A little hunter after big problems
Disorder of the heart rhythm could so far be examined by 24h monitoring of ECG, with the so-called "Holter" apparatus, which during this period could record any changes in the status of work and the rhythm of the heart. World studies, however, have shown that sometimes even such monitoring is not enough to identify certain disorders, which, with greater or lesser frequency, are not registered.
As Chief of the Clinic for Cardiology of the Military Medical Academy Colonel Professor Dr sc. med. Radomir Matunovic explains, a special problem occurs in patients with so-called crisis of consciousness, with which it was established that there is no neurological damage, and which are then appointed to a cardiologist for tests to find the cause of the aforementioned crisis.- The "crises of consciousness" are of such level that they directly or indirectly threaten the patient's life. Very common causes of the "crisis of consciousness", in addition to neurological, are of cardiac origin, and these are the pauses in heart rhythm or rapid irregular heart rhythm - emphasizes Colonel Matunovic.
He explains that the mentioned "holters" in these cases often gave "false negative" results, and signalled that there was no cardiac disease, and the patients were left without a proper diagnosis. Therefore, a method of registering heart rate within a few months, and up to three years has been developed, and it also demanded a certain level of technological development in medicine.
- It is a small device, called "Rivil link", which is placed under the skin and at all time registers heart rate, after which it reads and checks whether the rhythm in this period was regular or not. If, in the meantime, there has been a "crisis of consciousness", based on the reading of the record, we can determine whether this event is really tied to the work of the heart - says Dr Radomir Matunovic, adding that the model that is built in a patient at MMA is the latest version of the device, whose dimensions are much smaller and which is easier to install.
Counts heartbeats for three years, and fits in a box of matches
According to Colonel Matunovic, "link" is not only a major technological accomplishment, but it can be placed under the skin by a special syringe without a surgical procedure. He also added that the "intelligence" that it contains cannot be placed in a smaller format.
- It is connected to another smart device or software support, so that at any time we can have contact with the patient. In case a "crisis of consciousness" occurs, the patient presses a button on the device and then even a certain period before the activation is recorded. This means that the "link" does not only record a complete heart rate even up to three years, which later on we can check on the computer piece by piece, it can also send the signal and focus us on special moments and special conditions in which the patient is - explains Dr Matunovic, indicating that it is a state of the art piece of medical technology, which, in fact, fully sheds light on that grey zone, of previously unknown disturbances in the heart action.
Chief of the MMA Cardiology Clinic also believes that such a device allows cardiologists to look at what they had not been able to, and, on the other hand, to make a correlation between clinical events, possible syncope, "crisis of consciousness", nausea, or any other discomfort of the patient.
- In this way it is possible to "catch" a "crisis of consciousness" and syncope that is a result of a heart disorder, as well as to "catch the crisis of consciousness” which is not linked to functioning of the heart. With this device, we are able to refer to the right place those patients that have been "sent down the drain" with "crisis of consciousness" in a timely manner - concludes Colonel Matunovic.
The first "link" listens to hearts of members of our Armed Forces
The list of patients that are candidates for the application of the new method already contains a dozen names, and according to Dr Radomir Matunovic, in the last days of the year behind us, on 29 December, an SAF member, the father of two children, in his thirties, was given the first "link" in this part of Europe.
- With the patient, we already have first news on the device because he had a "crisis of consciousness" and have already processed the ECG recording. Accordingly to the recording and the findings, we set the parameters of the software which will in a possible next episode of "crisis consciousness" likely give the right answer and the ability to give the patient a diagnosis and determine appropriate treatment - explains the Chief of the MMA Cardiology Clinic, adding that the mentioned patient had battled "crisis consciousness" of unknown causes for several years. For these of sudden crisis, as Dr Matunovic explains, the patient had even had physical injuries, and this state was very embarrassing for both him and his family.
With regard to the continuation of the application of the procedure, Dr Matunovic points out that the device is registered with the Republic register, and that already in the next contract with the Republic Fund for health insurance this item will be included in the procedure, so the insured of the Fund will able to be adequately examined and treated.
- It means that we have opened to the system, and now it is a question of the healthcare system of our country to recognize the importance of what we want to offer and adopt it - concludes Dr Radomir Matunovic, Chief of the MMA Cardiology Clinic.
Biljana MILJIC
Photo Zarko SKOKO
