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World’s best cardiology training benefits Kiwis

New Zealand cardiologists are once again heading overseas to gain experience and skills at world-leading international hospitals, with the support of the Heart Foundation. Closed borders over the past few years interrupted travel but these training positions are now being keenly sought after again.

Over the past 50 years, more than 100 overseas training fellowships have been awarded by the Heart Foundation to talented cardiologists. The emerging specialists bring back to New Zealand transformational new treatments and procedures they learn from teams at internationally respected hospitals.

"It's good to be able to offer young doctors international learning opportunities with the aim of bringing important skills back to New Zealand," says Dr Gerry Devlin, Heart Foundation Medical Director.

"These overseas fellowships are valuable for training the next generation of clinicians and heart researchers who'll learn leading-edge cardiology techniques and make a difference to the future heart health of New Zealanders."

Four outstanding young cardiologists have been awarded Overseas Training and Research Fellowships from the Heart Foundation in 2023.

Blasting blocked arteries to expand heart stents

Dr Lance Ng, currently an Interventional Cardiology Fellow at Auckland City Hospital, is heading to Toronto General Hospital in Canada where he'll research a new treatment for under-expanded heart stents utilising an existing technology that's commonly used for pulverising kidney stones.

The technique, called lithotripsy, uses shock waves to break up kidney stones. Lance hopes to use it to crack the calcium in the walls of the heart arteries which can prevent stents (metal mesh tubes) from expanding completely. For over 30 years, stents have been inserted into narrow or blocked heart arteries (in a procedure called angioplasty) to treat heart attacks and to manage angina.

The use of lithotripsy in heart arteries is well-studied and currently used in New Zealand, but only before stents are implanted. Little is known about whether it's effective after a stent has been implanted and Lance aims to answer this.

Stent under-expansion can mean poorer outcomes for patients because the stent is more likely to narrow in the future and reduce blood flow to the heart.

Using AI in heart ultrasounds for cancer survivors

Dr Janine Mazengarb, currently working as a locum cardiologist at Auckland City Hospital, is embarking on an international imaging fellowship at Vancouver General Hospital in Canada. There she will gain skills in echocardiography (heart ultrasound) and learn about its use in the emerging field of cardio-oncology.

Cardio-oncology is a rapidly growing area of cardiology that focuses on heart complications arising from cancer treatment. It's expected to grow significantly due to both an ageing population and survival rates from cancers improving year on year.

Janine will research the use of artificial intelligence (AI) with heart ultrasounds in the follow-ups of cardio-oncology patients. This technology provides instant feedback to doctors to guide real-time treatment decisions, such as adjusting medications, and could ultimately reduce the need for follow-up and the associated healthcare burden.

"I hope to bring this cardio-oncology expertise back to New Zealand," says Janine, "and I'm grateful to the Heart Foundation for enabling this opportunity."

Heart failure telehealth tool for future app

Dr Hassan Fahmi, a cardiology advanced trainee at Auckland City Hospital, will be undertaking a fellowship in advanced heart failure and cardiac transplantation at St. Paul's Hospital in Vancouver, Canada.

During his fellowship Hassan plans to develop a telehealth tool for heart failure management which monitors the symptoms and vital information of patients living with heart failure.

The tool would provide guidance on self-management for the patient when appropriate, or escalate if needed to the patient's heart failure management team.

The end-goal of Hassan's research is to lay the foundation for a user-friendly smartphone application (‘app') which automates the process for both patients and doctors.

Emerging treatments in atrial fibrillation

Dr Allan Plant, a Cardiac Rhythm Management Fellow at Wellington Hospital, will be training in France on the latest technology with the team who developed catheter ablation treatment for atrial fibrillation (AF), a common heart rhythm problem.

Conventional techniques of catheter ablation use either heat (radiofrequency ablation) or freezing (cryoablation) to destroy a small area of heart tissue that is causing irregular heart rhythms, also called arrhythmias.

Allan will spend 18 months at CHU Haut Leveque in Bordeaux where he'll learn a new ablation technique called pulsed-field ablation using non-thermal electrical pulses, which can drastically reduce lengthy operating time and improve safety, and its application to a new ablation strategy for persistent AF.

"The institution is widely regarded as one of the founding centres of catheter ablation for AF," explains Allan. "I feel so fortunate to be able to gain clinical skills at the forefront of a new wave of ablation technology. I want to use these to help advance cardiology and improve the care of New Zealanders with atrial fibrillation."

Heart Foundation Medical Director Dr Gerry Devlin highlights the importance of these overseas fellowships. "With emerging areas of cardiology and rapid growth in new techniques and procedures, it's vital that New Zealand cardiologists gain early exposure through overseas training and research."

"I'm excited that with the generous support of our donors we're able to send our cardiologists to learn from the best in the world and bring those skills back to benefit all New Zealanders."