TASNEEM HASSAN
A Panorama heart specialist and his team are becoming leading experts on the continent in the use of a groundbreaking new technique that uses cold to treat a common cardiac rhythm disorder.
Dr Razeen Gopal, a cardiac electrophysiologist, and his team at the Cape Town Atrial Fibrillation Centre at Mediclinic Panorama have performed in excess of 350 cryoballoon ablation procedures to treat atrial fibrillation (AF).
Dr Gopal sees five patients a week and is booked until the end of the year to perform the procedure. He marvels at how they have been able to perform so many procedures within four years in Cape Town.
AF, an irregular rhythm affecting the heart’s upper chambers (atria), is the most common heart rhythm disorder and affects one in eight people over the age of 60, but, increasingly, said Dr Gopal, it also affects younger people.
“Due to extra electrical signals entering particularly the left upper chamber, the atria may contract at a fast, but chaotic rate of 150 to 200 beats per minute, instead of regular 60 to 90 beats per minute,” said Dr Gopal.
The irregular beat could disrupt blood flow in the upper chambers, leading to pooling and clotting of blood and resulting in a stroke, said Dr Gopal.
Ablations are performed where freezing energy is transmitted to each vein mouth selectively through a highly sophisticated balloon.
Dr Gopal said they accessed the heart through a puncture in the patient’s groin, inserting the balloon with a catheter to the heart. Once the balloon is in the left side of the heart, the balloon is filled with liquid nitrogen, which cools it to about minus 60 degrees Celsius.
The intense cold eradicates the signals causing the irregular heart rhythms.
The technology, said Dr Gopal, had the added advantage of hardly, if ever, causing additional rhythm disturbances from lesions forming, as in the case of radio-frequency ablation.
AF can be particularly risky for people with a history of stroke, diabetes, hypertension or those older than 65.
And persistent AF can lead to heart failure, since the pumping chambers (ventricles) cannot contract effectively at a constant high rate.
AF is associated with symptoms of fatigue, shortness of breath, listlessness, palpitations, chest discomfort, fainting and lightheadedness and reduces quality of life.
Dr Gopal works alongside specialist cardiac anaesthesiologists, clinical technologists, dedicated lab staff and radiographers and specialist arrhythmia nurses.
Megan Afrika, 36, from Kuils River is living proof that the cryoballoon ablation procedure has helped her. She said that she was referred to Dr Gopal by her cardiologist, and she says he has changed her life.
Ms Afrika said that due to her atrial fibrillation, Dr Gopal had placed her on medication to see if it would control it and it did.
“He said if the medication worked it means that they will have to do the procedure as he would not want to keep me on medication forever.
“And here I am, doing well and everything is under control,” said Ms Afrika.
She expressed her thanks to Dr Gopal and his team. “They are very helpful. They are really a phone call away.
If I didn’t feel well, I could just call and they would assist me,” said Ms Afrika.
Fourth season of Jive Culture Shock at Baxter