Operation a first for coast

This article appeared in the Sunshine Coast Daily on 25 May 2016

Patients at risk of cardiac arrest have new solution.

CARDIOLOGIST KK Lim has revolutionised the treatment of patients at risk of sudden cardiac arrest by being the first Coast doctor to implant an S-ICD defibrillator system. Dr Lim, who is based at the Sunshine Coast University Private Hospital, carried out the procedure at the hospital’s Cardiac Catheter Laboratory last week. Dr Lim said the new subcutaneous implantable defibrillator had only been available in Australia for a year. The technology was an exciting advancement, offering patients a less invasive procedure than the traditional transvenous implantable cardioverter defibrillators, where the leads are fed into the heart through a vein and attached to the heart wall. “The device is implanted just below the skin and the lead is implanted along the breastbone, just under the skin, thereby leaving the heart and blood vessels untouched and intact,” Dr Lim said. “It is designed to provide the same protection from sudden cardiac arrest as traditional ICDs, however as there is no direct contact with the heart or bloodstream, it avoids the risk of life-threatening infections that could travel directly to the veins and heart via the traditional ICD lead.”

Dr Lim said the the S-ICD was a great option for young patients with congenital heart conditions as the leads could be more easily replaced as the patients grow. “The first procedure with the new defibrillator went extremely well and my patient was well enough to go home the next morning, following an overnight stay,” he said. Dr Lim was assisted by anaesthetist Chris Graves, scrub nurse Lucy Fittler, scout nurse Joanne Quayle, monitor Deshna Fennell, team leader Melinda Taylor and radiographers Dani Roberts and Craig Saunders. The system has two main components: a pulse generator and a lead. The pulse generator is a small battery-powered device that constantly monitors a person’s heart rhythm and can provide a small electrical shock to restore the heart to normal rhythm when the heart is beating dangerously fast (tachycardia) or chaotically. Sudden cardiac arrest is an abrupt loss of heart function. Most episodes are caused by the rapid and/or chaotic activity of the heart known as ventricular tachycardia or ventricular fibrillation.

The new treatment is suitable for a large amount of patients; however it is not intended for patients who have symptomatic bradycardia (a slow heart beat) and who require a pacemaker,” Dr Lim said. More than 1000 patients have been treated at the Cardiac Catheter Laboratory at the Sunshine Coast University Private Hospital this year. CEO Oliver Steele said the high volume was a good indication of both the need and demand for high quality cardiac services on the Sunshine Coast together with the excellent calibre of the cardiac specialists in practice in the region and the successful outcomes for patients that are being achieved.