SINGAPORE \u2013 At 19, Coeus Lee was hardly someone you would expect to suffer a cardiac arrest.<\/p>\n
Yet, CCTV footage from his camp\u2019s medical centre caught the undergraduate from the National University of Singapore, who turned 20 on Sept 12, collapsing moments after he walked through the door.<\/p>\n
\u201cI went to the medical centre to do my ORD FFI, the compulsory final medical check-up before I was deemed to have completed my national service,\u201d Lee said.<\/p>\n
When he came to, he did not realise that he had had a cardiac arrest.<\/p>\n
\u201cI was disoriented and missing my two front teeth. I thought I just had a bad fall, hit my head and blacked out,\u201d he said.<\/p>\n
Seow Swee Chong, a senior consultant with the Department of Cardiology at the National University Heart Centre, Singapore, told The Straits Times that Lee was fortunate that there were medics on hand to render emergency life-saving treatment.<\/p>\n
\u201cHe survived without significant neurological impairment,\u201d Seow said.<\/p>\n
Lee was sent to Woodlands Hospital, the closest hospital to his camp, but was referred to the National University Hospital for specialist care.<\/p>\n
To reduce Lee\u2019s risk of another sudden cardiac arrest, Seow and his team decided to implant an extravascular implantable cardioverter-defibrillator (EV-ICD) \u2013 a new generation of defibrillators \u2013 under his breastbone, directly outside the heart.<\/p>\n
The surgery was carried out about 1\u00bd weeks later.<\/p>\n
Lee\u2019s young age made him a suitable candidate, making him one of the first patients in Singapore to receive the device.<\/p>\n
It uses a lead, a thin wire placed outside the heart and veins, to deliver life-saving shocks and send tiny electrical pulses to the heart muscle.<\/p>\n
\u201cThe lead goes under his breastbone (or sternum), with the main battery box placed under the skin near the left armpit. By doing so, the heart now sits behind the wire and the box. This allows the device to send painless electrical pulses like a pacemaker or, whenever there is the possibility of an arrest, stronger electric shocks to fix abnormal rhythms,\u201d Seow said.<\/p>\n
The battery box is about the size of the face of an Apple smartwatch.<\/p>\n
\u201cThe part where we make the space under the breastbone is pretty painful. So that\u2019s why we carry it out under general anaesthesia. Technically, it is not a difficult procedure, and it takes about an hour. The patient is usually discharged in a day with medication for pain management,\u201d Seow said.<\/p>\n
Lee said: \u201cThe first day was the worst, in terms of the pain, but as the days progressed, it got significantly better.\u201d<\/p>\n
Seow said Lee\u2019s young age also made it a bit difficult to work through his muscles, compared with those of an older patient.<\/p>\n
\u201cI did not use any cutting tools to make my way through the sternum to be near the heart. Rather, I used my finger to pave the way, which is safer as it will not damage anything along the way,\u201d he added.<\/p>\n
More than 3,000 people suffer from out-of-hospital cardiac arrests each year across all ages, with close to four in five occurring in public or residential places.<\/p>\n
However, according to the Ministry of Health, sudden cardiac death among those under the age of 35 is rare in Singapore, accounting for less than 3 per cent of all such deaths.<\/p>\n
When sudden cardiac arrest strikes seemingly healthy young men, it is rarely caused by the standard lifestyle-related blocked arteries.<\/p>\n Coeus Lee is under the care of Adjunct Associate Professor Swee Chong Seow (left), a senior consultant with the National University Heart Centre.<\/p>\n ST PHOTO: GIN TAY<\/p>\n<\/figcaption><\/figure>\n Instead, it is usually triggered by undiagnosed conditions such as a heart muscle disorder, an electrical problem, an infection weakening the heart muscle, or a congenital abnormality of the arteries.<\/p>\n Lee, however, said there was no history of congenital heart disease in his family.<\/p>\n Published studies estimate the incidence of sudden cardiac death among young athletes and active young adults to be approximately one to three cases for every 100,000 people annually.<\/p>\n Seow said the EV-ICD given to Lee was a \u201csignificant advancement in cardiac rhythm management\u201d.<\/p>\n \u201cInstead of placing the lead inside the heart and blood vessels, it is positioned beneath the breastbone, but outside the heart and vascular system. At the same time, it is near enough to detect irregularities and is able to rectify the situation,\u201d he said.<\/p>\n In the traditional ICD, the box sits under the skin in the upper chest, and the lead runs through a blood vessel to attach to the inside of the heart.<\/p>\n Seow said: \u201cThis wire will last between 15 and 20 years before it breaks. When that happens, we can leave the old wire there and put in a new one, or take the old one out first. Either way, there are risks.<\/p>\n \u201cIf we were to leave the old one in, the wires could knock against each other, causing inappropriate shocks. The additional wire across the heart valve may also cause it to leak and might choke the vein.\u201d<\/p>\n Adjunct Associate Professor Swee Chong Seow said the EV-ICD given to Coeus Lee was a \u201csignificant advancement in cardiac rhythm management\u201d.<\/p>\n ST PHOTO: GIN TAY<\/p>\n<\/figcaption><\/figure>\n He said the old wire also cannot be removed from the vein without risks because it is usually in the vein for years, so it gets encased by the tissues of the walls of the vein, and removing it \u201crequires quite a bit of work\u201d.<\/p>\n \u201cWe would need to separate the wire from the tissues and there is always the risk of complications,\u201d Seow added.<\/p>\n The EV-ICD would be the right fit for a young person like Lee, as changing a lead that is outside the heart would not result in such complications after 15 to 20 years.<\/p>\n With the EV-ICD implanted in him, Lee, who used to play ice hockey and basketball when he was growing up overseas, can no longer do so competitively.<\/p>\n \u201cThe clashes could and would cause trauma to the site where the defibrillator sits. For my peace of mind and safety, I guess I will have to comply,\u201d Lee said.<\/p>\n<\/div>\n SINGAPORE \u2013 At 19, Coeus Lee was hardly someone you would expect to suffer a cardiac arrest. Yet, CCTV footage from his camp\u2019s medical centre…<\/p>\n","protected":false},"author":1,"featured_media":84689,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"fifu_image_url":"","fifu_image_alt":"","footnotes":""},"categories":[2611],"tags":[],"class_list":["post-84688","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-buzz-headlines","wpcat-2611-id"],"brizy_media":[],"_links":{"self":[{"href":"https:\/\/sgbuzz.com\/index.php?rest_route=\/wp\/v2\/posts\/84688","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sgbuzz.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sgbuzz.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sgbuzz.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sgbuzz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=84688"}],"version-history":[{"count":0,"href":"https:\/\/sgbuzz.com\/index.php?rest_route=\/wp\/v2\/posts\/84688\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sgbuzz.com\/index.php?rest_route=\/wp\/v2\/media\/84689"}],"wp:attachment":[{"href":"https:\/\/sgbuzz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=84688"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sgbuzz.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=84688"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sgbuzz.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=84688"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<\/picture><\/div>
Better fit for younger patients<\/h2>\n
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