Cardiac catheterization is one of the most frequently performed procedures in the United States. Over the past 25 years, the number of procedures has increased 3.5 fold because of expanded indications and improvements in techniques and equipment. 1 In 2005, an estimated 1,322,000 inpatient left heart diagnostic catheterizations and 1,271,000 inpatient percutaneous coronary interventional (PCI) procedures were performed in the United States. 1 According to the most recent American Hospital Association survey, 36% of the 4,836 hospitals in the United States have adult diagnostic catheterization laboratories. Of the 1,728 hospital-centered adult diagnostic laboratories, 78% are PCI capable. 2