Health Scan: New 'umbrella' heart device slashes risk of stroke

Hundreds of thousands of Israelis suffer from a chronic condition of rapid, unsynchronized and irregular heartbeats.

By JUDY SIEGEL-ITZKOVICH
heart 88 (photo credit: )
heart 88
(photo credit: )
Hundreds of thousands of Israelis suffer from a chronic condition of rapid, unsynchronized and irregular heartbeats. The common type of cardiac arrhythmia known as atrial fibrillation increases the risk of blood clots n in the heart that can lead to strokes because the flow of blood through the upper chambers (atria) of the heart is slowed. It has a prevalence of 0.4 percent to 1% in the general population, and rises to approximately 8% in those 80 and over. The risk of stroke in the presence of atrial fibrillation can reach 20% annually in some patient subgroups if left untreated. Patients are often given anticoagulants such as coumadin that thin the blood, but some are not able to take such drugs, and weekly blood tests are annoying. Among patients who may not take anticoagulants are those with an increased bleeding risk, older patients at risk of falling, people with uncontrolled blood pressure and those who have difficulty in controlling blood thinning. It has been noted that the clots tend to form not in the body of the atrium; instead, about 90% of them are in a "side pocket" called the left atrial appendage (LAA). Over the years, cardiac surgeons have tried to sew, staple or even cut out this structure, but their efforts have met with variable success. Most recently, a novel device received European approval for use in closing the LAA based on technology used extensively in structural heart defects over the past 10 years. It is produced by the AGA medical device company. Dr. David Meerkin, a senior interventional cardiologist at Jerusalem's Shaare Zedek Medical Center, is the first in the country to apply the new technique, in which a tiny "umbrella" is implanted into the left atrium with a minimally invasive catheter and prevents clots from moving onward toward the brain. Meerkin, a leading catheterization specialist assisted by hospital echocardiographer Dr. Adi Butnaru, has implanted the "umbrella" in four patients at high risk for stroke. Dr. Joseph Degiovanni, a specialist from Burmingham, England, joined the team for the initial cases. All of the procedures were successfull, and three of the four patients were discharged the following day; the fourth was further treated for rhythm stabilization. Thus Shaare Zedek has joined a handful of medical centers in the world that carry out the procedure. Prof. Chaim Lotan, chairman of the cardiology branch at (competing) Hadassah University Medical Center, congratulated Meerkin on the "Israeli first." MEDITERRANEAN DIET CUTS KIDNEY STONE RISK An apple a day seems not only to keep doctors away, but also kidney stones. US researchers have found that eating plenty of apples and other fruits, vegetables, nuts, low-fat dairy products and whole grains - which is a Mediterranean diet - while limiting salt, red and processed meats and sweetened beverages is an effective way to ward off kidney stones. The Journal of the American Society Nephrology has just published the research conducted at Boston's Brigham and Women's Hospital. Because kidney stones are linked to hypertension, diabetes, increased body weight and other risk factors for heart disease, the findings have considerable health implications. They collected information from individuals enrolled in three clinical studies: the Health Professionals Follow-up Study (45,821 men followed for 18 years), the Nurses' Health Study I (94,108 older women followed for 18 years) and the Nurses' Health Study II (101,837 younger women followed for 14 years). A total of 5,645 kidney stones developed in the participants. Those who most followed the beneficial diet were between 40% and 45% less likely to develop kidney stones. The reductions in kidney stone risk were independent of age, body size, fluid intake and other factors. As many medications prescribed to treat kidney stones have unpleasant side effects, this diet may be an effective alternative, the researchers said. IMPORT & SALE OF E-CIGS BARRED Soon after learning of the US Food and Drug Administration's health warning on electronic cigarettes, the Health Ministry has decided to prohibit their import and sale and to warn against their use. The ministry said it will prohibit the import even of those that do not contain nicotine. The ministry in Jerusalem said it had previously approved the import and sale of e-cigarettes not containing nicotine, but as a result of the FDA warning, it has changed its mind and prohibited the arrival and sale of all e-cigarettes. They have been sold by the millions online and even in hospital shopping centers, and advertised as a safe way to "smoke" without suffering the deadly consequences of tobacco. Electronic cigarettes are expensive electronic devices containing cartridges filled with nicotine, flavoring and other chemicals. The electronic cigarette turns the nicotine and other chemicals into a vapor that is inhaled. Unlike tobacco smoke, they do not cause harm to people nearby. But the FDA found in its analysis of e-cigarette samples that they contain traces of carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze. WILL IT BE MOZART OR ROCK? Kaplan Medical Center in Rehovot recently began offering patients who undergo catheterization and angioplasty their choice of music. Listening to music through earphones during the procedure has been found to reduce the need for sedatives or pain killers. Valium, pethidine and other drugs used to be given via a vein, but now are almost unnecessary. The new music system includes a compact disk and wireless earphones. The patients in the units - as well as the interventional cardiologists who perform the procedure - can choose the type of music they prefer, from hassidic to classical, from South American to heavy rock. Dr. Oded Eisenberg, head of the catheterization unit, notes that with the musical diversion, patients lie completely alert with much less fear while a thin endoscope is inserted into the coronary arteries to free a clog and insert a stent to hold the blood vessel open. Nurse Ilana Vered said that before catheterization, a patient is asked what type of music he or she prefers. "One specifically asked for "Mashiah, Mashiah," a Breslav hassidic tune, so a staffer went out to buy the disk. During the procedure, he sang together with the medical team, and it was very nice and calming." As long as they didn't start dancing.