Source Website: https://www.straitstimes.com/singapore/health/tiny-device-detects-heart-problems-alerts-doc-immediately
By Timothy Goh, timgoh@sph.com.sg, The Straits Times, 22 October 2019 at 05:00 AM SGT
By Timothy Goh, timgoh@sph.com.sg, The Straits Times, 22 October 2019 at 05:00 AM SGT
PHOTO: Dr Seow Swee Chong (left), a senior consultant at the National University Heart Centre's Department of Cardiology, and his patient Ng Kok Seng, 65, who has an Insertable Cardiac Monitor implanted in his chest. In the picture, Dr Seow is demonstrating how the device, which is roughly the length of an AAA battery but flatter, is inserted into a patient via injection. The procedure takes around three minutes.
ST PHOTO: KELVIN CHNG
Picture posted by Timothy Goh, timgoh@sph.com.sg, The Straits Times on 22 October 2019 at 05:00 AM SGT
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https://www.straitstimes.com/singapore/health/tiny-device-detects-heart-problems-alerts-doc-immediately
Insertable Cardiac Monitor able to spot atrial fibrillation, a heart rhythm disorder responsible for 1 in 4 strokes.
One November morning in 2016, Mr Ng Kok Seng's heart stopped beating for six seconds but the retiree, then 62, did not notice and carried on with his daily activities.
He found out only later in the day after a tiny device implanted in his chest, known as an Insertable Cardiac Monitor (ICM), alerted a team at the National University Health System (NUHS), which called him and told him to go for an emergency consultation.
Mr Ng learnt he had atrial fibrillation, a common heart rhythm disorder, which causes the organ to beat much faster than usual - over 300 beats per minute, up from the usual 60 to 80. It is also responsible for about one-quarter of all strokes.
The device was inserted into Mr Ng after he had a stroke in October 2016.
ST PHOTO: KELVIN CHNG
Picture posted by Timothy Goh, timgoh@sph.com.sg, The Straits Times on 22 October 2019 at 05:00 AM SGT
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https://www.straitstimes.com/singapore/health/tiny-device-detects-heart-problems-alerts-doc-immediately
Insertable Cardiac Monitor able to spot atrial fibrillation, a heart rhythm disorder responsible for 1 in 4 strokes.
One November morning in 2016, Mr Ng Kok Seng's heart stopped beating for six seconds but the retiree, then 62, did not notice and carried on with his daily activities.
He found out only later in the day after a tiny device implanted in his chest, known as an Insertable Cardiac Monitor (ICM), alerted a team at the National University Health System (NUHS), which called him and told him to go for an emergency consultation.
Mr Ng learnt he had atrial fibrillation, a common heart rhythm disorder, which causes the organ to beat much faster than usual - over 300 beats per minute, up from the usual 60 to 80. It is also responsible for about one-quarter of all strokes.
The device was inserted into Mr Ng after he had a stroke in October 2016.
PHOTO: Insertable Cardiac Monitor able to spot atrial fibrillation, a heart rhythm disorder responsible for 1 in 4 strokes. This tiny device sends irregular heart rate data to your doctor.
The device was inserted into Mr Ng after he had a stroke in October 2016.
Picture posted by Liat Clark on Wednesday, 05 February 2014 (Note: may not be the one mentioned here. Only for illustration.)
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKCq-zrP8j39qlPaDxNBmjJb1VIx8LcgYJ3oTVRayPYvw_QBpZVeXCmDwuNcieqU0GZGiw3hzGzaxvETVNjLYaekWqa0vPxv2x5y9pGlGgzfIHRRf4Zkjo_13na8u30UqfGmoytG6g_-c/s1600/heart_4.jpg
https://wi-images.condecdn.net/image/rykmNaAjwm7/crop/810/f/heart_4.jpg
https://www.wired.co.uk/article/monitoring-heart-rate-real-time
Dr Seow Swee Chong, a senior consultant at the National University Heart Centre's Department of Cardiology who treated Mr Ng, said his experience is common among patients with atrial fibrillation. "Around 80 per cent to 90 per cent of our patients who have atrial fibrillation don't have any symptoms," he said.
