Two Initiatives Hope to Make New Jersey More Heart-Healthy

Beth Fitzgerald | April 13, 2012 | Health Care
Can a dedicated website and an early-warning device for heart attacks help lower the state's 25 percent death rate from heart disease?

About one-in-four deaths in New Jersey are due to heart disease, according to the Centers for Disease Control and Prevention. That helps explain why the quest for cardiac health is the focus of two initiatives underway in New Jersey.

The New Jersey Hospital Association has launched its first website for the general public, and it is devoted to heart failure. And four New Jersey research sites are among 75 nationwide participating in clinical trials of a new medical device designed to instantly alert individuals if they are having a heart attack.

The warning device, the AngelMed Guardian, was developed by Angel Medical Systems of Shrewsbury, which expects to enroll more than 1,000 patients throughout the country in a clinical trial expected to continue for at least another year. So far 15 New Jersey patients have enrolled, with more coming on board weekly. Participating in the study are St. Michael’s Medical Center, Jersey Shore University Medical Center, Lourdes Cardiology, and the Cardiovascular Institute of New Jersey of the University of Medicine and Dentistry of New Jersey.

At the NJHA website, patients and their families can find clinics and support groups, as well as information about the recommended kinds of exercise and nutrition. According to Aline Holmes, director of the NJHA Institute for Quality and Patient Safety, the site will help patients “make lifestyle changes so they can better manage and even improve their symptoms.” There is a slideshow with extensive text and audio discussion of heart failure; a feature for finding nearby walking paths; a tutorial on nutrition and how to read food labels to avoid excess sodium; and information on medications prescribed for heart failure.

Hospitals have a keen interest in improving public understanding of heart failure, which is a major cause for patient readmission. Beginning in October, the Affordable Care Act requires Medicare to withhold a portion of hospital reimbursements for patients with heart attack, heart failure, or pneumonia who are readmitted within 30 days of discharge. New Jersey hospitals had an average 26.2 percent 30-day readmission rate for heart failure from 2006 to 2009, compared with 24.3 percent for the nation, according to NJHA spokeswoman Kimberly Brook.

Nancy Winter, a nurse and clinical quality improvement manager at the NJHA, said shortness of breath is the symptom that typically sends heart failure patients back to the hospital. She said heart failure is a weakening of the heart muscle that is treated with medication and a low sodium diet to prevent a buildup of fluid.

Dr. Abbas Shehadeh is the principal investigator for St. Michael’s Medical Center on the heart attack warning-device trial. To be eligible for the pilot, the patient must be at high risk for a cardiac event.

“These are patients who already have had a heart attack or who already had bypass surgery or a stent,” said Shehadeh. He explained that the goal is to detect the heart attack immediately, so that angioplasty can be done sooner to reopen the clogged vessel.

According to Shehadeh, the device is like a pacemaker, with a wire that goes into the heart cavity; in the event of a heart attack, the individual feels a vibration and the device transmits a beep to an external telemetry device. “Studies have shown that if you open the [blood] vessel within 90 minutes,” he said, “the patient has a better outcome, and if we can shorten the time, the patients will do better.”

The device could be especially valuable in cases where “the patient does not feel any symptoms; the patient may not have any chest pains” that signal the onset of a heart attack.