Dr Viveka Kumar tells you how advanced palliative care can bring respite to patients with sudden cardiac arrest
With the surge in COVID-19 cases and deaths, the Indian healthcare system is struggling. The spike in cases is concerning as the new COVID-19 variant is more infectious and lethal. Amidst this, people with non-COVID health problems are bearing the brunt of the situation.
The fear of contracting coronavirus on their visit to the hospital, patients with heart ailments are dismissing their symptoms and refraining from consulting doctors. Consequently, there is rise in out-of-hospital sudden cardiac arrest cases that can be fatal if not treated immediately. The cause of sudden cardiac arrest is usually an abnormal heart rhythm or arrhythmia.
Considering that most sudden cardiac arrest cases occur out of hospital, it is important to educate the masses about sudden cardiac arrest and the importance of palliative care for managing it.
The abrupt loss of heart function, breathing and consciousness is known as sudden cardiac arrest. It is usually a result of the problem with heart’s electrical system which obstructs the heart’s pumping ability and stops blood flow to the body. If not treated immediately, sudden cardiac arrest can be fatal.
On the onset of sudden cardiac arrest, Cardiopulmonary Resuscitation (CPR) should be delivered immediately that increases the chance of survival. An effective chest compression is done by pushing the chest of the person in cardiac arrest at the rate of 90 compressions a minute. If CPR is continued until emergency help with defibrillator is made available, it can save a life. Moreover, if a person with sudden cardiac arrest is not given a shock through defibrillator, it can decrease the chance of survival by 10 per cent every minute.
Although cardiac arrest can affect a particular group of patients, it is difficult to predict when it can occur as there are no warning symptoms. Therefore, a continuous protection is required for such patients. Here is when technologies such Implantable Cardiac Defibrillator (ICD) bring respite to patients with sudden cardiac arrest. An ICD is a small device that runs on battery and is placed under the skin below the collar bone. By checking electrical signals from the heart, the device identifies the event of cardiac arrest. It treats the arrythmias or irregular heart rhythm in timely manner by delivering electrical pulses to restore normal heart rhythm.
Earlier these devices had to be replaced when the battery got depleted. However, as healthcare technologies are improving and growing by leaps and bounds, we now have devices with battery life up to 15 years. There are also ICDs that can be used subcutaneously. Known as subcutaneous implantable defibrillator (S-ICD), the device obviates the need to insert a wire inside the heart through a vein. Thereby decreasing the chances of infection rate and reducing hospital stays. S-ICD provides a treatment response in less than 30 seconds, is an alternative for those not suitable for an open-heart surgery.
The writer is Principal Director & Chief of Cath Labs (Pan Max) — Cardiac Sciences