Typically, atrial fibrillation is diagnosed using an electrocardiogram (ECG).
Dr Pipin Kojodjojo, another senior consultant at the Department of Cardiology, said, however, that this method has problems. As a majority of patients with the disorder do not have symptoms, they are unaware of their condition and do not get checked. The ECG will appear abnormal only if atrial fibrillation occurs during the test.
"Atrial fibrillation can come and go... if you just had a check-up yesterday, it doesn't mean you can't have the condition today," said Dr Pipin.
So in 2015, the Heart Rhythm and Stroke teams at the National University Hospital and National University Heart Centre did a study to find a better way to detect atrial fibrillation.
A total of 205 patients like Mr Ng, who had strokes with no known cause, were implanted with ICMs.
The device was inserted into Mr Ng after he had a stroke in October 2016.
Picture posted by Liat Clark on Wednesday, 05 February 2014 (Note: may not be the one mentioned here. Only for illustration.)
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKCq-zrP8j39qlPaDxNBmjJb1VIx8LcgYJ3oTVRayPYvw_QBpZVeXCmDwuNcieqU0GZGiw3hzGzaxvETVNjLYaekWqa0vPxv2x5y9pGlGgzfIHRRf4Zkjo_13na8u30UqfGmoytG6g_-c/s1600/heart_4.jpg
https://wi-images.condecdn.net/image/rykmNaAjwm7/crop/810/f/heart_4.jpg
https://www.wired.co.uk/article/monitoring-heart-rate-real-time
Dr Seow Swee Chong, a senior consultant at the National University Heart Centre's Department of Cardiology who treated Mr Ng, said his experience is common among patients with atrial fibrillation. "Around 80 per cent to 90 per cent of our patients who have atrial fibrillation don't have any symptoms," he said.
Typically, atrial fibrillation is diagnosed using an electrocardiogram (ECG).
Dr Pipin Kojodjojo, another senior consultant at the Department of Cardiology, said, however, that this method has problems. As a majority of patients with the disorder do not have symptoms, they are unaware of their condition and do not get checked. The ECG will appear abnormal only if atrial fibrillation occurs during the test.
"Atrial fibrillation can come and go... if you just had a check-up yesterday, it doesn't mean you can't have the condition today," said Dr Pipin.
So in 2015, the Heart Rhythm and Stroke teams at the National University Hospital and National University Heart Centre did a study to find a better way to detect atrial fibrillation.
A total of 205 patients like Mr Ng, who had strokes with no known cause, were implanted with ICMs.
PHOTO: Dr Seow Swee Chong (left) with his patient Mr Ng Kok Seng. The Insertable Cardiac Monitor was implanted inside Mr Ng 3 years ago and it detected atrial fibrillation two weeks after the implantation. [2]
ST PHOTO: KELVIN CHNG
Picture posted by Timothy Goh, timgoh@sph.com.sg, The Straits Times on 21 October 2019 at 1:33 PM SGT
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https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
The device, which is roughly the length of an AAA battery but flatter, takes around three minutes to be inserted into a patient under local anaesthesia via injection.
ICMs have a battery life of about three years and can record and analyse patients' heart rhythms throughout the day.
In the event of a heart rhythm disturbance, a team at NUHS is alerted. Once the condition is detected, appropriate treatment can be done to reduce the risk of stroke.
VIDEO: Dr Seow Swee Chong, senior consultant at the National University Heart Centre's Department of Cardiology, demonstrating the insertion of a Insertable Cardiac Monitor on a piece of dummy skin.
ST VIDEO: TIMOTHY GOH
https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
Atrial fibrillation was detected in about 12 per cent of the patients who had ICMs inserted, whose condition might have otherwise been missed.
The study also found that ICMs are more than seven times more effective than traditional methods in detecting atrial fibrillation with no symptoms.
