Description
The system matters as much as the operator
Door-to-balloon time is determined far more by the pathway than by the person holding the wire — who activates the lab, whether they can do so without a cardiologist’s approval, how transfer is arranged, whether the team assembles in parallel or in sequence. An excellent operator in a poor pathway produces worse outcomes than an average one in a good pathway.
Unusually for a technical text, these 30 chapters treat that seriously.
Academy placement
Interventional track, and recommended alongside it to members involved in service design or quality improvement — a group for whom the pathway chapters are the whole value.
Technical content
Recognition and the tracings that justify activation, including the patterns that are routinely under-called. Pre-hospital and inter-hospital transfer decisions. Access strategy in the acute setting. Thrombus management and aspiration where the evidence supports it. Stent choice. Complete versus culprit-only revascularisation against the current trial evidence. No-reflow, given a full chapter rather than a paragraph. Cardiogenic shock complicating infarction. Post-procedure antithrombotic strategy.
Where members find it hardest
The chapters on late presentation and on the patient in whom primary PCI is not clearly indicated. Both are decisions made under pressure with imperfect information, and both are where the book is most useful.
PDF, 437 pages, lifetime access from CardiologyBooks.com.
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