By Dr Balbir Singh, Chairman and Head, Max Hospital, New Delhi (Saket)
If you have an irregular pulse, experience palpitations, shortness of breath, chest pain, fatigue, and weakness, you could be suffering from a heart disease called atrial fibrillation (AF).Studies have reported AF as a growing epidemic with an expected doubling of its prevalence in India by 2030.It is a condition that involves irregular beating of the atrium (upper chamber) of the heart AF can lead to clot formation in the heart which can subsequently migrate to the brain leading to the brain stroke; as a result AF results 4-5 x higher risk of stroke compared to a normal person it.As stroke remains one of the leading causes of death and disability in India, scientists have introduced new methods of evaluating irregular heartbeat that have outperformed the approach that has been used conventionally in stroke units. Therapies like patent foramen ovale (PFO) and left atrial appendage (LAA) closure are performed to close the hole or defect in the heart of patients suffering from cryptogenic & non-valvular AF respectively. The therapies are a breakthrough that could lead to better treatment and outcomes for patients with cryptogenic & non-valvularAF.
Digital innovations are revolutionizing healthcare and technology in medicine is paving the way for better treatment. When suffering from this condition, blood clots are most commonly formed in a part of the heart called left atrial appendage (LAA). Closing the LAA is an effective way of reducing stroke risk in people with AF and that is what the new technology does. A nail like device called occluder is implanted inside the heart that permanently closes LAA and keeps blood clots from escaping.
AFcauses 15 to 20 percent of ischemic strokes, which occur when blood flow to the brain is blocked by a clot or by fatty deposits called plaque.Within a few hours after onset of a stroke, treatment with drugs or devices that dissolve or break up the clot,can restore blood flow to the brain and lead to a better recovery. Taking a blood thinner, such as warfarin reduces the risk of stroke in patients with AF.
If you take a blood thinner for AF, you are probably aware of the bleeding risks that come with it. Most people can take blood thinner for years without a risk. But because they help prevent blood clots by thinning the blood, even tiny cuts or bruises will bleed a lot more because of the daily consumption of these drugs. Also, there is a need of getting frequent blood tests done to make sure the patient takes the right amount of medication.
Understanding Technology: Alternative To Blood Thinners
PFO and LAA closure therapies are performed to close the hole or defect in the heart. These procedures do not require open-heart surgery. A permanent device that doesn’t have to be replaced and can’t be seen outside the body Is used. To implant the device, the doctor makes a small cut in the upper leg and inserts a needle stick, as done in a standard stent procedure. The doctor then guides the device into the LAA or PFO as per the treatment area. They are done under general anaesthesia and takes about an hour. Patients stay in the hospital overnight and leave the next day.
LAA and PFOimplantshave proven to reduce strokes in patients. It can also reduce the risk of bleeding associated with long term use of blood thinners that have been used conventionally.
Sometimes, bleeding can be serious or even life-threatening. If you have an increased bleeding due to a blood thinner, then talk to your cardiologist about the LAA or PFO implant. According to my experience, 90 percent of people can stop taking blood thinners just 45 days after getting the surgery done.Over time, heart tissue grows over the implant, making the device a part of the heart.
Stroke is becoming an important cause of death in low-income and middle-income countries like India. To prevent AF and stroke, there should be a focus on early diagnoses, public awareness and capacity building at different levels of health care.It’s important to live a heart-healthy lifestyle – eating a healthy diet, increasing physical activity, avoiding smoking, limiting or avoiding alcohol and reducing stress. Technology is a blessing in an era where diseases like AF have become an epidemic. Hence, it is time for patients to talk with their healthcare providers to know about the latest treatment option available to manage AF.
Padma Shri Cardiologist, Dr Balbir Singh, Chairman and Head, Max Hospital, serves as Chairman and Head, Cardiology for Max Healthcare. Dr Balbir Singh is an extremely well regarded and respected clinician and has won numerous awards and accolades for his contribution in the field of cardiac sciences over the past three decades. He is also serving as the President of the Cardiological Society of India (CSI) at present and has been the former president of Indian Heart Rhythm Society (IHRS). Along with being awarded the country’s fourth highest civilian honour in the year 2007, Padma Shri Dr. Balbir Singh has won numerous other laurels including – Best Operator award at India Live, prestigious Golden Hand Award at AICT Singapore 2012. A graduate from Maulana Azad Medical College, Dr Balbir did his DM (Cardiology) from Govind Ballabh Pant Hospital, and fellowship from American College of Cardiology, USA. After working as a professor at AIIMS for about four years, he joined Batra Hospital as a Senior Consultant. Before joining Max Healthcare, Dr Singh was the Chairman – Cardiology and Electrophysiology at Medanta – The Medicity.