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Waikato cardiologists using new technology to help high-risk patients

Source: Waikato District Health Board

Treatment of high-risk patients with coronary artery disease can now be done more safely, thanks to an Australasian-first performed by a Waikato Hospital cardiology team.

Te Whatu Ora – Health New Zealand Cardiologist Dr Madhav Menon said the team successfully completed a Complex High Risk Indicated Procedure (CHIP) angioplasty using a Pulse Cath iVAC2L hemodynamic support catheter, on 31 August.

Angioplasty is a procedure to open a narrowed or blocked artery, usually using a short wire mesh tube known as a stent.

“Patients who are complex cases with a very poor heart, need support during the procedure to maintain cardiac output,” Dr Menon said.

Previously, the heart was supported using a balloon pump that inflates and deflates to assist the heart’s pumping action.

The iVAC2L device provides a higher level of support by suctioning blood from the ventricle (the chamber which pumps blood out of the heart) and pumping it directly into the aorta (the main artery which carries blood away from your heart to the rest of your body). This takes more stress off the heart during the procedure and also provides better blood flow back to heart.

“This technology gives us better blood pressure support for very sick hearts while performing complex interventions,” Dr Menon said.

“It allows us to perform these procedures more safely with better clinical outcomes for the patient and less stress for our team.”

Coronary artery disease patients previously required a lot of hospital time and resources because of the risky nature of their surgery. It is estimated around 15 to 20 patients a year will benefit by being able to undergo this procedure. Improved clinical outcomes can also reduce the required hospital time and resource for this treatment.

“Though previously used in Europe, the Pulse Cath iVAC2L is new to New Zealand. Its introduction to this country last month, and the successful Pulsed Field Ablation (PFA) procedure a few days earlier, further builds Waikato Hospital’s reputation as a cardiology centre of excellence,” Dr Menon said.

Image caption: The successful CHIP team following successful completion.

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CYANOBACTERIAL WARNING UPDATE: Health warning issued for Lake Rotoroa (Hamilton Lake) and remains in place for Lakes Hakanoa, Whangape, Waikare and Kainui

Source: Waikato District Health Board

A health warning was placed in late August 2023 at Lake Rotoroa (Hamilton lake), and remains in place with more recent laboratory testing showing increasing levels of cyanobacteria. The warning signs at the lake will continue to show the ‘Alert’ warning until two consecutive samples show that the risk has decreased.

Lakes Hakanoa, Whangape, Waikare and Kainui continue to have a cyanobacterial health warning in place.

Cyanobacteria levels are regularly monitored at Lakes Rotoroa, Kainui, Rotokauri, Ngā Roto, Puketirini, Waikare, Whangape, Hakanoa and Waahi.

Dr Richard Wall, Te Whatu Ora Medical Officer of Health for Waikato recommends that where cyanobacteria health warnings are in place, lakes should not be used for any recreational activity that involves contact with the affected water.

“Swallowing water from lakes affected by blooms should also be avoided,” said Dr Wall.

“Cyanobacteria can release toxins which can trigger asthma and hayfever symptoms, and can cause skin rashes, stomach upsets, and in some cases neurological effects such as tingling around the mouth, headaches, breathing difficulties and visual problems.

“These symptoms may not appear until some time after contact with the affected water.

“Scums are a particular risk because they contain a high level of toxins.  If contact with scum does occur, skin should be rinsed clean and clothing changed as soon as possible. This warning is particularly important for children.

“If people do come into contact with the lake when warnings are in place, or any other lake where there are visible changes to water colour, they should shower and change their clothing as soon as possible afterwards, even if no symptoms are noticeable,” he said.

Dog owners should prevent their dogs from drinking or swimming in the water, as dogs are particularly sensitive to cyanobacteria.

Te Whatu Ora Public Health Unit for Waikato would like to be informed about health problems that develop after exposure to any of the Waikato lakes.
Phone Waikato Public Health Service: 07 838 2569

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Country’s first Cardiac Pulsed Field Ablation procedure successfully completed at Waikato Hospital

Source: Waikato District Health Board

In a national first, a Waikato Hospital cardiology team successfully completed a Pulsed Field Ablation (PFA) procedure yesterday to treat atrial fibrillation.

The Waikato Cardiology team involved in Tuesday’s procedure

Cardiologist, Associate Professor Martin Stiles, described PFA as a minimally invasive procedure involving a physician team threading a catheter (a thin, flexible tube) through a vein in the groin, guiding it into the patient’s heart and “ablating” veins at the back of the heart.

“Traditionally, we delivered hot or cold energy into the patient’s heart tissue, creating scars that help to break-up electrical signals which cause irregular heartbeats.

“PFA achieves the same thing using a ‘non-thermal’ electrical pulse to irreversibly damage the target cells while sparing the non-target tissue, which conveniently have a higher threshold for damage. PFA is faster and safer as adjacent structures are not heated or frozen.

“While recovery times between the two types of treatment are similar, due to PFA procedures being faster, we anticipate more day-stay rather than overnight stays being required which will free up hospital beds.”

While PFA has been used in cancer treatment for about a decade, Assoc Prof Stiles said it has only recently been used in treating the heart.

“The technology is brand new. It has been used in Europe since mid-2021, was introduced in Australia last year, and, as of Tuesday, is now here.

“Using the previous technique we used to complete two cases a day. Tuesday was our first day and we did three. I expect that eventually we will be able to complete four per day.”

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Recognition for Te Kūiti nurse making a difference in her community 

Source: Waikato District Health Board

A natural nurse, popular with her peers, easily able to establish a good rapport with patients and whānau is how a Te Kūiti nurse was described at an award ceremony recently.

Enrolled nurse Roberta ‘Bobby-Anna’ Wirepa was awarded the prestigious New Zealand Nurses Organisation’s National Leadership Award at Hamilton’s Te Pukenga Wintec campus in July.

The award came two days after the 49-year-old’s graduation, a culmination of two years study that required a lot of travel and dedication, achieved despite the impact of COVID-19.

Born and raised in Te Kūiti and described as a hearty Maniapoto- King Country person, ‘Bobby-Anna’ built her reputation as a hard and reliable worker on the back of experience in the shearing and hospitality industries including running her own businesses.

A 10-year stint working in Australia led to Bobby-Anna’s first entry into the health sector when she completed a Phlebotomy course in Cairns, leading to full-time employment with Queensland Medical Laboratories as a blood collector.

Among other duties, this role included flying around Queensland to various mine sites and conducting compulsory drug screening of fly-in and fly-out workers.

Returning home to Te Kūiti in 2018, Bobby-Anna found her Australian Pathology certificates weren’t recognised, cutting short her Phlebotomy career. Undeterred, she worked in a casual Health Care Assistant role at Waikato Hospital while undertaking Health Studies and qualifying to undertake nurse training, choosing a Diploma of Enrolled Nursing.

Her skills in pathology allowed Bobby-Anna an opportunity to be seconded to various COVID-19 testing teams around the King Country leading to an offer of post-graduate employment at Te Kūiti Hospital.

Throughout her training at Te Pukenga Wintec, Bobby-Anna was recognised as being a supportive and dedicated student, leading to her receiving the leadership award.

“I’m so grateful to have been given the opportunity to continue my career at my local hospital and can only thank ‘Whaea Tarn’ (CNM Tania Te Wano) for having faith in me,” said Bobby-Anna.
“It was a real surprise when I was told about the award and initially, I didn’t understand the significance of it all. I now understand I have a real opportunity to offer something to my community.”