Taking care of your heart will lower your risk for heart disease, stroke and other major health problems. — Photo: 123rf.com
Caring for your heart is not just a health necessity; it’s a crucial commitment to a vibrant and fulfilling life.
Gleneagles Hospital Medini Johor consultant cardiologist Dr Quek Chu Zhen shares his insights on the basics of heart health while discussing innovative technologies and collaborative care.
Dr Quek, who is a regular speaker for National Heart Association Malaysia and Malaysia Heart Rhythm Society, explains what is Electrophysiology (EP), shedding light on its evolution over the years.
An electrophysiology procedure comprises a set of tests used by doctors to assess the electrical activity of your heart.
“The technology to perform EP procedures has improved over the years to ensure procedure safety and success.
“This can be seen in ablation catheters incorporated with safety features like contact force sensors, high-density electroanatomical mapping catheters and artificial intelligence (AI) algorithms,” he says.
Innovations to reduce risks His field of expertise lies in Radiofrequency Ablation and 3D electroanatomical mapping, which can reduce the risk of cardiac death or other heart related complications.
He explains: “Management of tachyarrhythmia (abnormal heart rhythms) can broadly be categorised into pharmacological and catheter ablation. The latter provides the opportunity to cure the arrhythmia and restore the quality of life to patients.
“Certain cardiac arrhythmia like scar ventricular tachycardia (VT) could potentially cause sudden death, which could be reduced by an intracardiac defibrillator (ICD) and, when needed, a catheter ablation strategy.”
Dr Quek says patients with cardiac implantable electronic devices (CIED) can live a normal life with minimal adjustments in daily living. — Handout
What lies ahead
As we peer into the future of cardiology and EP, Dr Quek unravels the latest developments.
“Latest guidelines on atrial fibrillation (AF) emphasise a lot on screening for high-risk patients,” he shares.
This approach focuses on the early initiation of stroke prevention, highly associated with AF, and early treatment of AF to arrest the progression of the disease.
A personalised approach
Dr Quek says that patients with cardiac implantable electronic devices (CIED) can live a normal life with minimal adjustments in daily living.
“Home electrical appliances with strong electromagnetic field interference should be avoided,” he advises.
“Patients should follow the yearly schedule for clinic device check.
“Patients should notify healthcare practitioners if they plan to have an MRI performed.”
Additionally, in the era of wearables, Dr Quek shares their role in monitoring certain heart conditions.
“Patients at risk of developing AF could undergo simple tests like Holter as screening (the test involves wearing a small device that records the heart’s rhythm and detects any irregular heartbeats). Some wearables, like smartwatches, are equipped with algorithms to detect AF, but the findings need to be verified by physicians,” he says.
“Patients at high risk of having AF (including the elderly, those with chronic hypertension, coronary artery disease, and diabetes) could invest in wearables for early detection,” he suggests.
However, he emphasises the importance of medical validation, ensuring that recorded abnormal electrocardiograms (ECGs) from these devices are verified by healthcare professionals.
Sudden cardiac death
Dr Quek shifts the focus to the critical aspect of early detection in preventing sudden cardiac death.
“Poor cardiac function following myocardial infarction is one of the common causes of sudden cardiac death,” he explains.
Despite successful revascularisation procedures like angioplasty or bypass, Dr Quek stresses the importance of follow-up echocardiography to assess cardiac function.
“If it remains poor, an Intracardiac defibrillator (ICD) is highly recommended as the primary prevention of sudden cardiac death,” he highlights.
Collaborative care
Dr Quek champions collaborative care for the overall management of heart health.
“Primary care physicians have the opportunity to see patients more holistically,” he notes, highlighting the vital role they play in understanding the main health problems of patients.
“Close collaboration with primary care physicians is fundamental in this ecosystem of modern medicine.”
Early detection and treatment
For AF, Dr Quek further explains the impact of early detection for better outcomes.
“One of the complications of AF is stroke, so once the diagnosis of AF is made and patients’ stroke risk assessment is high, then we will recommend oral anticoagulation to prevent stroke.
“Secondly, if AF is treated appropriately at the early stage, it can potentially be cured and not degenerate into persistent AF, which has worse outcomes.
“Some patients with AF may complain of palpitations, but there are also some patients who are asymptomatic.”
