Nation’s First Neurocardiac Clinic Provides Comprehensive Care

Due to advancements in critical care during the past decade, people who experience cardiac arrest are treated faster and more successfully today than ever before, resulting in a marked increase in the survival rate.

Cardiac arrest is not solely a cardiac disease. As many as half of all cardiac arrest survivors suffer from cognitive and neurological deficits. Once circulation is restored, survivors face many challenges, including neurological dysfunction that prevents them from recovering their previous physical and mental status. 

Development of psychiatric disorders is also highly prevalent in these patients: Two-thirds experience anxiety or depression, a quarter develop post-traumatic stress disorder, and nearly all complain of severe fatigue and low life satisfaction. A quarter develop seizures and/or stroke and need continual neurological care. Only half of them ever return to work.

The Department of Neurology’s new neurocardiac program, the first of its kind in the country, provides survivors a “one-stop shop” that offers comprehensive, well-coordinated care to help survivors reach their full potential.

“Multiple studies have shown that early diagnosis and early appropriate systematic interventions result in better long-term outcomes among survivors,” says the program’s founder, Sachin Agarwal, MD, assistant professor of neurology.

Many of the clinic’s patients are first screened when they are admitted to the NYP/CUMC intensive care units. Before discharge, each patient is given a detailed neuropsychological test and screened for depression, anxiety, and PTSD. Patients also are assessed on their ability to perform daily living activities. They are then systematically followed and managed in the neurocardiac program to promptly identify and address any neurocognitive, neurological, or psychosocial problems to minimize disability and help patients re-integrate into the community. 

The neurocardiac team is comprised of specialists in neurocritical care (Dr. Agarwal), neuropsychiatry (Deepti Anbarasan, MD), neuropsychology (Alex Presciutti and Marykathryn Pavol, PhD), neurorehabilitation (Glen Gillen, EdD, and Janet P. Falk-Kessler, EdD), and pastoral care to provide coping strategies to patients and their caregivers (Linda Golding). 

Appointments are structured to ease the burden of seeing multiple specialists: Instead of moving from office to office, patients at the neurocardiac clinic remain in one room and specialists come to them. Together, the clinic’s specialists create an individualized care plan tailored to each patient’s unique needs. Special attention is paid to occupational therapy, which focuses on a patient’s ability to function at home and cognitive capabilities required to function in society. 

“The process of recovery is dynamic and may continue for months following the arrest,” says Dr. Agarwal. “We believe that these interventions can lead to a fast return to work, address psychiatric distress, improve overall quality of life, and decrease cardiovascular mortality for patients that have mild to moderate cerebral dysfunction.”

The program also runs support groups for patients and their caregivers to share experiences and advice.

—Susan Conova

The clinic can be reached at 212-305-4234