History of EPS in Egypt Dr Mervat Aboulmaaty Professor of Cardiology Ain Shams University 2013
Prof. Sherif El Tobgy President of EgSC
Prof. Wagdy Galal President of ECRA
Mohamed Sobhy
Adel El Eitrby
Ali Ramzy
First international meeting in cardiac electrophysiology ) Jan. 1999)
ď‚— Egypt has NEVER been far beyond the
tremendous progress in cardiac electrophysiology since Benjamin Scherlag in 1968, and Antony Damato in 1970 had succeeded in recording His Bundle Electrograms.
ď‚— That was the time for shifting from simple
ECG recording to Static and then to Dynamic His Bundle recording when Hein J. Wellens in 1971 introduced the technique of Programmed Electric Stimulation.
We were NOT far behind this amazing technical
progress in both fields of pacing & cardiac electrophysiology. The progress in Egyptian Electrophysiology in the fields of: Pacing Diagnostic Electrophysiology Interventional Electrophysiology
MD Thesis of Dr Mamdouh Elashry 1973 His bundle recording in Pts with AMI compared to Normal Egyptians MD Thesis of Dr Wagdy Galal 1977 Prognostic implication of HV interval in Patients with LBBB. Provocation with Ajmaline First extrastimulation technique in Egypt France
Prof. Sherif Mokhtar
Prof. Of Cardiology, CC unit Cairo University
History of Interventional EPS DC Ablation Surgical ablation RF Ablation 1989
DC shock Ablation of the AVN and His Bundle
1990
Surgical resection of accessory pathways
1994
RF Ablation for AVNRT, AP, Atrial Tachycardia, AT Flutter, Idiopathic VT
DC shock fulgration of the His bundle
Dr. Breithert, President of The European Society for pacing & electorphysiology during his last visit to the center “Jan 2003� to participate in the 3rd international meeting for cardiac pacing & electrophysiology.
History of Interventional EPS : RF Ablation in Egypt 1994
No of EP labs and EP specialists in Egypt Cardiac Center
Number of RP labs / EP doctors
Cairo University
3 labs
15
EP Doctors
Ain Shams University
2 Labs
17
EP Doctors
Alexandria University
2 labs
5
EP Doctors
El-Azhar University
2 Labs
5
EP Doctors
Mansoura University
1 Lab
5
EP Doctors
Banha University
1 Lab
4
EP Doctors
Assuit University
1 lab
3
EP Doctors
Elmenya University
1 Lab
1
EP Doctor
Suez Canal University
1 Lab
3 EP Doctors
National Heart Institute
1 Lab
6
Naser Institute
1 Lab
5 EP Doctors
Military Hospitals
4 Labs
3 EP Doctors
Private Hospitals
4 Labs
Total NO
24 Labs
EP Doctors
72 EP Doctors
History of Interventional EPS RF Ablation 1994
RF Ablation for AVNRT, AP, Atrial Tachycardia, AT Flutter, Idiopathic VT
No of EPS/ RF ablation `836 EP/RF ablations per year 210 Ain Shams 160 Cairo university 100 Alexandria University 1 20 NHI 150 Military hospitals 60 private hospitals 12 Mansoura children hospital 12 Banha University 12 Elazhar University
3D Electroanatomical Mapping 2004 2005
2010
Pulmonary Vein Isolation for AF Lasso CARTO xp 2 Cairo/ 2 Ain Shams 2008 Ischemic VT Ablation CARTO 3 Ain Shams /Alexandria/Cairo universities/ NHI Insite 3 D mapping system Air Force Military Hospital
PV isolation both conventional and Carto cases 2005 - 2012 Convent.,Carto XP then Carto 3
150 cases Cairo University 100 cases 100
NHI
Ain Shams
CARTO 3 has been launched in 2010
Progress of Pacing in Egypt 1981 1983 1986 1988 1989 1993
Simple VVI Pacing Epicardial then Endocardial Multi-programmable PM Dual Chamber PM Rate Responsive PM Antitachycardia Pacing for SVT Single Lead VDD
1994
ICD Implantation
Progress of Pacing in Egypt 2000 2001 2001
Single lead DDD AT pacemaker for AF prevention Multisite PM Implantation- CRT-p
2005
Multisite ICD Implantation-CRT-D
Surgeons implanting Epicardial PMs Surgeons Implanting epicardial VVI/DDD PM at OR 4 at Ain shams university 3 at Cairo university 1 at NHI 1 at Mansoura university
Cardiologists not EPS implanting Endocardial PMs 60 Cardiologists Implant VVI/DDD PM at Cath Lab 8 at Ain shams university 6 at Cairo university 24 at NHI 4 at Alx university 3 at Military Hospitals 4 at Mansoura university 3 at Assuit university 2 at Zagzig university 2 at Banisuiv university 2 at Banha university 2 at Tanta university
No of Devices implanted in Egypt (82 million population) in 2010 VVI/R DDD/R
1200 PM 350 PM
19/million population compared to 14/million in 1998 CRT-P ICD single& dual CRT-D
120 PM 40 ICD 20 Device
2/million population compared to 0.5/million in 1998
No of PM/ICDs/million implanted in Egypt in 2010 compared to Europe and USA Country
Egypt
Germany France
CRT-P
150
1,100
CRT-D
30
8,500
Population/ million
82
82
Italy
UK
Belarus
Poland
Austria
2,100
1,000
2,000
25
520
270
3,500
8,500
3,000
25
820
600
58
61
10
40
64
8,2
EPS Course 2003-2010
EPS Online
www.epsegypt.com
Cardiac EP in EGYPT Past, Present and Future ď‚— There might have been some difficulties, obstacles
and financial constraints but perseverance will overcome all problems and Whenever There is a Will There is a way.
Cardiac EP in EGYPT Past, Present and Future ď‚— We are finally facing the need for: ď‚— Recruiting new teams of young
electrophysiologists, enhancing their interest in electrophysiology with the most difficult task of keeping them away from being persuaded by the irresistible fees of interventional coronary angiography.
We are all ONE family