CHI introduces newest cardiac procedure

Aug 10, 2013 News

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– as plans are streamlined for another by year end

As part of its ambitious moves to deliver quality cardiac care to the Guyanese Society, the Caribbean Heart Institute (CHI) this week introduced its newest procedure. Although not new to the world of cardiology, the procedure, Intro-Cardiac Defibrillation, has arguably been introduced here for the first time.

Two female patients benefited from the operations that were undertaken on Monday under the guidance of the privately operated facility’s Medical Director, Dr Mahendra Carpen.
Dr Carpen, who doubles as the Consultant Cardiologist at the Georgetown Public Hospital Corporation, said that with an Intro-Cardiac Defibrillator (ICD) device, patients can be spared sudden cardiac deaths.
This can occur, he explained, when an individual’s heart adopts an abnormal rhythm. And according to him since “the vast majority of these patients don’t ever reach the hospital, the approach is to find those who are at higher risks for developing what is known as sudden cardiac deaths and putting in the device before this occurs.”
Moreover, it was based on the findings of early screening programmes at CHI that the two patients, one in her 30s and the other in her 50s, were identified for the procedure which Dr Carpen said is very similar to the implanting of pacemakers. However he noted that the ICD device is in fact much bigger and complex as it is complicated in terms of its functioning and what it is designed to do.
And since implanting the device requires a great deal of coordination, Dr Carpen disclosed that usually companies that sell it insist on having one of their representatives on site of the implantation. This is so, Dr Carpen said, as the companies normally take some of the responsibility for proper functioning of the device.
In this case the device was procured from Puerto Rico, and according to the Medical Director, moves were required to coordinate the travel of someone coming from the office there. In fact Dr Carpen said that the decision to conduct the procedure saw nurses at CHI benefiting from training from the Puerto Rico representative.
Dr Carpen said the procedures on both patients were successful as they were able to leave CHI by midday Tuesday and are doing quite well.
“We expect to see them here next week for follow-up to see how things are going,” he added.
The ICD, according to Dr Carpen, is designed to shock a patient with an abnormal rhythm in order to pace the heart in such a way that it reverses that condition which could cause them to ‘pass out ’ or even die. Unlike the pacemaker which is intended to treat the heart when its rate is too slow, Dr Carpen said that the ICD in fact does the opposite.
“The pacemaker is the simpler of the two devices so they require less computerised functions, so therefore the device is much smaller…ICDs however require a bigger computer and it is all built into that device that is inserted under the skin,” said the Medical Director.
The procedure, he said, is one that will be available on demand at CHI to patients in need when the conditions are appropriate.
“We are starting to look for patients who are at high risk for these things; and with enough experience we will be able to recognise more patients who really can benefit from it,” added Dr Carpen.
He further went on to explain that “there are certain conditions that run in families where young people just don’t wake up from their sleep with no explanation.”
And this according to the Medical Director is in fact something that a lot of researches have shown. It has been deduced, he said, that these people have some kinds of abnormalities in the structure or the function of the heart that had not been recognised, thus there was no real reason to examine further because there were no warning signs.
“You are not going to do extensive invasive testing on somebody who has no complaints whatsoever, but when patients present with symptoms it is a good opportunity to look for these problems.”
And even as the ICD becomes a regular feature at CHI, Dr Carpen said that there are plans apace to soon introduce yet another procedure in the form of Radio Frequency Catheter Ablations for arrhythmias.  This procedure, he disclosed, will be on stream by year end. “You have a lot of patients coming and say like they feel their hearts racing and there are palpitations that happen from time to time,” speculated Dr Carpen.
He noted too that the condition is known to happen a lot more in young women and usually it is because there are some abnormal electric circuit within the heart.
“You can try medicines but every medicine has side-effects and if you take them for a long time you can develop a higher chance of getting side effects,” said Dr Carpen thus the need for Radiofrequency ablations.

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