and occurs most frequently in in heart disease, this landmark multi-site
post-menopausal women. Scott Sharkey, MD, study will enroll 2,000 young women and
has extensive knowledge in this area and has 1,000 men for comparison. As the largest,
developed a database designed to study the most comprehensive investigation of young
cause and course of stress cardiomyopathy women with heart attacks, VIRGO will identify
and to improve the care of patients with this key determinants of recovery and assist in
condition. Women account for 97 percent of improving care in this population. (Norma
this population. Thiessen, MD, principal investigator)
Women’s Marathon Study For more information about these and other
This study is a follow-up to the Minneapolis studies or to refer a potential participant, call
Heart Institute Foundation Marathon Study the Minneapolis Heart Institute Foundation at
conducted by Robert Schwartz, MD. It will 612-863-3833.
determine the effects of extreme fitness
in women. It will compare female long
distance runners for coronary artery status
The summit: eliminating untimely
deaths of Women from heart disease
save the date: april 29, 2010
Marquette Hotel – Windows on Minnesota, Minneapolis, Minn.
Join professionals from around the country and honorary guest Mary Pawlenty, first lady of Minnesota, for dialogue and
planning to improve women’s heart health and cardiac care. Nanette Wenger, MD, professor of Medicine in the Division
of Cardiology at Emory University School of Medicine, will deliver the keynote address. Moderator-led panel discussions
will focus on four key areas that are considered critical to improving women’s heart health, including screening and
prevention, symptom recognition and delays in seeking treatment, the gender gap in survival and ongoing management.
The summit is intended to serve as a call to action for providers, researchers and other stakeholders in the design and
delivery of women’s health care. For more information call 612-863-3816.
MHI™ Quarterly 5
6. Genetic Arrhythmia Center Offers
Systematic Approach to Treat Rare Conditions
syndrome, arrhythmogenic right ventricular aunts, uncles and cousins with multiple last
dysplasia, Brugada’s syndrome, left ventricular names who are spread out across the country.
noncompaction and catecholamine-induced The structure of the Center allows us to track
polymorphic ventricular tachycardia. a great deal of information that otherwise
would be unavailable.”
These disorders can lead to sudden cardiac
arrest and death, but they are often Katsiyiannis noted that the Genetic
undetected until a life-threatening event Arrhythmia Center benefits from the clinical
occurs. Furthermore, the conditions are so resources available at the Minneapolis
rare that the average cardiologist may see only Heart Institute® and Abbott Northwestern
a few cases of each disorder throughout his or Hospital. “We have a symbiotic relationship
her career – and most cardiologists do not have with many of the other programs,” he
the resources to coordinate the extensive testing said. “Because of programs like Cool It,
and follow-up that are required when a family is we have people surviving these events
affected by a complex genetic disorder. who otherwise might not have survived.
Among those survivors are people who we
Growing frustration with the lack of guidance have subsequently diagnosed with a genetic
in treating such disorders led Katsiyiannis and arrhythmia disorder. This has led to screening
his colleagues to seek funding to develop a and follow-up with other family members and
systematic approach for screening, diagnosis in some cases, recommending a defibrillator.”
and treatment.
Katsiyiannis said that the Center is quickly
William Katsiyiannis, MD The Genetic Arrhythmia Center is modeled becoming known as a resource when there is
after the Minneapolis Heart Institute a sudden, unexplained death due to cardiac
A new program at the Minneapolis Heart Foundation’s Hypertrophic Cardiomyopathy arrest. “I think that is a credit to our group
Institute® is offering hope for families who (HCM) Center, which was started by Barry of physicians as well as an indication of the
have many questions but few answers. It is Maron, MD, an internationally known expert on need. We have family members coming to
also giving researchers a unique opportunity HCM. us who have no answers. We’re here to help
to study several genetic disorders that are them find some answers and to prevent a
not well understood and for which treatment Similar to the HCM Center, the Genetic life-threatening event from occurring in any
remains uncertain. Arrhythmia Center will gather information other family members.”
about patients and family members and
The Genetic Arrhythmia Center, determine over time how best to treat them.
led by William Katsiyiannis, MD, an It brings together experts from several areas
who are dedicated to improving outcomes,
electrophysiologist at the Minneapolis When to consider a
Heart Institute®, was created last year with including electrophysiologists, cardiologists,
imaging specialists, a genetic counselor and
referral to the genetic
support from the Minneapolis Heart Institute
Foundation and private donors. It serves clinical nurse specialists. “The clinical nurse arrhythmia center:
patients and families who are affected by rare specialists are the backbone of the program,”
• Family medical history includes
genetic conditions like long QT said Katsiyiannis. “It’s not uncommon for
them to work with several siblings, children, an unexpected, sudden death
before age 40 (including
unexplained car accidents
or drownings)
• Fainting episodes (syncope)
Get Timely Clinical Updates Via Email
during or immediately after
The Minneapolis Heart Institute® is building an email list for those interested physical activity, or as a result
in receiving timely clinical information and helpful educational materials for of emotional excitement or
patients on topics like Plavix-PPI interaction, a case of the week discussion and the distress.
use of fish oil in managing cardiovascular risks. Your address will not be spammed
or shared. If you are interested in being added to the Minneapolis Heart Institute® For more information, call the
email list, please send a blank e-mail with MHI™ as the subject line to Genetic Arrhythmia Center at
info@mplsheart.com. 612-775-3905.
