The Asia-Pacific Heart Rhythm Society (APHRS), in collaboration with the Hong Kong College of Cardiology, organized the 16th Asia-Pacific Heart Rhythm Society Scientific Session 2023 from Sept. 1 to Sept. 3 at the Hong Kong Convention and Exhibition Centre. Several Hong Kong cardiologists explained the latest research on conduction system pacing and optimizing left atrial appendage occlusion to improve treatment effectiveness and reduce surgical risks.
Dr. Lau Chu Pak, Honorary President of the Organizing Committee for the 16th APHRS Scientific Session, stated that approximately 2,600 patients with bradycardia in Hong Kong require pacemaker implantation yearly. However, the conventional right ventricular apical pacing (RVAP), used for over 50 years, reduces heart function. Research has shown that the latest left bundle branch pacing method can reduce the risk of heart failure by 2 to 5 times and effectively improve heart function and mortality rates. He noted that Hong Kong doctors are leading the way, surpassing other regions with a 40 percent adoption rate of the new pacing method.
He also cautioned bradycardia patients to be aware of their symptoms, especially elderly males, those with pacing rates over 40 percent, and patients with other cardiovascular diseases. These individuals are at an exceptionally high risk of heart failure. If there are suspicions, consulting a doctor and considering medication or changing the pacing method early can help prevent cardiac functional decline.
Dr. Mark TK Tam, Clinical Lecturer in the Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, added that according to a clinical study conducted in collaboration with the Chinese University of Hong Kong and Prince of Wales Hospital, patients with severe heart failure require simultaneous pacing and defibrillation therapy. The results showed that conduction system pacing is safer and more effective than traditional pacing methods. Compared to traditional pacing, conduction system pacing helps improve heart pumping function, relieving symptoms and enhancing the quality of life.
Dr. Chan Ngai Yin, Co-chair of the Organizing Committee for the 16th ASPRS Scientific Session, introduced a new technique for atrial fibrillation surgery. He pointed out that atrial fibrillation can lead to ischemic stroke and other diseases, with one-fifth of ischemic stroke patients being related to atrial fibrillation. Left atrial appendage occlusion catheterization surgery can be performed to treat atrial fibrillation patients unsuitable for anticoagulant therapy to prevent strokes.
He continued explaining that Hong Kong conducted the first research in the Asia-Pacific region on optimizing heart surgery using new cardiac computer scan software. Using this new computer scan software to replace pre- and post-operative transesophageal echocardiography showed increased accuracy, safety, success rates, and efficiency in surgery. The study’s second phase will be launched to apply this new technology to clinical medicine, benefiting more patients.
Mr. Lee, aged 79, had experienced acute heart disease and had undergone an angioplasty surgery. About ten years ago, Mr. Lee was diagnosed with atrial fibrillation and had to take anticoagulant medications long-term to prevent strokes. However, doctors found thrombosis near his left atrial appendage last year. Despite increasing the dosage of anticoagulant drugs, the situation remained unchanged, so surgery was necessary to prevent thrombosis from entering the arteries. Due to Mr. Lee’s advanced age, the traditional surgical method posed higher risks due to general anesthesia, so the new method, which only required partial anesthesia, was adopted.
