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Sudden Cardiac Death a Major Health Challenge; Better Risk Evaluation, Lifestyle Modifications Crucial

  • Dr Aparna Jaswal, a leading Delhi-based expert in the field of cardiac pacing and electrophysiology, delivers a highly informative talk for cardiologists and physicians in Agra 
  • Major surge in cardiovascular diseases in northern India due to unhealthy lifestyles and lack of physical activity 

Agra, July 9, 2015: Sudden cardiac deaths are one of the prominent causes of cardiovascular disease related deaths, claiming a significant number of human lives. In India, however, there is limited awareness both among people and healthcare providers about mechanisms needed to be adopted to reduce risk and save lives.

Dr Aparna Jaswal, Senior Consultant in the Department of Cardiac Pacing and Electrophysiology, Escorts Heart Institute & Research Centre, New Delhi, was in Agra to deliver a highly informative health talk on the importance of evaluating and identifying patients who are at high risk of suffering sudden cardiac death. The objective of the session was to increase the flow of information between doctors and create a more liquid system of sharing the latest and best practices in the field.

Sudden cardiac death afflicts an estimated 1 in 1000 persons every year, making it one of the major causes of natural deaths across the world. While there is no consolidated data to estimate the number of SCD in India, cardiologists agree the number is significantly high.

Caused due to a sudden malfunction in the heart’s electrical impulse system, a sudden cardiac arrest can cause a loss of heart function, and result in sudden unexpected death. In most cases, the patient dies within an hour of suffering an SCA. Most sudden cardiac deaths are caused by abnormal heart rhythms or irregular heartbeats called arrhythmias. However, severe coronary atherosclerosis or narrowing of arteries due to deposition of excess plaque on the walls, is found to be associated with a large number of sudden cardiac deaths.

Speaking to an audience comprising cardiologists and physicians of Agra, Dr Jaswal underlined the importance and need for better evaluation and identification of patients who are at higher risk to prevent sudden cardiac arrest.

“Sudden Cardiac Arrest (SCA) is a condition which is more fatal than a heart attack as chances to survive an SCA are very dim. A sudden cardiac arrest happens when the electrical impulse system of the heart malfunctions, resulting in collapse of the normal heart function. This in turn cuts the crucial blood and oxygen supply to most parts of the body and if the heart is not resuscitated immediately, the person is certain to die. For physicians and cardiologists who deal with heart patients every day, it is immensely important to evaluate their patients for their degree of risks, and identify the subset of patients who are at a higher risk or susceptibility to sudden cardiac arrest. The condition is treated by implanting ICDs or implantable cardioverter defibrillators which help control irregular heart rhythm problems. Equally important is regular monitoring of patients who have ICDs implanted to check their functioning and heart conditions,” said Dr Aparna Jaswal.

“The epidemiology of cardiovascular disease in northern India points to a story of rising lifestyle disorders. Adopting healthy lifestyles including right diet, exercise and shunning bad habits like smoking and drinking is crucial to controlling the epidemic of heart disease in the country. Studies have concluded that a mammoth 10-11 % of India’s urban population while 8-9 % of the rural population suffers from coronary artery disease (CAD). This is an alarming number. Controlling risk factors of CAD help reduce the risk of sudden cardiac death at the initiation point,” added Dr Jaswal.

Risk factors for sudden cardiac arrest 

People with a history of heart attack or coronary artery disease are more prone to sudden cardiac arrest. Also, chances of sudden cardiac arrest are higher in people whose ejection fraction is less than 35% or who have history of syncope (fainting intermittently). Ejection fraction is a measure of the heart’s pumping power. A healthy person’s ejection fraction ranges between 60-70%. People with a family history of irregular heart rhythm are also at risk of Sudden Cardiac Arrest.

“From the healthcare providers’ perspective therefore, it is very important to monitor and evaluate these risk factors among patients. This set of people will invariably be at a high risk of suffering from sudden cardiac arrest. A comprehensive evaluation and assessment of risk factors helps identify the patients who may need an implantation device to prevent loss of heart function,” said Dr Jaswal.

Patients with coronary heart diseases undergo Percutaneous Transluminal Coronary Angioplasty (PTCA)or surgery to treat their condition. After 35-40 days, they should get an Echo done and if the ejection fraction is less than 35%, they should further be evaluated the SCD risk and if indicated patient should be getting an implantation of Implantable Cardioverter Defibrillator (ICD) done or getting radiofrequency ablation done. Also, any person with a history of ventricular tachycardia and ventricular fibrillation should get themselves evaluated by cardiologist also get an ICD implanted or get done a radiofrequency ablation if indicated.

ICDs work automatically by constantly monitoring the heart rate and detecting ventricular tachycardia and ventricular fibrillation episodes as soon as they begin. When an ICD detects an episode of ventricular tachycardia and ventricular fibrillation, it immediately delivers therapy in the form of low energy electrical pulses or electric shocks to terminate the arrhythmias before they harm the patient. ICDs are very effective solution to Sudden Cardiac Arrests.

As people with coronary heart diseases are more at risk of Sudden Cardiac Arrest, certain lifestyle changes can reduce high blood pressure and cholesterol levels and cut the chances of Sudden Cardiac Arrest.

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