Abstract 13866: Interventional Heart Failure: Current State of the Field

Abstract

Introduction: The expanding intersection between interventional cardiology (IC) and advanced heart failure (AHF) has raised interest in an Interventional Heart Failure (IHF) specialty. Methods: We conducted a survey among cardiologists trained in AHF and IC to investigate the state of this new field. This was distributed by the Society of Cardiovascular Angiography and Interventions (SCAI) via their newsletter and publicized via Twitter. Results: Data from 55 respondents in 47 medical centers (22% outside the United States) was acquired. In the US, these centers are concentrated in the South (43%) and Northeast (23%), and commonly host advanced therapies programs: 89% ECMO, 69% durable LVAD and 56% heart transplant. Respondents were 94% men; 47% were 35-45 y. and 41% were &gt45y. old. Foreign physicians accounted for 13%. In the US, 56% of respondents were international medical graduates (IMGs) and 31% were American medical graduates (AMGs). Most completed training after 2013 (69%). IC fellowship was completed first by 47% of AMGs, 50% of IMGs (Figure). Only 23% trained beyond AHF and IC. Area of clinical focus is coronary artery disease (CAD) 42%, cardiogenic shock (CS) 40%, structural procedures 13%. Respondents regularly implant IABP (95%), Impella (83%) and VA-ECMO (69%). Time devoted to IC is 50-80% in 49% (Figure). Most take STEMI call (84%) and do CCU rounds (95%) while only 21% take donor call. Only 32% feel their training was excessive and 82% would repeat it. Most (84%) support the creation of integrated 2-year AHF and IC fellowships. Conclusions: We report the first survey assessing the IHF specialty. We observed a growing workforce focused on CAD, mechanical circulatory support and CS. Development of integrated training pathways is viewed favorably by the IHF community.