Dr Seow said accurate diagnosis is important as without a diagnosis of atrial fibrillation, stroke patients are typically discharged on weaker blood thinners such as aspirin.
However, such medication is ineffective to prevent strokes caused by atrial fibrillation, which requires specific blood thinners called oral anticoagulants.
A patient whose atrial fibrillation is undetected is thus at higher risk of getting a second stroke.
Dr Seow noted that all the patients in the study who had their condition detected were given such medication and have not been hit by a second stroke.
In Mr Ng's case, after his ICM alerted Dr Seow that he had an abnormal heart rhythm, he had a pacemaker inserted and was given anticoagulants.
The retiree said: "Because of the ICM, the atrial fibrillation was detected... It saved me."
Given its success, Ng Teng Fong General Hospital will also be introducing ICMs to detect atrial fibrillation in patients with unexplained stroke. This will start in December.
NUHS will also be expanding the operating hours of its nurse-led clinic for atrial fibrillation at Bukit Batok Polyclinic to better facilitate management of the condition.
ST PHOTO: KELVIN CHNG
Picture posted by Timothy Goh, timgoh@sph.com.sg, The Straits Times on 21 October 2019 at 1:33 PM SGT
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https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
The device, which is roughly the length of an AAA battery but flatter, takes around three minutes to be inserted into a patient under local anaesthesia via injection.
ICMs have a battery life of about three years and can record and analyse patients' heart rhythms throughout the day.
In the event of a heart rhythm disturbance, a team at NUHS is alerted. Once the condition is detected, appropriate treatment can be done to reduce the risk of stroke.
VIDEO: Dr Seow Swee Chong, senior consultant at the National University Heart Centre's Department of Cardiology, demonstrating the insertion of a Insertable Cardiac Monitor on a piece of dummy skin.
ST VIDEO: TIMOTHY GOH
https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
Atrial fibrillation was detected in about 12 per cent of the patients who had ICMs inserted, whose condition might have otherwise been missed.
The study also found that ICMs are more than seven times more effective than traditional methods in detecting atrial fibrillation with no symptoms.
Dr Seow said accurate diagnosis is important as without a diagnosis of atrial fibrillation, stroke patients are typically discharged on weaker blood thinners such as aspirin.
However, such medication is ineffective to prevent strokes caused by atrial fibrillation, which requires specific blood thinners called oral anticoagulants.
A patient whose atrial fibrillation is undetected is thus at higher risk of getting a second stroke.
Dr Seow noted that all the patients in the study who had their condition detected were given such medication and have not been hit by a second stroke.
In Mr Ng's case, after his ICM alerted Dr Seow that he had an abnormal heart rhythm, he had a pacemaker inserted and was given anticoagulants.
The retiree said: "Because of the ICM, the atrial fibrillation was detected... It saved me."
Given its success, Ng Teng Fong General Hospital will also be introducing ICMs to detect atrial fibrillation in patients with unexplained stroke. This will start in December.
NUHS will also be expanding the operating hours of its nurse-led clinic for atrial fibrillation at Bukit Batok Polyclinic to better facilitate management of the condition.
PHOTO: Bukit Batok AF-Clinic patient So Teng Hung (left) under the care of Advance Practice Nurse Liau Wei Fong.
Retiree So Teng Hung learnt he had atrial fibrillation while hooked up to an ECG machine. The 83-year-old, who has been attending the clinic for 11 months, said: "When you go to see a doctor, most of the time you feel very nervous, but when you see nurses, you feel at ease, and you can ask them a lot of questions regarding your condition, and they give a lot of good advice.
"I really appreciate what they have done." [2]
ST PHOTO: KELVIN CHNG
Picture posted byy Timothy Goh, timgoh@sph.com.sg, The Straits Times on 21 October 2019 at 1:33 PM SGT
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https://www.straitstimes.com/sites/default/files/articles/2019/10/21/fh-apn-21.jpg
https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
What is atrial fibrillation?
