Anyone who is familiar with cardiac health already knows that the Costa del Sol has scored a real coup with the recent announcement that Doctor and Professor, Pedro Brugada, is Head of the new Cardiac Arrhythmia Unit at the Hospiten Hospital in Estepona. Arrhythmias (irregular heartbeats) are a growing problem in society today and one of the most dangerous, since they can cause stroke or sudden death. Most arrhythmias can be easily detected through an electrocardiogram, echocardiography, stress test and Holter monitor, yet some require more complex diagnostic and therapeutic techniques if they are to be detected and treated accordingly.
Arrhythmia: An often silent but deadly condition
Dr. Brugada, who specialises in arrhythmia diagnosis and treatment at the University Hospital in Brussels, decided to launch the new Arrhythmia unit at Hospiten almost by chance, while he was holidaying on the Coast. Dr. Brugada had a patient who resided in Gibraltar and who had to travel to Brussels to receive treatment. Since Dr. Brugada was in town, he approached Dr. Ramírez of the Cardiology Unit at Hospiten, requesting to see his patient at this hospital. The doctors realised that there were some 1.5 million patients between Málaga and Madrid, who were not receiving adequate treatment for arrhythmias and the new unit was born. Without a doubt, this is excellent news for so many people who do not enjoy a good quality of life, or who are unwittingly putting themselves at risk for stroke or sudden cardiac death, owing to arrhythmias. Dr. Brugada, awarded the Gold Medal by the European Society of Cardiology, tells me: “Arrhythmia can have symptoms, such as palpitations, a feeling of faintness and losing consciousness but sometimes, patients do not experience any symptoms at all.”
The importance of early diagnosis
One of the primary causes of sudden death from arrhythmias is Brugada Syndrome, a specific pattern in the electrocardiograms of patients who suffer sudden death, discovered by Dr. Brugada and his brother, Dr. Josep Brugada, in 1992. He says: “Brugada Syndrome is one of the most common causes of cardiac sudden death. It is a genetic effect which is the second leading cause of death in the youth in some countries. It can affect various members of the same family, which is why testing is ideal, especially for those with risk factors (such as having a family history of the disease, smoking, having high blood sugar and cholesterol levels, hypertension, etc.).” Dr. Brugada tells me that we should be on the lookout for heart problems since childhood. “I normally recommend testing at three key stages in life: when a child is 12 (because this is the age that they first become vulnerable to smoking, alcohol, drug abuse and unsafe sex), at 18 (when they commence university) and at 24.” Children and youths are tested for cholesterol, blood sugar, diabetes, etc. Those most at risk are men over 40, however, so this is a crucial time to see a cardiologist.
Pioneering Technology at the new Cardiac Arrhythmia Unit
At the new Cardiac Arrhythmia Unit, Dr. Brugada and his team carry out numerous important functions, everything from the diagnosis and treatment of arryhthmia to electrophysiology, diagnostic and therapeutic studies, the implantation of pacemakers and automated defibrillators (to ensure a regular heartbeat), cardiac resynchronisation therapy and much more. Pioneering techniques carried out at the new Unit include cryoablation of pulmonary veins in patients with atrial fibrillation, electrophysiology studies, radiofrequency catheter ablation of tachycardia and implanting resynchronisation devices and cardiac defibrillators.
The importance of electro- physiology study
Electrophysiological studies allow doctors to bring on tachycardia so they can see where it is coming from and how to treat it. A minimally invasive technique called ‘endocardiac catheter ablation,’ can cure tachycardia indefinitely. Up until now, arrhythmia has been treated with medication, yet Dr. Brugada notes that “the efficiency of medication is extremely low.” At the new Unit, he carries out a revolutionary technique called ‘cryoablation’, which puts a definitive stop to the irregular electrical impulses that cause arrhythmia. Dr. Brugada, as affable as he is intellectual (he speaks various languages, including Italian, English and Flemish), says that “Medication is like buying a house with a mortgage; ablation is like buying the same house upfront.” Dr. Brugada stresses the importance of early diagnosis: “If you detect the problem quickly enough, you can avoid myocardial infarction (a heart attack) and you can prevent the ensuing complications, such as having to place a stent, etc.”
There is always hope
Dr. Brugada tells me that the youngest patient treated for arrhythmias was a foetus (in utero) and the oldest was in his 90s. “One thing I have never uttered to a patient, are the words, ‘You’ll have to learn to live with that’. A patient is never too old to treat and this does not only apply to cardiology.” He adds, “Seeing an arrhythmia specialist is like seeing a dentist. Don’t wait until your cavity is too big or you may lose the tooth!”
Words Marisa CUTILLAS – Photography courtesy of Hospiten Estepona Hospital
Partido de Velerín, CN 340, km 162, Estepona. Tel: 952 760 600. www.hospiten.com