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One doesn't have to be elderly or suffer from coronary artery disease to drop dead from cardiac arrest due to arrythmia. Many hundreds of Israelis die of this condition each year as well as 1,000 Americans on an average day, and while many of them are over 65, some of them are young and even athletes.
A major conference - the 8th International Dead Sea Symposium and the 17th Rappaport Symposium - will open on Sunday and continue for four days in Tel Aviv. Some of the world's leading experts in arrythmias are here to attend the event, including Prof. Douglas Zipes of Indiana University School of Medicine, Prof. Melvin Scheinman of the University of California at San Francisco and Prof. A. John Camm of the department of cardiovascular sciences at St. George's University in London.
There are no real warning signs of cardiac arrest due to arrhythmia, said Zipes in a phone interview from his US office last week. "They can't feel it themselves; there is no chest pain that sounds the warning. In people under 35, the electrical failure in the heart is almost always due to a genetic abnormality. In older people, high cholesterol and diseased coronary arteries are responsible for the irregular heartbeat."
Abnormal heart function can be identified with various types of equipment, but "you don't know who is at risk. Many people have an irregular result from an Echo doppler," said Zipes. "You can take 100 people who all have similar irregular heartbeat patterns, but you can't pinpoint exactly who is at major risk of cardiac arrest. If one of your parents died of it, your risk is twice as high, but if both parents died of it, the risk is 10 times greater. We doctors are still not very good at picking them out of the general population. It's also very expensive, so it can't be used as a screening measure for large numbers. To find a significant number, you have to screen a million."
The conference, he said, will be a "wonderful blend between basic research and new clinical information."
"This is the first time that the Dead Sea symposium has been combined with the Rappaport symposium, and it will interest experts in both fundamental research and application at the bedside," he added.
The risk for cardiac arrest, according to recent studies, is greater in the morning than in the evening, higher in the winter months than in the summer even if is a mild winter, said Zipes.
"It is more frequent in winter in Australia, which occurs in June, July and August, than in northern hemisphere winters. We don't know why. Maybe the answer is shorter days and less exposure to sunlight. There are still lots of riddles."
A major technological breakthrough in preventing sudden death is implantable cardioverters, which shock the heart when the heartbeat is irregular or stops. But these devices can cost as must as $25,000.
Zipes expects that in the years ahead, advances in genetics will bring about a cure, at least of the type that affects younger people. Israeli cardiologists in the field of arrythmia are very bright, he added.
"The Israel Heart Society asked me to start an international organization called Friends of the Israel Heart Society. We did so and raised money that will pay for two young Israeli cardiologists to attend meetings in the US next month. One of my goals is to have a symposium of Israeli Arab doctors to show that physicians can transcend religious and political barriers in finding solutions to common medical problems."
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