Dr Pipin Kojodjojo, senior consultant at the National University Heart Centre's Department of Cardiology, estimated that 50,000 Singaporeans have atrial fibrillation, although the actual figure could be higher.
It is a chronic and progressive condition, which means that with time, it will recur more frequently until the heart is unable to beat regularly again. It affects around 15 to 20 per cent of those over the age of 80.
Retiree So Teng Hung learnt he had atrial fibrillation while hooked up to an ECG machine. The 83-year-old, who has been attending the clinic for 11 months, said: "When you go to see a doctor, most of the time you feel very nervous, but when you see nurses, you feel at ease, and you can ask them a lot of questions regarding your condition, and they give a lot of good advice.
"I really appreciate what they have done." [2]
ST PHOTO: KELVIN CHNG
Picture posted byy Timothy Goh, timgoh@sph.com.sg, The Straits Times on 21 October 2019 at 1:33 PM SGT
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https://www.straitstimes.com/sites/default/files/articles/2019/10/21/fh-apn-21.jpg
https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
What is atrial fibrillation?
Dr Pipin Kojodjojo, senior consultant at the National University Heart Centre's Department of Cardiology, estimated that 50,000 Singaporeans have atrial fibrillation, although the actual figure could be higher.
It is a chronic and progressive condition, which means that with time, it will recur more frequently until the heart is unable to beat regularly again. It affects around 15 to 20 per cent of those over the age of 80.
PHOTO: Atrial fibrillation
In a normal heart rhythm, a tiny cluster of cells at the sinus node sends out an electrical signal. The signal then travels through the atria to the atrioventricular (AV) node and then passes into the ventricles, causing them to contract and pump out blood. In atrial fibrillation, electrical signals fire from multiple locations in the atria (typically pulmonary veins), causing them to beat chaotically. The AV node — your heart's natural pacemaker — is unable to prevent all of these chaotic signals from entering the ventricles. Your ventricles respond to these extra, chaotic signals by beating faster than normal.
Picture posted by Mayo Foundation for Medical Education and Research (MFMER)
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https://www.mayoclinic.org/-/media/kcms/gbs/patient-consumer/images/2014/07/07/14/43/mcdc11_heartforafib.jpg
https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
Those who have certain conditions including obesity, hypertension and obstructive sleep apnoea are also at higher risk of atrial fibrillation, which is responsible for about one-quarter of all strokes. Atrial fibrillation-related strokes are also typically more disabling, said Dr Pipin.
He added that Singapore has seen a significant increase in the proportion of stroke patients with atrial fibrillation - 20.6 per cent in 2016, up from 16 per cent in 2007. Citing the growing number of patients requiring treatment for the condition here, he said: "It's really a major healthcare issue for us, and even more so in future."
Timothy Goh
In a normal heart rhythm, a tiny cluster of cells at the sinus node sends out an electrical signal. The signal then travels through the atria to the atrioventricular (AV) node and then passes into the ventricles, causing them to contract and pump out blood. In atrial fibrillation, electrical signals fire from multiple locations in the atria (typically pulmonary veins), causing them to beat chaotically. The AV node — your heart's natural pacemaker — is unable to prevent all of these chaotic signals from entering the ventricles. Your ventricles respond to these extra, chaotic signals by beating faster than normal.
Picture posted by Mayo Foundation for Medical Education and Research (MFMER)
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzloKMNS425ks766MELTAwpy8OWmWZnolb6p3UkFvNk4sGzCy7UlhOUVAHwsiQzSv2CeIZPEAy-q80KykbIEKaPCWp3596tOLACz9itth662vZoDG6BbIgaXKNmjQ1z36Fa_qf6BxZyzA/s1600/mcdc11_heartforafib_1.jpg
https://www.mayoclinic.org/-/media/kcms/gbs/patient-consumer/images/2014/07/07/14/43/mcdc11_heartforafib.jpg
https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
Those who have certain conditions including obesity, hypertension and obstructive sleep apnoea are also at higher risk of atrial fibrillation, which is responsible for about one-quarter of all strokes. Atrial fibrillation-related strokes are also typically more disabling, said Dr Pipin.
