Health Topics

Healthy Living

February 2010
Latest in Heart Care within Your Reach
Dr Rabin Chakraborty
Medicine is perhaps one of the fastest evolving sciences in the world. It is the wonderful marriage of human expertise and technology, understanding and application skill. Medical science touches our lives in every way. Technology in heart care have moved at lightning speed

Cath Lab
A good Cardiac Catheterisation Lab is an absolute prerequisite as catheterisation procedures are technically challenging and need the highest level of skill. With a number of cardiac procedures like coronary and peripheral angiography, angioplasty, stent implantation, primary angioplasty (angioplasty performed during a heart attack), non-surgical closure of congenital defects and embolisations carried on every day, a cath lab has to be at its best to ensure the desired outcome. The Flat Panel Digital Cath Lab is the latest on the scene.

MRI-compatible Pacemaker
We already have had mobile-friendly pacemakers. But now the pacemaker becomes an ally to the Magnetic Resonance Imaging (MRI) as well.

Pacemakers have been the standard treatment procedure for conditions like heart block, where the Sino- Atrial Node (SA Node) or our heart's natural pacemaker is diseased and starts beating slow. With heart rate coming down to 50s or even lower, patients experience symptoms like vertigo, dizziness, sudden loss of sense for a brief period or even a blackout, shortness of breath and chest pain. After tests like ECG and Holter, the diagnosis is confirmed and a pacemaker is implanted, which acts as a battery supplying electrical impulse to the heart. Ever since its first implantation in 1958, pacemakers have undergone radical changes in terms of design and underlying technology. The initial single chamber pacemakers have been joined by the rate responsive and dual chamber ones, which offer a better support.

With advances in medicine, the average life-span has increased and a number of elderly people with cardiac diseases need advanced imaging tests for evaluation. As a diagnostic tool, MRI is of immense value for diagnosing stroke, blood clot in brain, acute injury of spine and many other structural anomalies. But pacemaker users were not able to undergo MRI tests. This is because the strong electro-magnetic field generated by the MRI machine interferes with the pacemaker's magnetic field, resulting in severe malfunctioning like erratic rhythms, rotation or over-heating of the pacemaker leads. Thus patients with implanted standard pacemakers were not able to undergo MRI tests.

MRI compatible pacemakers are completely devoid of any ferro-magnet alloy and other iron-containing compounds that can interfere with the external magnetic field. It has also evolved in terms of design. Since pacemaker implantation is a one-time process, the patient's needs and lifestyle are evaluated before deciding on the type of pacemaker.

Mapping the Errant with Confidence
A few errant heartbeats – during a job interview, first time date, or when watching a cricket match - are not a cause of concern. But when one experiences recurrent palpitations, blackouts or other serious symptoms, even without any apparent cause, it needs further examination.

Conditions like atrial fibrillation can increase the risk of stroke manifold. Recurrent ventricular irregularities can turn life-threatening at any moment. Although a number of medicines can keep arrhythmia (abnormal electrical activity in the heart) under control. None of them can cure them and in most cases, they come with side-effects apart from the financial burden. Here is where EP (Electro Physiology) and RFA (Radio Frequency Ablation) become helpful to cure the problem from the root. Electrophysiology is the stream of cardiology dealing with the conduction of electrical impulses inside the heart.

Ensuring Right Rhythm from a Distance
Though our heart is the best pump known to man, heart failure results in inefficient pumping and accumulation of fluid in the body. This leads to swelling or edema and breathing difficulty. Often simple day-to-day activities of the patient become a chore, leaving the person utterly debilitated.

Cardiac Resynchronisation Therapy (CRT) is available for patients of heart failure. It involves the implantation of an advanced pacemaker, which provides the stimulus to the weakened ventricles to beat in synchrony and maintain adequate blood flow. This device reduces breathing difficulty, improves heart pumping capacity, exercise capacity and the overall quality of life. The implantation of CRT involves complex programming and needs considerable expertise.

This CRT has now taken even a step further. The latest CRT implant can be accessed and programmed remotely. After the initial programming, the implanting doctor is provided with a code which enables him/her to help the patient even from a distance! This device is able to sense crises like accumulation of fluid in the lungs long before the patient experiences any symptoms, which gives time to take the necessary corrective action and even emergency admission to the hospital in acute crisis. This is an immense empowerment for the patients.

Despite these advances in technology that are within your reach, there are basic things you have to do to ensure a healthy heart: the basics of a healthy lifestyle, balanced diet, regular checkup etc. Even we doctors believe that prevention is better than cure.

Flat Panel Digital Cath Lab
  1. Flat Detector increases image sharpness and contrast.
  2. DoseWise guarantees excellent image quality at low dose X-ray.
  3. It reduces manual work and delivers efficient workflow.
  4. Xres reduces noise and enhances image quality.
  5. Stentboost technology gives better Stent image ensuring a better inflation of Stent that guarantees longer and better function.
Beyond the technical detail, what it means for the patient is a faster procedure with a better outcome.
Dr Rabin Chakraborty is Senior Consultant Interventional Cardiologist, Electrophysiologist and Director, Cardiac Cath lab at Apollo Gleneagles Hospitals, Kolkata.