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How many cath labs do we need?
  1. D Hackett,
  2. for the British Cardiac Society Guidelines and Medical Practice Committee
  1. Correspondence to:
    Dr David Hackett, Hemel Hempstead General Hospital, Hillfield Road, Hemel Hempstead, Hertfordshire HP2 4AD, UK;

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The need for laboratories for cardiac catheterisation and angiography, and pacemaker implantation, is assessed

The National Service Framework (NSF) for coronary heart disease (CHD) states that: “By international standards, the UK has high rates of CHD but low rates of coronary artery revascularisation. This does not appear to be because most other countries are over-using revascularisation but rather there has been under-provision of revascularisation in the UK. Another major difference between the UK and most other developed countries is that people in the UK wait considerably longer for investigation and treatment than people elsewhere.”1

The NSF has been welcomed by the cardiology community as a means to improve the medical management of people with coronary heart disease in England. Included among the various objectives and aims of the NSF are plans to increase the number of revascularisation procedures nationally to achieve more than 750 coronary artery bypass graft operations, and more than 750 percutaneous coronary interventional procedures, for each million population per year. Proposed maximum waiting times for investigation and treatment are specified in the NSF. In order to achieve more revascularisation operations, with shorter waiting times, it is obvious that more national capacity for diagnostic cardiac catheterisation and angiography procedures is required.

Historically, the UK has been characterised by fewer numbers of revascularisation procedures, and fewer diagnostic cardiac catheterisation and angiography procedures, when compared with other countries in the European Community.2,3 In various European countries, the number of diagnostic cardiac catheterisation and angiography procedures are usually in the range of 2.0–2.5 (mean 2.2) times the number of revascularisation procedures; and UK planning assumptions for the need for cardiac catheterisation and angiography have previously used a ratio of 2.0 times all cardiac surgical and interventional procedures, including valvar, electrophysiological, and other surgical operations.4,5 For planning …

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