A heart-regulating device, implantable cardioverter defibrillator (ICD), was the centre of an Asian study recently. The findings of this new research were presented during the 21st Asian Pacific Society of Cardiology Congress, at Suntec Convention Centre recently.

Few Singaporeans received ICD device even though eligible

The ICD serves as a small device, inserted under the skin, to monitor and regulate the patient’s heart rate. Thus, it can aid in preventing sudden cardiac deaths. However, researchers have shown that not many Singaporean heart patients have opted for the implant – despite them being eligible for it.

Roughly two-thirds of the 1,066 patients in Singapore were found to be eligible for the ICD device but only 9.4% received one.

“This is despite Singapore having one of the highest ICD eligibility rates in Asia, after India and Indonesia,” commented Professor Carolyn Lam, senior consultant at the department of cardiology of the National Heart Centre Singapore (NHCS). The ICD device has been available in Singapore for roughly 10 years now.

The study that was conducted in 11 Asian territories namely Singapore, Indonesia, Malaysia, Philippines, Thailand, China, India, Hong Kong, Japan, Taiwan and South Korea. It was started in 2012 and the average age of participants involved is 60 years old.

Education important to overcome factors contributing to ICD under-utilisation

Professor Lam published a separate study in 2013 documenting certain factors that possibly deter patients from utilising the implants.

“This we believe may be due to lack of understanding around the device and cultural resistance to the idea of having a foreign body implanted, which represent opportunities for patient education,” she said. Some also might believe that they will not benefit from it due to old age.

Interestingly enough, cost was not stated to be a major factor. Even for a subsidised patient at the NHCS, the device costs a whopping SGD3,883 in 2016. Patients can still take medications to treat their heart diseases if they do not decide to have an ICD.

Professor Lam also pointed out that doctors could only do so much in advising patients to have an ICD. She stressed that more education is essential to promote the usage of this implant.

Professor Lam led this latest study and the team also found that sudden cardiac deaths are reduced by 66% with the use of an ICD implant. Besides that, a person’s overall risk of death is slashed by 29% – secondary to heart issues or any other reason.

Out of all the regions included, Japan recorded the highest ICD utilisation rate at 52.5%. This was based on 305 patients eligible for the device. Hong Kong came second with a utilisation rate of 21.2% out of the 19 eligible participants. China succeeded this as, out of 229 eligible patients, 17.9% used the ICD device.

Overall, it was concluded that only 12% of eligible Asian participants used this device.

Singapore still made good progress in cardiovascular diseases treatment

Speaking at the opening ceremony of the cardiology congress, Health Minister Gan Kim Yong said Singapore has made good progress in treating cardiovascular diseases. However, he said people should continue to take responsibility for their own health.

“Between the years 2000 and 2015, the premature mortality rates for ischaemic heart disease and stroke were halved,” he said.

“However, significant challenges remain. In 2015, about one in three deaths was attributed to cardiovascular diseases,” he added. Gan explained that the Health Ministry launched the ‘War on Diabetes’ campaign last year due to the strong association between cardiovascular conditions and diabetes. MIMS

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