He added that Singapore has seen a significant increase in the proportion of stroke patients with atrial fibrillation - 20.6 per cent in 2016, up from 16 per cent in 2007. Citing the growing number of patients requiring treatment for the condition here, he said: "It's really a major healthcare issue for us, and even more so in future."
Timothy Goh
PHOTO: Atrial fibrillation can come and go... if you just had a check-up yesterday, it doesn't mean you can't have the condition today. - DR PIPIN KOJODJOJO, senior consultant at the National University Heart Centre's Department of Cardiology
"While we are fortunate that there are a number of treatments and interventions for treating these conditions, the problem is finding those patients before they arrive at the hospital with a life threatening condition." [3]
"Target our prayers for the sinus node, that it would function normally and that the nerve impulses it sends would flow correctly through the heart and cause it to pump blood in the way that it should."
Picture posted by Dreamstime.com
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[2] Timothy Goh, timgoh@sph.com.sg, The Straits Times, Tiny devices help detect 'silent' heart rhythm problems, aid stroke management, posted on 21 October 2019 at 1:33 pm SGT, https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
[3] Liat Clark, This tiny device sends irregular heart rate data to your doctor, posted on Wednesday 05 February 2014, https://www.wired.co.uk/article/monitoring-heart-rate-real-time
"While we are fortunate that there are a number of treatments and interventions for treating these conditions, the problem is finding those patients before they arrive at the hospital with a life threatening condition." [3]
"Target our prayers for the sinus node, that it would function normally and that the nerve impulses it sends would flow correctly through the heart and cause it to pump blood in the way that it should."
Picture posted by Dreamstime.com
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By Timothy Goh, timgoh@sph.com.sg, The Straits Times, 22 October 2019 at 05:00 AM SGT
A version of this article appeared in the print edition of The Straits Times on October 22, 2019, with the headline 'Tiny device detects heart problems, alerts doc immediately'.
A version of this article appeared in the print edition of The Straits Times on October 22, 2019, with the headline 'Tiny device detects heart problems, alerts doc immediately'.
Reference
[1] Timothy Goh, timgoh@sph.com.sg, The Straits Times, Tiny device detects heart problems, alerts doc immediately, posted on 22 October 2019 at 05:00 AM SGT, https://www.straitstimes.com/singapore/health/tiny-device-detects-heart-problems-alerts-doc-immediately[2] Timothy Goh, timgoh@sph.com.sg, The Straits Times, Tiny devices help detect 'silent' heart rhythm problems, aid stroke management, posted on 21 October 2019 at 1:33 pm SGT, https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
[3] Liat Clark, This tiny device sends irregular heart rate data to your doctor, posted on Wednesday 05 February 2014, https://www.wired.co.uk/article/monitoring-heart-rate-real-time
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- https://www.straitstimes.com/sites/default/files/styles/article_pictrure_780x520_/public/articles/2019/10/22/ST_20191022_TGHEART22STDU_5200359.jpg?itok=ewINlHrT×tamp=1571682183
- https://www.straitstimes.com/singapore/health/tiny-device-detects-heart-problems-alerts-doc-immediately
- https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKCq-zrP8j39qlPaDxNBmjJb1VIx8LcgYJ3oTVRayPYvw_QBpZVeXCmDwuNcieqU0GZGiw3hzGzaxvETVNjLYaekWqa0vPxv2x5y9pGlGgzfIHRRf4Zkjo_13na8u30UqfGmoytG6g_-c/s1600/heart_4.jpg
- https://wi-images.condecdn.net/image/rykmNaAjwm7/crop/810/f/heart_4.jpg
- https://www.wired.co.uk/article/monitoring-heart-rate-real-time
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- https://www.straitstimes.com/sites/default/files/articles/2019/10/21/fh-cardiac-21.jpg
- https://www.straitstimes.com/singapore/health/tiny-devices-help-detect-silent-heart-rhythm-problems-aid-stroke-management
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