Heart-starting research has lifesaving potential

Nathan Engstrom will combine 20 years of experience as a cardiac scientist and a $70,000 Study, Education and Research Trust Account (SERTA) grant into a potentially lifesaving study.

Mr Engstrom said his research would explore a new system for selecting patients who require an implantable cardioverter-defibrillator (ICD) to prevent a cardiac arrest after suffering heart failure.

’’The study was born from my observations of Townsville University Hospital patients who had experienced heart failure and then had an ICD implanted,” Mr Engstrom said.

‘‘An ICD is a battery-powered device placed under a patient’s skin that keeps track of a person’s heart rate and if an abnormal heart rhythm (arrhythmia) is detected, the device will deliver an electric shock to restore a normal heartbeat.

“As a cardiac scientist working in the device clinic, I’ve seen a lot of patients fitted with an ICD, in line with the current medical guidelines, who did not experience an arrhythmia post-implant.

‘‘This means, an ICD may not be the most appropriate type of care for their condition as they have life-long implications for our patients and, if there is minimal risk of an arrythmia post-implant, there is little benefit aside from being a precautionary, but potentially lifesaving, measure.

“Patients with ICDs require lifelong appointments and hospital care, there is a small risk of the device being tricked which can give an electric shock when not needed and they must be replaced every few years through an invasive surgery.”

Mr Engstrom said his pilot study, conducted in 2020, demonstrated that only a small percentage of patients with an ICD experienced an arrythmia post-implant and a similar number experienced an inappropriate firing of the device.

“I conducted a pilot study during my initial phase of research, and it showed that only 20 per cent of people with an ICD benefited from the device fixing their ventricular arrhythmia and another 14 per cent had some form of inappropriate therapy from their device.

 “The aim of this PhD is to establish a better way of determining who needs an ICD and improving outcomes for our patients.”

 Mr Engstrom said without the support of Townsville HHS’s SERTA grants, he wouldn’t be able to undertake this research.

 “I never thought I would end up doing my PhD; I started with my graduate certificate which was good because it allowed me to dip my toes in the water,” Mr Engstrom said.

 “The support from the Townsville Hospital and Health Service research team and Professor Geoffrey Dobson and Dr Hayley Letson from James Cook University has been invaluable to me.

 “My goal is to have a research paper that eventually leads to an improved patient experience by exploring new methods for determining who needs an ICD.

 “I know it can take a long time to enact this sort of change, but I will wait and see where my research takes me.”