Leading the way in robotic heart medicine

A local team of heart specialists is showing the way with its use of state-of-the-art robotic technology.

Wednesday, March 10 2010

Just like when South Africa took the lead in heart medicine some forty-two years ago when Professor Christiaan Barnard and his team performed the world’s first heart transplant, a local team of heart specialists is showing the way with its use of state-of-the-art robotic technology.

In the space of just six months Dr Faizel Lorgat and his team at the Netcare Christiaan Barnard Hospital have become one of the leading centres in the world for treating arrhythmias (heart rhythm disturbances) with new robotic technology. Since they acquired the SENSei Robotic Catheter system, the team has successfully completed a total of 94 of these extremely difficult procedures. This is no mean feat when one considers that some Northern Hemisphere centres have had the technology for a few years now and have not built up such vast experience as Dr Lorgat’s team has.

Dr Lorgat, an Interventional Cardiologist, says that while there are a number of centres using the Robotic Catheter system in the Northern Hemisphere and Australia is planning to introduce one, the Netcare Christiaan Barnard Hospital is currently the only centre of its kind in the whole of the Southern Hemisphere.

‘We are already a major global centre and are now routinely offering these procedures,’ points out Dr Lorgat. ‘And this is only the beginning. There are many advantages for patients when it comes to the use of the technology, which is a major advance in the treatment of heart rhythm disturbances. Patient numbers will no doubt increase as the benefits of it become more and more apparent. As a result of its efficiency, procedures using the technology are likely to soon become the standard of care.’

The robotic system is designed to facilitate complex cardiac procedures by providing physicians with accurate and stable control. Minimally invasive catheter-based procedures in the heart are facilitated by providing physicians with more control over catheter placement compared to the manual techniques traditionally used. The robotic catheter navigation technology also incorporates fluoroscopic, intracardiac ultrasound, 3D surface map and patient electrocardiogram data into one portable workstation.

Dr Lorgat explains that using the system is rather like flying a ‘fly-by-wire’ aircraft. The operator guides a robotic ‘probe’ through tiny punctures in the groin area up into the heart. ‘Hot spots’ in the heart can be destroyed with a heated tip reducing the need for pacemakers and drugs, many of which are highly toxic to the human body.

Arrhythmias affect millions of people around the world each year. Nearly two million people in the United States alone suffer from a form of arrhythmia called atrial fibrillation (AF). AF is a complex arrhythmia in which the atria or upper chambers of the heart beat rapidly and never adequately fill the ventricles or lower chambers with blood. This results in an inadequate blood flow to the body and may lead to stroke as the blood left in the atria pools forming clots that can dislodge and travel to the brain.

Prior to the introduction of robotic technology such as the SENSei system, most electrophysiology (EP) procedures were done using a manual technique requiring physicians to perform a series of complex manipulations at one end of the catheter with inadequate assurance that the tip of the catheter would respond as desired inside a patient’s heart.

Dr Lorgat says that besides allowing much greater control of catheters, the new technology also has benefits for the interventional cardiologist who no longer has to remain standing in theatre in order to complete the procedure, which can easily take as long as five hours.

‘Now one can sit down. This reduces user-fatigue considerably and improves concentration and performance,’ notes Dr Lorgat. ‘In addition, during the traditional procedures cardiologists had to wear heavy lead protective coats in order to protect them from x-rays. Now there is no need as the technology removes the need for x-rays and the operator is removed from the old operating environment and into a viewing room.’

According to Dr Lorgat the technology has reached a point at which an operator can perform procedures from anywhere in the world. Already a procedure has been performed on a patient in Milan, Italy, from a centre in Boston in the USA. He believes that technology such as this therefore holds great promise for cardiac medicine in places such as Africa where many people do not have access to the expertise of specialists such as cardiologists.

Dr Lorgat suggests that arrhythmias can be very treatable especially if they are caught early and before the heart is seriously damaged. In fact a complete cure can often be achieved thereby rendering the procedure more cost effective, particularly as the long-term use of costly drugs and even pacemakers are avoided. In the last five years Dr Lorgat and his team have enjoyed a 90% success rate in treating arrhythmias using traditional methods as well as the new technology when it was introduced recently.

The SENSei system at the Netcare Christiaan Barnard Hospital has been purchased from Hansen Medical, the developers of the technology and is the most advanced system available.

Dr Lorgat is one of those unique individuals who combines a passion for both computers and medicine. He has studied overseas and travels extensively to keep up with the latest developments in his field, which has helped to place him as a leading authority in the treatment of arrhythmias.

‘South Africa is now in the enviable position of not only having the only treatment centre of its type in the Southern Hemisphere, but has considerable experience to back it,’ concludes Dr Lorgat. ‘Possessing this amazing state-of-the-art technology has allowed us as a country to be a leader in this field of heart medicine.’



Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Christiaan Barnard Hospital
Contact : Martina Nicholson or Graeme Swinney
Telephone : (011) 469 3016
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