TUNING THE HEART

The burdening trend of cardiovascular disease has reached such proportions that next decade will have hospitals swelled with cardiac patients. The overwhelming majority of those patients will be those who have “breathlessness” and “fatigability “as their major symptom. But why? because they will be those patients who would be having squeal of  diseases which had onset several years ago or in medical terms it is called “ HEART FAILURE”, which means that the heart is functionally unable to pump adequate blood as per requirement of the daily needs.

So here we have an entity where this disease takes away quality of life of the patient and leads to repeated hospitalisation.

So what is the option for these patients who fail medical therapy? Do we leave them to die/or make their life as good as it was earlier.

Here comes a revolutionary, form of treatment called “RESYNCHRONISATION”-to synchronise both chambers of the heart which in this type of diseases is lost & it requires implant of a device which synchronises the heart it is called –CARDIAC RESYNCHRONISATION THERAPY (CRT) device .It looks like a pacemaker and is even called a pacemaker i.e biventricular pacemaker or a pacemaker which beats at both the right & left side of the heart.

A similar patient  was treated few days back at Neotia Getwel Healthcare Centre Siliguri where the device was implanted .The patient was a patient with a condition called dilated cardiomyopathy with EF less than 35 % and after meeting careful selection & stringent implantation criteria (which must be fulfilled before device implantation ) ,the patient was posted for the implantation .Now coming to the costs these devices cost 3-4 times a normal pacemaker .so how was the same tailor made for a patient who was economically weak. The hospital in association with certain institutions arranged for an EMI Scheme wherein the patient could pay the cost in instalments. This requires great deal of vision on part of a hospital to finance the needs of the poor.

The technical challenge to implant the device as to why it differs from a conventional pacemakers is the fact that a normal pacemaker has one or two wires called” leads “But this CRT device has three wires (leads) ,so two are on the right side & one is on the left side implanted through a vein inside the heart. The technical challenge is to put the third or the left sided wire /lead.

Once successfully accomplished this device makes wonders to the quality of the life of the patients, reduces hospitalisation there by prolonging life.

It is a boom for north Bengal that such devices are now reaching this part of the country and people will be benefitted more in the days to come. However the caveat to implant such devices is that they are to be done in patients with a condition called DILATED CARDIOMYOPATHY with an EF of less than 35 % which means heart function is less than 35 % and even after that certain other medical criteria should be fulfilled because if they fulfil implantation criteria then chances of benefit are huge.

As physicians our endeavour should always be to take newer infrastructure to patients & society so that they are benefitted.

Written by -Dr.Joy Sanyal , MD,DM (Cardiology)

Sr.Consultant Interventional Cardiologist at Neotia Getwel Healthcare Centre