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Outpatient cardiac catheterization: its role in managed care.

Cardiac catheterization, as developed by Dr. Sones, has revolutionized the practice of ischemic heart disease. I personally appreciate his support on behalf of the development of outpatient cardiac catheterization, as he counseled me over the years in regards to this methodology. I believe its appropriate use, both in certified ambulatory facilities as well as in expanded hospital programs, would lower the death rate in those who experience sudden death as well as myocardial infarction. Cardiovascular administrators must now position themselves in the outpatient area in order to coordinate not only outpatient catheterization, but also noninvasive assessment. They also must provide support for managed care, which utilizes low-cost programs such as: outpatient cardiac rehabilitation for drug selection, assessment of ischemia, appropriate management (rather than relying on sudden death and myocardial infarction as a satisfactory method of identifying patients with heart disease).