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Abu Dhabi, UAESunday 17 February 2019

'A GPS for the heart': x-ray alternative to reduce radiation risk

Live demonstration at Arab Health conference in Dubai shows how 3D mapping procedure can benefit patients and boost safety for medics

Dr Sabine Ernst, a cardiologist at Royal Brompton Hospital in London, demonstrates 3D heart mapping at the Arab Halth event at Dubai World Trade Centre. Leslie Pableo for The National
Dr Sabine Ernst, a cardiologist at Royal Brompton Hospital in London, demonstrates 3D heart mapping at the Arab Halth event at Dubai World Trade Centre. Leslie Pableo for The National

A new 3D mapping technique used to detect heart problems will transform patient care, providing a safer alternative to x-ray and cutting the risk of radiation exposure for staff.

A live demonstration of the procedure, carried out using an animal heart, took place in Dubai on the opening day of Arab Health, one of the region's biggest healthcare conferences.

One of the few doctors already embracing the method in the UAE hailed it as a "GPS for the heart" - and said it will have major health benefits for patients and staff alike.

Dr Sabine Ernst, a cardiologist at the Royal Brompton Hospital in London, said 3D mapping is much safer for staff exposed to radiation while working in x-ray clinics.

3D mapping creates a multidimensional image of the heart. During the mapping procedure, a doctor stimulates the heart muscle in order to watch it beat and identify abnormalities in its rhythm.

Cardiac mapping is an electrophysiology (EP) procedure, which traces the electrical impulses generated by the heart cells.

“A standard x-ray gives only limited information on a patient’s heart,” said Dr Ernst, who also carries out surgeries in the UAE.

“This 3D mapping is like a GPS system for the heart.

Dr Sabine Ernst showcases 3D mapping technology at the Arab Health event in Dubai.  Leslie Pableo for The National
Dr Sabine Ernst showcases 3D mapping technology at the Arab Health event in Dubai.  Leslie Pableo for The National

“Staff working in hospital catheter labs are more exposed to radiation, so 3D mapping is much safer for them.”

At about half the price of an x-ray suite that can typically cost about $1 million (Dh3.7m), 3D mapping can also cut costs.

this is a good example of precision medicine and how it can improve patent outcomes.

Dr Sabine Ernst, cardiologist at the Royal Brompton Hospital in London

It has only recently been used on heart patients, with about 50 to benefit so far in the UAE - where men are more predisposed to heart problems due to genetics and lifestyle.

Obesity, a sedentary lifestyle and smoking can all lead to heart problems, and other related life threatening health issues like strokes.

Atrial fibrillation (AF) is the most common heart problem, where the muscle beats irregularly, interrupting blood flow around the body.

An operation to repair this defect can take between 70 and 90 minutes, with a surgeon able to understand exactly where to operate on the heart using the 3D mapping system.

Dr Ernst is often referred commercial airline pilots with heart problems who are showing symptoms of AF 10 years earlier than she would expect to see, on average.

This could be a result of long term exposure to radiation, fumes or irregular sleep patterns, she said.

Endurance athletes are also more likely to suffer from AF, as the heart has become larger due to long periods of intense exercise, causing the heart to become more susceptible.

“I have treated lots of cyclists and runners for this issue, and people working on commercial airliners,” said Dr Ernst.

“People are becoming more aware of heart problems now, particularly with increased use of fitness trackers monitoring heart rates.

“Once you trust the 3D mapping, you can move in a virtual space so it is much more accurate.

“You can then pinpoint where the faults are that are leading to atrial fibrillation.”

Cardiologists at the Cleveland Clinic in Abu Dhabi have reported more Emiratis seeking treatments for AF, some only in their 20s.

About half of all stroke victims in the UAE are under 45, significantly younger than the global average of 65.

The use of 3D mapping systems is increasing in the region, but it is still not the first option used to identify heart problems by most doctors, Dr Ernst said.

“More people need to be trained in how to use the technique accurately before it can become more widely used,” she said.

“If doctors have a choice of using 3D mapping or x-ray, they will usually go with what they know out of habit and choose x-ray to diagnose.

“It can be hard to change this culture.

“But this is a good example of precision medicine and how it can improve patent outcomes.”

Updated: January 28, 2019 05:11 PM

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