The Bryan Heart Improvement Program is a comprehensive heart failure evaluation and treatment program featuring advanced medical and surgical therapies.
To provide a comprehensive diagnostic and treatment program for the heart failure patient that includes:
- evaluation of the patient for correctable cause of heart failure
- optimization of conventional medical management
- placement in an investigational drug trial if eligible
- referral for transplant if eligible
- patient education, rehabilitation and long-term follow-up.
Dr. Steve Krueger is the Physician Director of the program. Nurse Coordinator is Pat VerMaas, RN, APRN. Staff includes masters-prepared Nurse Practitioners, bachelor-prepared registered nurses and ancillary staff.
Patients are referred to the program by a cardiologist or their family physician. Patients initially undergo a cardiac evaluation, including an assessment of their heart failure. An echocardiogram is usually done as part of their baseline evaluation to determine left ventricular function.
If it is determined that medical management is the best option, patients are referred to the Heart Improvement Program. Patients are seen in the clinic on a weekly, bi-weekly, monthly, quarterly, and/or as needed basis.
Clinic visits include:
- a cardiovascular exam, labs and EKG as warranted
- bioimpedence (used to measure heart pressures)
- medication review
- uptitration of medications with appropriate monitoring (blood pressures, heart rate)
- patient education including disease process, medications, diet and fluid restrictions, and activity/exercise needs.
Patients are seen by experiences nurses, and by a cardiologist if after assessment it is determined that further medical evaluation and treatment are needed.
When patients reach optimal medical therapy, evaluation for additional treatment options will take place. This may include placement of implantable devices, i.e. defibrillator or pacemaker. A cardiopulmonary exercise test may be recommended to further evaluate cardiac function and to develop an exercise program. Patients are seen each year by the cardiologist and an echocardiogram as well as labs including a BNP and EKG, are performed.
Our goal at the Bryan Heart Improvement Program is to keep patients out of the hospital while improving quality of life. Accumulation of fluid is the primary reason that heart failure symptoms worsen, and for hospitalization. At the Bryan Heart Improvement Program we have tests, such as BNP and Optivol fluid index, to monitor fluid accumulation and treatment administered. Our outpatient clinic can administer intravenous diuretics and/or fluids if needed. If hospitalization is required, treatments such as aquapheresis are available to remove fluids and shorten the length of stay.
The Bryan Heart Improvement Program has a very active clinical research program. Patients will be selected for a clinical trial if eligible.
Heart failure clinics across the nation have proven their effectiveness in reducing hospitalizations of heart failure patients, decreasing length of stay if hospitalization is needed, and improving quality of life. The Heart Improvement Program at Bryan Heart is no exception. In seeing over 600 patients on a routine basis, we have noted a significant impact on decreasing hospitalizations, reducing mortality and improving quality of life for heart failure patients.