NeuroCardiac Program | TGH Heart & Vascular Institute (2024)

The heart and brain are intimately linked in the causal evaluation of stroke. The TGH NeuroCardiac Program - the only one of its kind in the nation - was designed in collaboration with Vascular Neurology and Electrophysiology, to offer patients defined care pathways for cardiovascular testing and treatment that can greatly reduce stroke risk, while aiding in recovery. By standardizing a collaborative approach, we are able to ensure that patients seamlessly receive cutting-edge, evidence-based treatment without having to navigate the challenges of siloed subspecialty care.

What Sets Us Apart

Collaborative Approach to Care

Based on a collaborative structure fully integrated through all phases of the care continuum, patients admitted with stroke are routinely screened for cardiac needs, receive in-hospital consultation for acute needs and are ultimately transitioned to dedicated clinics in the outpatient setting post-discharge to ensure the follow-up loop is completed. From this setting, which also offers the option of same-day Neurology and Cardiology consultation, patients can be expeditiously scheduled for procedures where indicated, or additional sub-specialty consultation and medical therapy. The core pathways within our program, which are tied together by both clinical and research efforts, include: 1) left atrial appendage occlusion (LAAO), 2) patent foramen ovale (PFO) closure, 3) Cerebral-protection, and 4) a spectrum of options for post-stroke heart rhythm monitoring.

Volume & Quality

In conjunction with the USF Vascular Neurology Service, TGH is a certified Comprehensive Stroke Center, offering the full spectrum of advanced care in the acute stroke setting. Every patient admitted through this service is screened for inpatient referral to the NeuroCardiac Program, so that the care experience may proceed uninterrupted when transitioning from an acute care setting to long term follow-up. By ensuring that patients with cardiac needs for stroke prevention do not fall through the cracks, we are able to guide hundreds of complex patients annually through a challenging care journey, culminating with the utilization of evidence-based pharmacologic and procedural therapies. We also take pride in continually drawing on our multi-disciplinary expertise to maintain the highest standards of quality in the field of stroke care and prevention.

Advanced Technology & Research

Not only has the NeuroCardiac Program garnered national attention as novel care model, it has served as the bedrock for multiple clinical research studies targeting stroke prevention. Our experts are invited to participate in numerous multi-center clinical trials (see below), bringing cutting edge concepts, drugs and devices to patients in the Tampa Bay region. As an example, we were one of the first programs in the country to develop and publish a complete minimally invasive pathway for left atrial appendage occlusion (LAAO), which enables patients to safely avoid general anesthesia, hospital admission, and multiple healthcare visits, while completing their LAAO procedure. Efforts like this - to streamline the care experience for patients with stroke - continues to drive ongoing care-innovation in this uniquely collaborative arena.

Meet the NeuroCardiac Program Team

Our nationally recognized multidisciplinary system of care ensures comprehensive patient evaluations and the best possible care. This is achieved under the collaborative leadership and teamwork of:

Additional Physicians Operators:

Diseases We Treat

• Cardiac causes of stroke
• Atrial fibrillation-related stroke
• Stroke-secondary to cardiac anatomic defects (such as PFO)
• Secondary stroke risk
• Procedural stroke risk

Treatment Options

• Trans-catheter Left Atrial Appendage Occlusions (LAAO)
• Trans-catheter Patient Foramen Ovale (PFO) Closure
• Procedural Cerebral Protection
• Subcutaneous and External Rhythm Monitoring Systems
• Intra-cardiac Echocardiography-bases Procedural Guidance - reducing need for general anesthesia and facilitating same-day discharge

Clinical Trials

As the only program of its kind, our collaborative expertise has allowed us to initiate investigator-sponsored research and be invited to participate in several multi-center clinical trials. Active trials include:

• CONFORM – multi-center randomized testing of a novel left atrial appendage occlusion device that may reduce leak
• PerFOrm – multi-center randomized testing of a novel PFO closure device with less arrhythmia risk
• LAAOS-4 – multi-center randomized testing of LAAO in combination with anticoagulation for added stroke protection
• LEAPPS – multi-center randomized testing of surgical LAAO in patients at risk of atrial fibrillation
• RELIEF – multi-center randomized testing of PFO closure in the treatment of migraines
• LAAO in Malignancy – in collaboration with Moffitt Cancer Center, grant-funded study of how patients with cancer and atrial fibrillation may benefit from LAAO
• LAAO in Transplant Recipients – investigator-initiated study of LAAO outcomes in patients with solid organ transplant
• DIVERT-2 – multi-center observational study of rhythm monitoring strategies in a post-stroke population
• PFO Closure and Arrhythmia – investigator-initiated study of arrhythmia risk post PFO closure
• Neuro-Afib National Registry – registry of stroke patients, to follow trajectory of care and care delivery