Archive for month: August, 2024

New Delhi: Health Minister J P Nadda informed on Monday that the budgetary allocations have gone up from Rs 33,278 crore in 2013-14 to Rs 90,958 crore in 2024-25 registering an increase of 164 per cent. Of the total budget, 55 per cent of the amount is spent through the National Health Mission (NHM). 

The Minister also urged state governments to spend more on improving healthcare infrastructure and dismissed opposition allegations on the reduction of allocations under the PM-Ayushman Bharat Healthcare Infrastructure Mission (PM-ABHIM).

During a Lok Sabha debate on the health and family welfare ministry’s budget, Nadda highlighted the government’s accomplishments, including the rise in medical colleges, measures to lower out-of-pocket healthcare costs, and initiatives for early disease screening, such as for cancer and sickle cell anaemia.

According to a PTI report, the minister said, “We don’t believe in just making announcements. We believe in effective planning, ensuring last mile delivery, identifying bottlenecks in last mile delivery and taking steps to remove them”.

On opposition claims on reduction of funds for the health infrastructure mission, the health minister said states were able to spend just Rs 1,806 crore out of the budgetary allocation of Rs 4,200 crore in last year’s budget.

“We are giving money, but it is not spent. You spend the money, we will allocate more funds if the existing funds are spent,” Nadda said, adding that Rs 3,200 crore have been earmarked for PM-ABHIM this year, news agency PTI reported.

Speaking about the infrastructure of Primary Healthcare and Tertiary Healthcare Centres, the Health Minister informed that under the Modi government, a total of 22 AIIMS were sanctioned out of which 18 are operational and four are under construction. Mr Nadda further informed that the government is implementing Pradhan Mantri Bhartiya Janaushadhi Pariyojana to provide quality and affordable medicines to patients.

He said, under this scheme, a total of 13 thousand outlets of Janaushadhi Kendras are operational and the Modi government has decided to open 25 thousand more such Kendras in the next five years. He added that the initiatives taken in the Union Budget 2024-25 will have a far-reaching impact.

“In the prospective clinical trial involving 183 patients, 80.9% experienced no device- or procedure-related adverse events, while the average reduction in mean LV end-systolic volume was 16.4%,” the researchers reported in JAMA Cardiology.

Heart failure (HF), a condition where the heart is unable to pump blood effectively, affects millions of people worldwide. For many patients, cardiac resynchronization therapy is a crucial treatment. Traditionally, CRT involves implanting a device with leads that stimulate the heart to improve its rhythm and function. However, this approach requires invasive procedures and carries risks associated with lead placement and device-related complications.

Previous studies have shown that about 40% of patients with HF who are eligible for CRT either fail to respond or are untreatable due to anatomical constraints. Considering this, Jagmeet P. Singh, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, and colleagues assess the efficacy and safety of a novel, leadless, LV endocardial pacing system for patients at high risk for a CRT upgrade or whose CS lead placement/pacing with a conventional CRT system failed.

The SOLVE-CRT study was a prospective multicenter trial conducted from 2018 through 2022, with follow-up data collected up to March 2023. It analyzed data from both an initial randomized, double-blind study involving 108 participants and a subsequent single-arm study with 75 participants. The trial spanned 36 centers across Australia, Europe, and the US and included patients who were nonresponders, previously untreatable (PU), or high-risk upgrades (HRU). All participants were included in the safety analysis, while the primary efficacy analysis focused on 100 patients, including 75 from the single-arm portion and 25 from the randomized treatment arm.

In the trial, patients were treated with the WiSE CRT System (EBR Systems), which featured a leadless LV endocardial pacing electrode stimulated using ultrasound energy delivered by a subcutaneously implanted transmitter and battery. The primary safety endpoint was the rate of freedom from type I complications, while the primary efficacy endpoint was the reduction in mean LV end-systolic volume (LVESV).

The study led to the following findings:

• The study included 183 participants; the mean age was 68.1 years, and 77% were males.
• The trial was terminated at an interim analysis for meeting prespecified stopping criteria.
• In the safety population, patients were either New York Heart Association Class II (34.6%) or III (65.4%).
• The primary efficacy endpoint was met with a 16.4% reduction in mean LVESV.
• The primary safety endpoint was met with an 80.9% rate of freedom from type I complications, which included 12 study device system events (6.6%), five vascular events (2.7%), three strokes (1.6%), and seven cardiac perforations which occurred early in the study (3.8%).

“The SOLVE-CRT study has shown that using the WiSE CRT system for leadless LV endocardial pacing leads to a reduction in LVESV in heart failure patients. This innovative system could offer an alternative to traditional CRT implants for certain populations with heart failure,” the researchers concluded.

Reference:

Singh JP, Rinaldi CA, Sanders P, et al. Leadless Ultrasound-Based Cardiac Resynchronization System in Heart Failure. JAMA Cardiol. Published online July 31, 2024. doi:10.1001/jamacardio.2024.2050