NHS Improvement � Delivering tomorrow�s improvement agenda for the NHS

What is reperfusion?

After a heart attack, the main treatment is to quickly open the blocked arteries and restore blood flow (reperfuse) the heart muscle. Early reperfusion minimises the extent of heart muscle damage and preserves the pumping function of the heart.

There are two ways of opening blocked arteries in patients in patients suffering a heart attack. The treatment they receive is dependent on the type of heart attack they are having.

  • Thrombolysis - giving a drug to dissolve the blood clot in the artery
  • Percutaneous coronary intervention (PCI) - this involves re-opening the artery with a balloon and deploying a stent to keep the artery open

There is good evidence that PCI (so-called primary angioplasty) is superior to thrombolysis provided the angioplasty can be performed within a reasonable timeframe (preferably within 90 minutes of the time that the patient would have received thrombolysis), These reperfusion strategies available for patients having a ST segment myocardial infarction.

For patients with other types of heart attack and unstable angina timely PCI is the treatment of choice.

The work of NHS Improvement will link with the DH vascular programme, the British Society of Interventional Cardiologists (BCIS) cardiac networks and Strategic Health Authorities to implement and share learning from the National Infarct Angioplasty Audit (NIAP) which supports the growth of primary angioplasty (PCI) where possible and early thrombolysis when timely PCI is not possible.

Workstream to include:

  • Facilitation of national programmes of work to deliver dual reperfusion strategies -
    pre hospital thrombolysis and primary PCI
  • Providing a national supporting and coordinating role by organising a series of national meetings and providing sharing opportunities
  • Sharing the learning on workforce issues, ambulance service provision and commissioning associated with the two reperfusion strategies.

The national improvement team leading on reperfusion work are Dr Jim McLenachan (National Clinical Lead), Carol Marley (National Improvement Lead /Reperfusion). Sheelagh Machin ( Director/Heart)