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.

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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