Ludhiana, August 09, 2016 (Neel Kamal Sonu): In a first-of-its kind surgery, a team of experts, led by cardiologist Dr Paramdeep Singh Sandhu in Fortis Hospital Ludhiana, performed a complex heart surgery to implant a sophisticated device in a 47-year-old man. Known as a cardiac resynchronization therapy defibrillator (CRT-D), an MRI-compatible device, this new-generation instrument synchronizes the muscles of the heart, in case of weak pumping of heart. This could prevent future heart failures, sudden cardiac deaths, and give patients an overall better quality of life than previously had.
“The surgery lasted about two hours, and it was a technically challenging procedure. Besides the actual implanting, the programming of the device is the most important, and as doctors, we need to get this right. It is implanted on the left side of the heart, just below the collar bone. The device itself doesn’t weigh more than 80 grams. For this surgery the cut made is not more than 3 cm long and the patient can go home in three days’ time. Recovery is quick, and people get back to their regular lives, without the feeling of breathlessness and fatigue. The wound heals in about two weeks, and the procedure is done under local anesthesia,” says Dr Sandhu.
Cardiac resynchronization therapy is literally the resynchronization of heart muscles that are functioning out of sync with each other. So the left and right walls of the left chamber are not contracting and relaxing together. This gives rise to the less effective pumping of the heart, which in turn cause breathlessness and fatigue. The reasons for this can range from heart attacks, congenital (birth) defects, myocarditis (inflammation) to idiopathic (unknown) reasons. Those with an ejection fraction (EF) lower than 35% are at risk for heart failure and have a 5-6 times greater chance of sudden cardiac death. Hence, these patients are usually advised to opt for a CRT-D device. (EF is the fraction of blood pumped out of the heart, and this should ideally be 60%.)
“People between 30 and 60 opt for the device that is MRI-compatible, while those who are older opt for simple devices, due to the cost factor. MRI-compatible ones have been launched in India only recently. The life of the battery of the CST device is 6-8 years, after which it is replaced with a minor surgery. We have been doing this surgery in Punjab for a couple of months now, and are the only hospital that has this expertise. Our patients come to us through referrals. This is a doctor’s greatest joy—when a patient shows his confidence and trust in his doctor,” says Dr Sandhu.
It is important for patients to understand though, that medication, exercise, a healthy diet, and regular check-ups are all to be followed, as instructed by the doctor.