Heart Care in Sweden

Arrhythmia Center Stockholm recently performed the first treatment of atrial fibrillation in their new facility. In this interview, we speak with Dr. Anders Englund from the Arrhythmia Center Stockholm about the new technology and innovation available at this facility in Stockholm, Sweden. Tell us about the Arrhythmia Center Stockholm. When did it open? How large is it? We opened on May 6, 2009. We plan on treating approximately 400 patients per year. We will also have an outpatient clinic. The Arrhythmia Center Stockholm is a private center owned by Global Health Partner. We are located in South Hospital (Södersjukhuset), which is a large public hospital with an extensive cardiology program, and this is where we will perform all medical services. We also have research programs together with the “host” hospital. We plan to treat patients referred from public hospitals and patients with private insurances. What technology is included at the center? What is your staff makeup? We have the following equipment: • echo machine with transthoracic (TTE), transesophageal (TEE) and intravascular ultrasound (IVUS) possibilities – ACUSON Sequoia™ (Siemens Medical Solutions USA, Inc., Malvern, PA) • syngo DynaCT for 3D reconstructions of the left atrium (Siemens) • x-ray (Artis Zee®) (Siemens) • Carto XP EP Navigation System (Biosense Webster, Inc., a Johnson & Johnson company, Diamond Bar, CA) • EP recording system from Siemens (Sensis) • stimulator (EP MedSystems, Inc., West Berlin, NJ) • RF generator (Biosense Webster, Inc.) Our staff is made up of two electrophysiologists, two nurses trained in EP, and one nurse specialized in anesthesia. What prompted the need to create a center dedicated to the treatment of arrhythmias? At the moment there is a very long waiting list in Sweden for atrial fibrillation ablations — approximately one year. Therefore, it was important to open a center that addressed this need for patients with atrial fibrillation. The Arrhythmia Center Stockholm was the first clinic in Sweden to use magnetic navigation. Tell us about your experience with this technology. Our first experience was very positive — we appreciate the accuracy of the Stereotaxis system and the ability to have much more relaxed working conditions (no lead, no stress, no standing for many hours). We also believe that it is a safer treatment with an almost nil risk for creating tamponade. It has been easier than expected to start using the system. What other EP procedures are performed at the Arrhythmia Center Stockholm? We will primarily focus on the treatment of atrial fibrillation, although we will also perform ablations on patients with ventricular tachycardia and supraventricular tachycardia. How many patients have been treated thus far at the Arrhythmia Center Stockholm? We have planned a slow start in order to learn the system in a controlled manner. Therefore, we plan on approximately 20 patients before mid June. However, our goal for the year 2010 is to perform 400 ablations. How many people in Sweden are affected by heart arrhythmias? What do you consider the most prevalent heart arrhythmia experienced by patients in Sweden? Is the number of atrial fibrillation cases on the rise in Sweden? Approximately 150,000 patients in Sweden suffer from atrial fibrillation. This figure is most likely growing, but there are no current totals showing this yet. What are some of the challenges being faced today in hospital heart care in Sweden? The challlenge is to create patient awareness of the different treatment options for atrial fibrillation and to allocate resources to expand electrophysiology services in Sweden over the next coming years. We are lacking labs, staff and mainly operators that are competently trained for complex ablations. Will the Arrhythmia Center Stockholm be involved in research trials as well? Yes, we already have several projects that will run in the clinic. These trials will involve testing of new drugs as well as testing different methods of atrial fibrillation ablation. Is there anything else you would like to add? This center is very unique in Sweden, since it is the first time a collaboration between a private company and a public hospital has been tested in full scale. For more information, please visit www.arytmicenter.se