JANUARY, 2019 | Th e HEALTH Plus
“Patients who have gone through heart
transplant can return to having a normal life.
However, they will have to take medications
all throughout life as well.” – Dato Dr Azmee
05
p05
“IJN is currently the only health center in Malaysia
to perform heart transplant, and we have quite a strong
track record,” Dr Azmee says.
Correctly transplanting
Heart transplantation is a procedure where a heart is
transferred from one person to the other, to help the
one aff ected by heart failure to survive.
Experts at IJN has been doing this for a while, and
the chances of succeeding is generally quite high, given
that the heart is deemed fi t for the patient.
“We have a very strict process in selecting the heart
to be donated to the patients in the waiting list. Besides
having the same blood type and free from any heart
condition, the donor must also be similar to the patient
in body weight and height,” explains Dr Azmee.
Strict regime needed
He continues, “Patients who have gone through heart
transplant can return to having a normal life. However,
they will have to take medications all throughout life
as well.”
Th e medication is a type of immunosuppressant,
to ensure that our body is not rejecting the organ.
Th erefore for heart transplant survivors, they will face
another challenge; having to take medication (on time!)
all their life, while also having a harder time fending off
infections due to the same medication.
But hey, taking medication, eating well, and keeping
away from germs isn’t that bad compared to the other
option. — Th e Health Plus
Dr Azmee
with Chief
Clinical
Offi cer of
IJN Datuk
Dr Aizai
Azan Abdul
Rahim.
Pacemaker
for the pregnant
Pregnant woman with heart condition gets
pacemaker through 3D mapping system
T
HERE is a certain risk when it comes
to the implantation of pacemakers
for pregnant patients, and it has to
do with radiation.
By standard practice, the way doctors
are able to locate the exact part of your
heart that needs to be connected to the
pacemaker is by using an imaging tool called
fl uoroscopy. Fluoroscopy is much like an
X-ray “movie” where a continuous X-ray
beam (radiation) is passed through the body
so that the body part and its motion can be
seen in detail on a monitor.
To most of us, the radiation emitted to
provide the images is otherwise harmless.
Yet to someone who is pregnant, the same
radiation can pose developmental risks to
the baby in the womb. Th erefore when a
pregnant patient who was diagnosed with
heart failure came into the hands of Institut
Jantung Negara (IJN), there was instantly a
problem for them to tackle.
Dr Azlan Hussin, Senior Consultant
Cardiologist and Head of Electrophysiology
at IJN weighs in on their innovative method
to help the woman conceive safely.
“Atrial fi brillation is a
condition where the heart is
beating at an irregular pace.
It mostly exhibits in people
who are 65 years old and
above.” – Dr Surinder Kaur
heat (radiofrequency ablation) or freezing (cryoabla-
tion) is used at the area of the heart where the irregular
electrical pulse is.”
“Pacemakers are also an option, but it depends on
how bad the AF is in a patient,” she adds.
More should know about the condition that increases
the risk of stroke by 5 times. If you have symptoms such
as the ones you just read, maybe it’s time to talk to your
doctor. — Th e Health Plus
THE PATIENT: “The patient is prob-
ably born with a slow heart rate, and her
condition was only diagnosed during her
pregnancy,” Dr Azlan says. “So she defi nitely
needed a pacemaker, and even more so if
she wants to safely deliver her baby.”
FREEPIK
THE PACEMAKER: A pacemaker in its
essence is a device to assist people with
slow heartbeat by increasing or managing
the heartbeat to its needed tempo. And the
implantation of it is a fairly simple process.
“Th rough fl uoroscopy, we can see the ves-
sels of the heart and track the wires which
goes from the device itself (implanted usu-
ally below the collar bone) into the heart.”
THE RISK; “Exposing radiation to some-
one who is pregnant doesn’t just pose an
increased risk for malignancy for the child,
but may also cause stunted growth.”
THE METHOD: Dr Azlan and his team
came up with an idea to use another type
of imaging tool, called the magnetic three
dimensional tracking with no radiation
usage. “We used magnetic tracking from a
system we normally used for another type
“Exposing radiation
to someone who is
pregnant doesn’t just
pose an increased
risk for malignancy
for the child, but may
also cause stunted
growth.” – Dr Azlan Hussin
The part of the heart to be fi tted with
the pacemaker in 3D imagery.
of surgery. Essentially cheated the system to
track the pacemaker wires into the right part
of the heart,” Dr Azlan explains.
“Th e system basically comprises of two
components. One is the magnetic position-
ing that can track the movement of whatever
connected to it by magnetic fi eld, in this
case the heart. Th e second part is the three
dimensional location system. It is essentially
like using GPS to navigate ourselves into the
heart.”
By having the system to map out the
inner parts of the heart in a 3D setting with-
out any radiation exposure to the pregnant
patient, the team can then look at it from
diff erent angles and pin-point where exactly
does the pacemaker wires need to be.
The method is far more difficult to
conduct as opposed to fluoroscopy and
consumes more time, but just as eff ective
and accurate.
THE PATIENT AFTER: Th e patient is cur-
rently in recovery at IJN, and is expected
to deliver early next year. According to Dr
Azlan, her slow heart rate will defi nitely
affect the delivery in the worst way.
Equipped with a pacemaker, she now has
a real chance to become a mother. — Th e
Health Plus