HR-ACT testing platforms for cath lab

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We currently use the ACT Plus and just recently got the HMS Plus in our H&V department for running HR-ACT testing.  The HMS Plus is way more that what we need, it was acquired because Medtronic no longer offers the ACT Plus and we only use it for HR-ACT testing.  

The H&V department is now asking me about i-STATs for ACT testing.  Does anyone have any input on these devices for ACT testing?  Or recommend another POC instrument that would be recommended for HR-ACT testing in the cath lab?  Thanks for any input or suggestions!

My email is aholland@catawbavalleymc.org if you would prefer to send responses via email. 

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Was there a statement by Medtronic about the ACT Plus? I hadn't heard that they were discontinuing it.

There was no statement that I am aware of.  I just know that they no longer have the ACT Plus because our H&V department was supposed to be ordering another one for our new heart center and were told they no longer make the ACT Plus and the HMS Plus was the alternative.

We were surprised when we found out as well. Our EP Lab was trying to order another Medtronic ACT Plus for a project, and Medtronic informed them that they were no longer manufacturing that instrument. Medtronic suggested the HMS, but we knew that was way more than the department needed. We were very disappointed in Medtronic, as we have over 20 ACT Plus instruments at our site, and more throughout our system. They never notified us (and we have all of our instruments PM's annually, so there was opportunity). We have decided to go with the Werfen Hemochron 100 for the EP Project and will work to convert our entire site to these as budgets allow. 

We're using hemochron signature elites and iSTATs. There's pluses and minuses to both. 
Based on the journal articles I've read, it seems like the iSTAT ACT is more consistent. The sig elites have a high degree of variability even when comparing sig elite to sig elite. 
The sig elites will display the current time for ACT value and alert the operator of a specimen failure earlier than the iSTAT.

But based on our 6 years of biannual comparison testing, the iSTAT and sig elites have performed and yielded similar results. 
There's also a new version of the hemochron signature elite called the hemochron gem that has wireless connectivity. 

We've always had Hemochron ACT devices for both ACT-LR and ACT+. Earlier this year, we replaced the Signature Elites with GEM100s. I did look at the iSTAT for ACT, since we already have them for bedside creatinines, but the perfusion manager was adamant that he did not want those in the CVOR and not receptive to hearing about the iSTAT. The methodology is completely different, and the iSTAT sounds really good-- but for the reasons stated in another response (Current time ACT value, specimen failure alerts), we continued with Hemochron (Now Werfen.). 

We are also on Medtronic and received no notice until I saw a post here and reached out. The letter (that we didn't get) went out in Fall 2021. They are no longer manufacturing but "expect to be able to support current customers for 10 years". 
We were already in the process of transitioning to iSTAT so are continuing that. 

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Ashlee Holland
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