Low take-up of heart-regulating implant in Singapore: Asian study

SINGAPORE - A small device, placed under the skin to track and regulate one's heart rate, can help heart failure sufferers prevent sudden cardiac deaths.

Yet, too few patients in Singapore aged 60 and above have such a life-saving implant, although majority would be suitable for it.

This finding stems from an ongoing study conducted in 11 Asian territories - South Korea, Japan, Taiwan, Hong Kong, China, India, Thailand, Malaysia, Philippines, Indonesia and Singapore - which started in 2012. The average age of patients involved is 60.

The device, called an implantable cardioverter defibrillator (ICD), monitors the heart rhythm. When it detects an abnormal heart rhythm, it delivers an electric shock to restore a normal heartbeat. The device is inserted under the skin in the chest and is connected to the heart through wires.

Patients who do not use an ICD can take medication to treat their heart condition.

Although two-thirds of the 1,066 patients (66 per cent) studied in Singapore are eligible for an ICD, only 9.4 per cent of them received one. This is despite the country having one of the highest eligibility rates for the device in Asia after India and Indonesia, said Professor Carolyn Lam, senior consultant at the department of cardiology at the National Heart Centre Singapore.

The low ICD utilisation rate in Singapore could be due to an unwillingness to have an unatural object in their body, as well as a belief that they are too old to benefit from it, according to a separate study conducted by Prof Lam, which was published in 2013.

The study, led by Prof Lam, also found that an ICD implant slashes sudden cardiac deaths by 66 per cent. One's overall risk of death - be it due to heart issues or other reasons is reduced by 29 per cent.

On the whole, ICDs are under-used in Asia, with only 12 per cent of eligible patients receiving them.