6 MHI™ Quarterly
7. New Physicians at the
Cardiac Device Registry Minneapolis Heart Institute®
Expanding Its Scope
Raed h. abdelhadi,Md,
is a cardiac electro-
Researchers at the Minneapolis Heart Institute
physiologist who joined
Foundation are preparing to expand the scope
the electrophysiology
of a one-of-a-kind independent cardiac device
group at the Minneapolis
registry.
Heart Institute® in August.
Abdelhadi completed a
The Multicenter Registry was started in 1998
cardiac electrophysiology
by Robert Hauser, MD, a cardiologist at the
fellowship and cardiovascular
Minneapolis Heart Institute®. The Registry
medicine fellowship at
began collecting failure data on pacemakers and
the University of Pittsburgh Medical Center.
implantable defibrillators from nine centers. “Our
He completed a research fellowship in clinical
initial thought was to provide an early warning
electrophysiology as well as an internal medicine
system on device failure and this has proven to be
residency at the Cleveland Clinic Foundation in
Robert Hauser, MD exactly what we have done,” said Hauser.
Cleveland, Ohio. He earned his medical degree at
the University of Jordan in Amman, Jordan.
The Registry has been used to track the performance of batteries in pacemakers
and defibrillators and to characterize the ways in which the leads connecting
the device to the heart can fail. It has also been instrumental in the recall of
david s. feldman, Md, Phd,
cardiac devices and in a recent legal case involving faulty defibrillators.
joined the Minneapolis Heart
Institute® in June and is the
Currently, 15 centers participate in the Registry. It is unique among device
new medical director of
registries because participation is voluntary, and it focuses specifically on
the Heart Failure, VAD and
device failure. The Registry contains information on 7,500 devices, including
Cardiac Transplant program.
4,000 pacemakers/pacemaker leads and 3,500 defibrillators.
Previously Feldman was the
director of the Heart Failure
“The value of this registry is that it helps us better manage the care of our
and Cardiac program at the
patients. We know more about what’s going on with these devices after
Ohio State University Medical
implantation than anyone else, including the manufacturers and the Food and
Center. He received his doctorate of Philosophy and
Drug Administration,” said Hauser.
Medicine from the Medical College of Georgia. His
cardiology fellowship was completed at Barnes-
Members of Registry can search the database and information is made available
Jewish Hospital, Washington University School of
to other researchers by request. In addition, the Registry submits papers and
Medicine in St. Louis, Mis. Feldman was an assistant
abstracts for publication and presentation at national and international
professor of medicine and cardiology at the Medical
scientific meetings.
University of South Carolina before moving to the
Ohio State University.
A recent $1 million grant will help to fund further study about the use of
cardiac devices and expand the Registry’s scope to include information about
all devices implanted at the participating centers, not just the faulty devices. nada b. Memon, Md,
“The deficiency in the Registry is that we have the numerator but we don’t is a cardiac electrophysiologist.
know the denominator,” said Hauser. “We’ll be able to look at not only device She joined the electro-
complications, but clinical complications and that may help us improve physiology group at
surgical procedures.” the Minneapolis Heart
Institute® in August. Memon
For more information, visit www.pacerandicdregistry.com or email completed fellowships
rhauser747@aol.com. in electrophysiology and
cardiology/electrophysiology
at Washington University in
PaRTIcIPaTIng cenTeRs
St. Louis, Mo., and a cardiology fellowship at the
· Minneapolis Heart Institute® · Milton S. Hershey Medical Center University of Texas Southwestern Medical Center.
· Montefiore Medical Center · Grey Nuns Hospital She is also board certified in internal medicine,
· University of Alabama · Good Samaritan Hospital completing her residency at Washington University.
· Mayo Clinic · University Hospital at Stony Brook Memon earned her medical degree at the University
· San Pedro Peninsula Hospital · University of British Columbia of Alabama.
· Eastern Heart Institute · University of Southern California
· Winthrop-University Hospital · Newark Beth Israel Medical Center
· Marshfield Clinic
MHI™ Quarterly 7
8. 800 East 28th Street
Minneapolis, MN 55407
MHI™ Quarterly is
published regularly by the
Minneapolis Heart Institute®
09-3528 ®2009 ALLINA HEALTH SYSTEM
® A REGISTERED TRADEMAKR OF ALLINA HEALTH SYSTEM
MINNEAPOLIS HEART INSTITUTE® AND MHI™ ARE TRADEMARKS
OF MINNEAPOLIS HEART INSTITUTE®, INC.
EDITOR IN CHIEF
M. Nicholas Burke, MD
MANAGING EDITOR/WRITER
Mary Pat McGinnis
www.mplsheart.com
612-863-3900
CME Events 2009 & 2010
evenings of cardiology in 2009
Thursday, Nov. 5: Northfield, Minn.
Thursday, Nov. 19: Crosby & Aitkin, Minn.
For information: 612-863-7032 or email lisa.wahl@allina.com
emergency cardiac Resuscitation conference
Miracle on Ice: Therapeutic hypothermia for cardiac arrest Patients
Thursday-Friday, Dec. 3 &4: Marriott Minneapolis Airport
For information and to register: www.mplsheart.com/miracleonice/
The summit: eliminating untimely deaths
of Women from heart disease
Thursday, April 29: Marquette Hotel – Windows on Minnesota
Minneapolis, Minn.
For more information: 612-863-3816.