New solutions for deadly heart conditions

Posted on 17 May 2019

On Tuesday 23 April 2019, Dr Razeen Gopal, a cardiac electrophysiologist at the Cape Town Atrial Fibrillation (AF) Centre located at Mediclinic Panorama, implanted the world’s smallest smart device to control heart beats and pumping action – a first in the emerging markets region.

The device, known as an Implantable Cardioverter-Defibrillator (ICD), is being increasingly utilised worldwide, predominantly for the management of life-threatening cardiac rhythm disorders. Dr Gopal has, in recent years, introduced a number of groundbreaking procedures into the South African healthcare arena, pushing for the best outcomes for his patients.

The Cape Town AF Centre, with its experience of using these devices and its leading role in teaching doctors about electrophysiology, implanted this device in a 77yr old patient with ischaemic cardiomyopathy (poor cardiac function due to coronary artery disease). He has had a successful ablation of his ventricular tachycardia with Dr Gopal.

The new device, produced by Biotronik, has only recently been introduced in Europe, so this South African application has occurred very early in the worldwide introduction of this medical device. “We are proud of the work being done within our hospital,” says Riaan Vorster, Hospital General Manager of Mediclinic Panorama, “Mediclinic Panorama has become known for the super-specialist expertise available to our patients and Dr Gopal is continuously raising the bar in terms of what is possible for our patients.”

Unique features of this heart-support device are its greater longevity, reliability and ease of implantation; these are very important attributes in developing environments where long term solutions need to be available and where patients feel confident in the device. The battery life of the ICD device is expected to be about 15 years. The more sophisticated device, which offers synchronisation of heart chamber pump action plus a ‘shock/defibrillation’ function, has a battery that lasts for up to 9 years.

This ultra slim and bio shaped device (10mm) is smart and can provide information directly to the clinic or doctor’s surgery remotely. An added benefit for the patient, which is not available for many other heart assisted devices, is that it can also be kept working while full or partial body scans such as MRI’s are performed for diagnosis of other diseases.

Dr Gopal’s unit remains one of the leading centres for management of cardiac arrhythmias on the African continent and he feels that the addition of the new platform of devices is in keeping with the centre’s motto that “with innovation, comes cure”.

The Cape Town AF Centre, as a centre of academic excellence has taken a leading role in the dissipation of knowledge in the discipline of cardiac electrophysiology (both in cardiac ablation and device therapy). Dr Gopal proctors quite broadly, having regularly travelled to the Middle East, Indian Ocean Islands, Namibia and nationally. He runs an extremely popular pacemaker implantation course (Medtronic EBAC/EHRA accredited), which has been attended by hundreds of training cardiologists and qualified specialists from within South Africa and the African continent. In addition, his avid passion for teaching the ECG has been popularised by the national ECG courses he hosts annually.

Published in Innovation