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Building a better heart defibrillator

With the deteriorating diet and lifestyle of the Filipino people, heart failure has become increasingly common. It is estimated that about 90% of the Filipino people suffer from different cardiovascular problems - a situation that can lead to an increased risk of sudden cardiac death.

For cardiovascular disease patients who are at high risk of sudden cardiac death, an implantable cardioverter-defibrillator (or ICD) can be inserted into the heart to help regulate the heart beat.

For over ten years, researchers at the Ottawa Heart Institute in Canada have been developing and studying a new-and-improved version of this device, which adds insulated wires capable of transmitting electrical impulses to three chambers of the heart. This new addition is called cardiac resynchronization therapy (or CRT) and helps the lower chambers of the heart to beat more strongly and more in unison. In November 2010, a study published in the New England Journal of Medicine revealed that the CRT was found to reduce the risk of death by 24% compared to a traditional ICD.

Co-led by Dr. Anthony Tang and Dr. George Wells at the Heart Institute, the study showed that CRT has the potential to save the lives of thousands and possibly millions of heart patients.

In a healthy heart, the muscles all fire at once, pumping blood in a coordinated way. When a dysfunction occurs in the heart, some parts of the organ may contract while others do not.
That's where the CRT comes in - the device helps to synchronize this process, making the heart work in a more coordinated fashion. However, until now, no research had been undertaken to examine the specific benefits and survival rates in heart failure patients who have been implanted with a CRT.

"This particular study is unique in that it actually demonstrated that it keeps more patients out of hospitals for heart failure and also helps them live longer," explains Dr. Tang. "It really translated into meaningful benefits to individuals."

"The patient doesn't really care whether the heart contracts and is coordinating or not," notes Dr. Tang. "What is meaningful for patients is 'Can I live longer?' 'Can I live better?' And we've now demonstrated that this indeed can be the case."

Athough the work of Dr. Tang and Dr. Wells is very promising, it is still best that we take action in preventing cardiovascular disease. Prevention is stll a lot better than cure.

The Facts on Cardiovascular Disease in the Philippines

  • According to Philippine Heart Association, heart disease is the number 1 killer of women over 25 years old, accounting for 500 deaths of women each year. One in every 2.5 women will die of heart disease and stroke
  • In 2007 more than 30 percent of deaths in the Philippines were due to cardiovascular causes making the diseases of heart and blood vessels the top two causes of mortality in the country today. Of these, 40 percent occurred in women.
  • About 17 million people worldwide die annually due to cardiovascular disease. In the Philippines, heart disease and stroke are the leading causes of mortality with 120,000 Filipinos dying each year because of these diseases
  • Nine in ten individuals over the age of 20 years have at least one risk factor for cardiovascular disease. Four in ten have three or more of these risk factors. As the number of risk factors increases, so does the risk of cardiovascular disease.
  • The most dominant risk factors for the development of heart disease are smoking, physical inactivity, high blood cholesterol, high blood pressure, obesity or overweight and diabetes.
  • The risk for developing cardiovascular disease can be reduced by stress management, healthy nutrition, regular physical activity, and maintaining a healthy weight, and by not smoking, avoiding alcohol abuse, and controlling diabetes, hypertension, and high cholesterol.