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Cardiology: The past, the present and the future with Rachel Barnes-Bryant

Rachel Barnes-Bryant, Business Unit Manager for UK and Ireland, Boston Scientific

Originally an intensive therapy unit nurse for four years, Rachel moved into the interventional cardiology medical technology arena in 2000 and has experienced first-hand the significant advances in the management of patients with coronary artery and structural disease. Percutaneous coronary intervention (PCI) – a minimally-invasive procedure for opening blocked coronary arteries, used in the prevention of heart attacks - moved from a high risk necessity for patients unable to have open heart surgery to a specialised and targeted procedure for a wider population of patients debilitated by cardiac symptoms, supported by highly engineered catheter technology, drug eluting stents, percutaneously replaced heart valves and adjunctive drug treatment.

How integral is medical technology to the cardiology sector?

Innovative developments in med tech devices have enabled significant advances in cardiology. Over the last 50 years Interventional cardiology has advanced to a level where patients experiencing an acute heart attack can have the underlying cause of their blocked or blocking coronary artery treated within 90 minutes from the onset of chest pain and can start to return to their normal daily activities by the following day. Also patients with previously considered untreatable coronary blockages can be quickly revascularised to restore blood flow.  

These advances have been made possible by partnerships between industry and motivated physicians to design, develop and continuously refine catheter based technologies that enable access and treatment of the underlying disease in a minimally invasive way. The majority of coronary artery procedures performed in the UK are now approached via the radial artery and many don’t require a hospital stay. Heart valve procedures which were originally only possible with surgery are now routinely performed in the majority of centres offering a PCI service.

What are the key factors that define value when looking at quality cardiology care?

Solution based approaches to delivering optimal patient management means that we can Identify, assess and apply the best strategy to return patients to their best possible quality of life.

The NHS turns 70 this year. How has interventional cardiology changed in that time?

It is unrecognisable. The impossible is now possible. Minimally invasive procedures, definitive treatment of a myocardial infarction giving the patient a not significantly different experience than going to the dentist. Heart transplantation and surgical and percutaneous heart valve repair and replacement have all evolved so that patients are able to receive cutting-edge treatments, with the UK leading the way in many cases, which is partly made possible by the partnership between the NHS and the medical technology industry.

Looking ahead, what role will data play in cardiology of the future?

In the future data will be used to refine and optimise patient pathways and treatment protocols, identifying patient populations that best respond do variations in these. In addition, it will help to make sure all patients are treated equitably.

Rachel Barnes-Bryant