Medtronic and Sohu Health Launch Public Education Initiative on Prevention and Management of Arrhythmia

CHENGDU, China, Sept. 22, 2020 /PRNewswire/ -- In September 2020, Medtronic partnered with Sohu Health to launch "Unstoppable Heartbeats," a public health education initiative focused on the prevention and management of arrhythmias. The program aimed to enhance public awareness of arrhythmias, particularly among high-risk populations. Through various formats, including dialogues with authoritative experts, patient story sharing, and the collection and answering of public inquiries, the initiative provided accessible explanations of professional knowledge such as sudden cardiac death prevention and pacing therapy.

“Black Technology”Pacing Therapy: Safeguarding a High-Quality Life

During a public science education event, Professor Huang Dejia from West China Hospital of Sichuan University stated, “Among arrhythmias, a very common category of cardiac diseases, bradycardia accounts for approximately one-third to one-half of cases. It is particularly prevalent among the elderly and patients with comorbid cardiac conditions, such as coronary heart disease, cardiomyopathy, myocarditis, hypertension, and diabetes.” Professor Huang cited examples, noting, “Some patients experience symptoms such as palpitations, shortness of breath, fatigue, loss of appetite, and malaise when bradycardia occurs; in severe cases, it can be life-threatening.” Currently, the primary treatment for bradycardia, especially severe cases, is the implantation of a cardiac pacemaker.

Professor Liu Xingbin stated, “The development of pacemakers in China is now on par with global standards. The implantation procedure is a minimally invasive surgery performed under local anesthesia, taking only about one hour, and patients can ambulate shortly after the operation. In the future, patients will also be able to use mobile phones and travel by air without restriction. Therefore, I believe there is no need for anyone to fear or reject pacemakers.”

In the public education segment, Ms. Qin, the daughter of patient Mr. Qin, also shared how a leadless pacemaker had improved her father’s quality of life. “We live on the sixth floor. My father can now climb the stairs with just two brief rests along the way, and we no longer have to worry about sudden episodes of blacking out or shortness of breath. Previously, he experienced intermittent pauses in his heartbeat, with his heart rate sometimes dropping to only thirty-something beats per minute. Since the pacemaker was implanted, these dangerous episodes have not recurred, and he is now able to take regular walks. So if you ask me what limitations the pacemaker imposes on patients’ lives, I would say there are none; it has significantly enhanced our quality of life.”

However, public awareness of cardiac pacemaker therapy remains relatively limited. “Many people still hold the mistaken belief that bradycardia is a condition exclusive to the elderly, and that a slow heart rate is not life-threatening and can be managed by simply taking medication and enduring it until it passes. In reality, bradycardia is common among the elderly but also occurs in young and middle-aged adults, significantly impairing quality of life and even leading to sudden cardiac death,” added Professor Liu Xingbin from West China Hospital of Sichuan University. “Therefore, it is crucial for the industry to vigorously promote public education on the hazards of bradycardia, and widespread dissemination of knowledge regarding its prevention and treatment is essential.”

Meanwhile, Professor Xu Yuanning from West China Hospital of Sichuan University stated, “The development of new technologies has not only improved existing therapies but also turned many impossibilities into possibilities. For instance, the leadless pacemaker implanted in Mr. Qin represents a revolutionary advancement in the field of cardiac pacing. Furthermore, for a long time, pacemakers were considered a contraindication for magnetic resonance imaging (MRI). This meant that patients with implanted cardiac pacemakers who developed tumors, neurological disorders, or orthopedic conditions could not undergo MRI for accurate diagnosis. With the advent of MRI-conditional pacemakers and defibrillators, clinical practice is gradually shifting. In particular, the emergence of new-generation pacemakers and defibrillators compatible with 3T MRI allows patients to benefit from both pacing therapy and MRI examinations. Patients can now have peace of mind regarding MRI safety, treatment efficacy, and quality of life.”

Meanwhile, Professor Fan Jie added, “Patients with conventional pacemaker therapy previously required regular hospital visits for follow-up, which imposed certain limitations on comprehensive disease management and quality of life. Now, we have an advanced remote monitoring system that serves as a highly effective solution, enabling patients to conveniently undergo remote follow-up and achieve optimal therapeutic outcomes.”。”

Early Screening, Early Diagnosis, and Timely Intervention: Preventing Sudden Cardiac Death Through Proactive Measures

It is estimated that there are approximately 550,000 cases of sudden cardiac death in China annually, with at least 1,500 people experiencing cardiac arrest each day, ranking first globally. However, fewer than 1% of these individuals are successfully resuscitated.^[1]. More notably, in recent years, the incidence of sudden cardiac death in China has been increasing year by year, while the age of onset has been decreasing.

Professor Zhang Shu from Fuwai Hospital, Chinese Academy of Medical Sciences, pointed out that arrhythmias have two very important characteristics: concealment and sudden onset. Concealment means that there are not necessarily symptoms under normal circumstances. Sudden onset refers to the fact that once it occurs, it may cause sudden death in patients, i.e., cardiac arrest. Cardiac arrest is defined as a sudden and severe malignant ventricular arrhythmia where the patient's heartbeat becomes extremely fast and irregular, unable to function properly, leading to insufficient or interrupted blood supply to the brain and the entire body, resulting in death, often too late for rescue.

Sudden cardiac death is most common among patients with various cardiovascular diseases, but it can also occur in individuals who appear to be healthy. Recently, we have frequently observed that with rapid economic development and increasing social pressure, sudden death incidents are becoming more frequent and affecting younger populations. Although media reports often highlight sudden deaths among elite professionals, such cases are relatively rare; the majority of sudden cardiac deaths occur in patients with significant risk factors. First, individuals with a family history of sudden death are at high risk. Second, patients with coronary heart disease, particularly those who have undergone stent implantation, represent a high-risk group for sudden death. Third, patients with heart failure are also at elevated risk.

