Current State of CT Coronary Angiography Service Provision in New Zealand - A 2017 Snapshot

Background: CT coronary angiography (CTCA) is an established modality for undifferentiated chest pain assessment, resulting in significant improvement and savings in chest pain pathways. CTCA has been gradually adopted in various parts of New Zealand, with significant geographic variations. Here, we document the current status of CTCA service provision in New Zealand. Methods: A semi-quantitative survey is carried out with the 20 DHBs in New Zealand. CTCA availability and service provision including personnel and facilities are detailed as of 1st March 2017. Anticipated change in the next 12 months is also enquired. Results: CTCA is available in 12 DHBs, most of which are predominately out-patient based or out-patient only service with an average throughput of 10 ± 5 scans per week. Five day a week inpatient service with integration with acute chest pain pathway is available in 4 DHBs. The main indications include chest pain with or without prior stress testing. Referrals are approved either by a CTCA reading doctor or a chest pain nurse specialist following a protocol. Most CTCA reading doctors (either cardiologist or radiologist) have Level A recognition of CTCA training. Two DHBs have business plans to start a CTCA program this year. Conclusion: CTCA in New Zealand remains in its infancy, with significant geographic variation in its availability. The majority of DHBs providing CTCA currently concentrates on outpatients, rather than being integrated to acute chest pain pathways.