Let’s do what it says on the tin !

(www.cardiac-rehabilitation.net)

In previous issues of THROBNEWS I have bemoaned the fact that there is no consolidated list of cardiac rehabilitation programmes in the UK. The advantage of such a list being that one could quite easily discover (e.g. by postcode) what was available in any particular region or town. There are however two Organisations that have the potential to develop such a list namely the British Heart Foundation (BHF) and the British Association of Cardiac Prevention and Rehabilitation (BACPR). (Note: BACPR used to be known as BACR)

The BHF on its website (www.bhf.org.uk) has recently developed a comprehensive on-line search facility that enables anybody to search, by postcode, and identify any of its Cardiac Support Groups. Excellent though this feature is, it has two disadvantages - firstly that it does not include Groups that are not affiliated to the BHF - and secondly that all affiliated BHF Groups are classified together whether they carry out cardiac rehabilitation programmes or not.

However the BHF, through its Cardiac Care and Education Research Group, directs and funds the National Audit of Cardiac Rehabilitation (NACR) project (www.cardiacrehabilitation.org.uk) at the University of York. This project processes and publishes statistical data relating to a range of factors relating to heart disease gathered from both Organisations and Patients. Up to the present moment the vast bulk of the data processed relates to cardiac rehabilitation phases I, II and III; Phase IV being almost entirely ignored ! Sadly anybody searching the NACR on-line database (www.cardiac-rehabilitation.net) for phase IV Groups will be sadly disappointed particularly so as the Site clearly states: “Cardiac Rehabilitation in your area. Find your nearest cardiac rehabilitation programme” . It just doesn’t do what it says on the tin!

The BACPR however is the Organisation that certifies and re-certifies any and all Instructors as fit to supervise Phase IV cardiac rehabilitation activities and exercise programmes. It has therefore, as near as practicable, up to date information of the location of all Phase IV - qualified Instructors. However up to now it has not gathered information on their working environments or activities.

However - WONDER of WONDERS - the BACPR has just recently contacted all Phase IV certified Instructors requesting information from them regarding their work - by 31 May (!). The reason given is that the cardiac rehabilitation programmes with which they are associated can be forwarded for inclusion in the NACR on-line register (www.cardiac-rehabilitation.net). If and when that happens - it will do what it says on the tin!.

Here’s hoping !

Sid Barker

THROB buys Defibrillators

Examination of the statistics reveals that almost 90,000 people lose their lives in the UK to sudden cardiac arrest. Many of these deaths occur in public places. Sudden cardiac arrest is caused by a malfunction in the normal electrical activity in the heart, strikes without warning and can affect both young and old. Normal electrical activity in the heart is vital as it regulates the action of the heart in pumping oxygenated blood around the body to maintain life. Any interruption to this process can cause sudden collapse and certain death unless the victim receives appropriate treatment. Sudden cardiac arrest can have many causes: coronary heart disease, drug abuse, electrocution and drowning to list but a few. Young children are particularly susceptible to a condition known as commotion cordis where a blow to the chest can cause the electrical system in the heart to go into an abnormal rhythm and thus cause sudden cardiac arrest.

Sudden cardiac arrest is not the same as a heart attack. The latter occurs when a blockage or narrowing of the coronary arteries in the heart prevents the flow of oxygenated blood to the heart muscle itself - this causes heart muscle to die. However, if the heart attack is serious enough the patient may subsequently suffer a sudden cardiac arrest characterised by a loss of consciousness and respiration. Unless treatment is carried out immediately the patient will die. The only effective treatment for sudden cardiac arrest is defibrillation at the earliest possible opportunity. For every minute defibrillation is delayed, the chance of survival falls by 10 per cent. Waiting for an ambulance to arrive is not an option as response times can be, at best, between eight and ten minutes.

Fortunately the treatment of sudden cardiac arrest has developed greatly over the past few years with the introduction of the automated external defibrillator (AED). This intelligent and easy to use device is designed for non-medics to use in the event of a sudden cardiac arrest occurring and can be an inexpensive lifesaver. The AED is designed to take the rescuer through the steps required to defibrillate the patient using voice prompts to instruct the rescuer every step of the way. The AED analyses the victim’s heart rhythm, and if in sudden cardiac arrest, automatically charges itself and instructs the rescuer to press a shock button that delivers an electrical shock into the patient’s heart. The placement of AEDs in public places and in workplaces has seen survival rates in the UK rise from around 1 per cent to over 25 per cent in the past few years.

Members may remember the incident at the Magnet Centre last year when a 15-year old boy suffered a sudden cardiac arrest and was saved by staff using a defibrillator purchased by THROB (see August 2010 THROBNews). This was only possible as the defibrillator was immediately available. This realisation led to THROB purchasing a further six units to be distributed around our area. Four of these units will be in fixed locations, namely the Haymill Centre at Burnham, the

Cox Green Community Centre, the Carnation Hall at Winkfield, (Bracknell), and Maidenhead Town Hall. The other two units will be held by Sarah Robinson and Kevin Johnson and travel with them at all times.

David Read

THROB Annual Lecture

The Fourteenth Annual THROB lecture was given by Elaine Roles, a Phase IV qualified trainer from the Sidcup area in Kent, who entitled her talk “Cardiac Rehabilitation - a life changing experience”. Over the past decade Elaine has built up a cardiac rehabilitation service to the West Kent PCT based on 23 years as an Advanced Fitness Trainer. She first came to the attention of THROB through her website which opens up healthy exercise to many more people.

Elaine described how she was directed towards cardiac care by her family history. Her Grandfather died immediately from a heart attack and her father also had a heart attack which he survived. Elaine pointed to the woeful statistics of exercise among British adults which together with poor diet is probably what drives the incidence of Cardiac Heart Disease (CHD) to the levels we see today. She also made special mention of women and said that women are three times more likely to die from CHD than breast cancer. Elaine reviewed the benefits that Cardiac Rehabilitation can bestow to the patient, most of which we are all cognisant.

Elaine went on to talk about her websites. The main site is Heart Rehabilitation and is an online guide to recovery after a cardiac event tailored for patients who cannot benefit from the usual service provided locally. The second site is called Healthy Hearts in Retirement and backs up a weekly class at a local church hall. As a support to the cardiac support she also offers a prescription for successful weight loss. For those wishing to follow up on this lecture, the website addresses are www. heartrehabilitationexercise.com and www.healthyheartsexerciseinretirement.com

David Read

A Milestone Achievement

There was an article in the Telegraph which is of interest to members of THROB. It recorded that researchers at the University of Leicester had published a paper in the Proceedings of the National Academy of Sciences which is claiming to be a “Milestone Achievement” in the treatment of heart attacks and strokes. We are all aware that heart attacks and strokes are caused by a blockage in the blood flow. However, most of the permanent damage is caused later when the circulation is eventually restored, because the body’s own defences attack the oxygen starved cells. This effect starts around 12 hours after the attack or stroke and causes massive inflammation and more than 80 per cent of the permanent damage and it is this that often causes the reduction in the quality of life of the patients. The researchers at Leicester University have come up with an injection which they claim stops the body attacking the oxygen starved cells and allows them to oxygenate normally and so reduces significantly the permanent damage. At present, this has only been tested on mice and more advanced mammals but it has been shown to work on human blood in the laboratory and human trials are hoped to begin within two years. The reason for this is that the research has found an enzyme which causes the problem and, more importantly, an antibody which will counteract it. It is hoped that two injections in the first week following the incident will completely stop the inflammation and allow the heart to heal itself.

Roger Mills