We recommend that both the elderly and white-collar workers undergo annual routine check-ups, including electrocardiogram (ECG), chest X-ray, and echocardiography, to detect cardiovascular diseases early for timely prevention and to reduce the risk of sudden cardiac death. A key indicator of sudden cardiac death risk is the left ventricular ejection fraction (LVEF). This refers to the heart’s ability to pump blood““Ejection fraction” is a standard metric for systemic circulation; a higher value is preferable. A low value indicates weak cardiac contractility, i.e., heart failure, and is associated with a higher risk of sudden cardiac death.

Specifically for post-PCI myocardial infarction patients, Professor Fan Jie vividly stated: “Our heart is like a house. To make it habitable, it must have both plumbing and electrical wiring. Stents manage the ‘plumbing,’ ensuring blood supply, while pacemakers manage the ‘electrical wiring.’ If the electrical circuit short-circuits, the lights will not turn on. Therefore, it can be figuratively understood that pacemakers manage electricity, while stents manage water flow.” In other words, stents and pacemakers represent two distinct therapeutic modalities addressing two different types of conditions—stents cannot replace pacemakers, nor can pacemakers replace stents. Particularly for myocardial infarction patients who have undergone stent implantation, this does not mark the end of treatment, but rather the beginning. Regular follow-up with echocardiography is essential to monitor whether the left ventricular ejection fraction (LVEF) has declined. An LVEF ≤40% indicates an increased risk of sudden cardiac death.

The most effective way to prevent sudden cardiac death is to avoid developing heart disease and to prevent minor conditions from progressing into serious illnesses. This involves controlling high-risk factors for heart disease at their source, such as hypertension, diabetes, and obesity. Of course, once high-risk factors for heart disease are present, the safest approach to preventing the sudden onset of arrhythmias is the implantation of a miniature “automatic defibrillator” within the body, known as an Implantable Cardioverter Defibrillator (ICD). The ICD can automatically monitor heart rhythm; if the heart rate becomes too slow, it can provide conventional pacing; if it becomes too fast, it can deliver anti-tachycardia pacing; and in the most severe cases, it can administer an electrical shock to defibrillate the heart, restore normal rhythm, and save the patient’s life.

In a public science outreach session, some audience members expressed concerns about the safety and efficacy of cardiac device implantation. Mr. Yu from Kunming, Yunnan Province, addressed these concerns by sharing his personal experience.

Mr. Yu has been a patient with coronary heart disease for 12 years and has undergone implantation of three coronary stents. In 2017, he experienced an episode of malignant arrhythmia, and his life was saved thanks to timely resuscitation. As Mr. Yu’s attending physician, Professor Fan Jie, Chief Physician at the First People’s Hospital of Yunnan Province, observed that although the resuscitation was successful, the patient remained at high risk. Echocardiography revealed progressive left ventricular enlargement from 2006 to 2016 and further into 2017, accompanied by a continuous decline in left ventricular ejection fraction (LVEF), indicating an elevated risk of recurrent cardiac arrest. Although the medical team recommended implantable cardioverter-defibrillator (ICD) therapy, Mr. Yu initially declined due to concerns about safety and efficacy. However, after experiencing another episode of malignant arrhythmia in 2017, he ultimately agreed to undergo ICD implantation.

Two months after the implantation, Mr. Yu felt energetic and drove alone to Dali for a trip. That evening, while he was at his hotel, his arrhythmia recurred with a very rapid heart rate. He was transported to the hospital by emergency medical services (EMS) for intravenous infusion therapy. However, the medication administered to control his heart rate proved ineffective; his heart rate would decrease only to rise again, resulting in recurrent episodes. Subsequently, under the remote guidance of Dr. Fan Jie, the threshold settings of his defibrillator were adjusted. Following a single electrical shock, his heart rhythm returned to normal. Mr. Yu then promptly took a train back to Professor Fan Jie’s clinic. Follow-up evaluations revealed that he had experienced a malignant arrhythmia, which was accurately detected and treated by his Implantable Cardioverter Defibrillator (ICD). It can be said that advanced technology safeguarded his health and ultimately saved his life.

“Thanks to innovations in medical technology, the ICD can indeed be described as a life-saving device that patients carry with them, offering a second chance at life. Meanwhile, if people can understand and pay attention to early symptoms and high-risk indicators, and take timely intervention measures when abnormalities are detected, it will certainly help reduce regrettable outcomes,” stated Professor Fan Jie.

Finally, experts emphasize the need for prevention and treatment of arrhythmias. This approach comprises two aspects: First, health awareness should be raised, with strengthened screening and preventive measures to ensure early detection and timely treatment. High-risk individuals, in particular, must not rely on luck but should promptly choose and accept effective therapies. Most arrhythmias can be clearly diagnosed based on symptoms or through electrocardiogram (ECG) examinations. Furthermore, prevention and control can be enhanced by screening high-risk populations and improving the emergency response capabilities of patients’ relatives, colleagues, and society as a whole. Second, scientific treatment should be promoted, with rational utilization of medical technologies. Once diagnosed, patients can select appropriate interventions under medical guidance, such as pharmacological therapy, catheter-based interventional procedures, or implantation of cardiac pacemakers or defibrillators, to achieve preventive and therapeutic objectives.

^[1] Jun-bo Ge, Improving public defibrillator use in China. The Lancent, 2016 VOL.388