A recent ACC survey published in JACC: Advances exploring the current landscape of Cardiac Intensive Care Units (CICUs) found substantial variability in subspecialty training, operations and practice patterns as well as growing critical care trends toward high-intensity staffing models incorporating critical care cardiologists in cardiac care delivery. To stay aligned with growing trends, institutional leaders should adopt a structured approach to establishing and growing critical care cardiology training programs.

The 42-item self-administered survey, developed by the ACC on behalf of ACC's Critical Care Cardiology Member Section and the Society of Critical Care Cardiology, was emailed to 1,085 CICU cardiologists in the U.S. and Canada. The online survey focused on CICU cardiologist training, CICU operational models, practice characteristics, career satisfaction and work expectations. The survey was open from Oct. 5, 2023, through March 4, 2024. The survey response rate was 20%, with a final sample size of 166 (16% women, 63% White, 59% between 30 and 50 years of age).

Results showed that most of the respondents were from medium (34%) or large (64%) academic (81%) medical centers. Additionally, 61% reported that their CICU was dedicated exclusively to medical cardiology patients, and 53% reported working in high-intensity care models.

Critical care cardiologists participated in patient care through consultative roles (53%), co-management (29%), and/or serving as the primary provider (44%). Of note, most respondents held additional subspecialty training beyond cardiology (82%), most commonly in critical care medicine (46%), followed by echocardiography (37%), advanced heart failure (21%) and interventional cardiology (16%). Nearly all respondents (97%) reported that their job description included non-ICU service, and 70% reported being highly or extremely satisfied in their career.

Despite limitations including likely selection bias and lack of formal pilot testing, Alexander I. Papolos, MD, FACC, et al., "strongly urge institutional leaders to develop a deliberate, strategic framework – guided by insights from this survey and informed by consultation with experienced [critical care cardiology] professionals – to support the successful launch or expansion of [critical care cardiology] programs.