Partnership reduces from 30 to 7 days the wait for pacemaker implantation in a hospital in SP

The pacemaker implantation interval in cardiac patients in a municipal hospital in São Paulo decreased from 30 to 7 days of waiting. The result came after a year of partnership between the government and the Sociedade Beneficente Israelita Albert Einstein.

The decrease in waiting time directly affects the availability of ICU beds at Hospital Municipal do M’Boi Mirim, in the south of São Paulo, where the program between Einstein and the Centro de Estudos e Pesquisas Dr. João Amorim (Cejam).

“We understand that the daily cost of the ICU exceeded the cost of the pacemaker, we took this project to the secretary [municipal da Saúde] and she hugged him”, says Mariana Granado, medical manager at M’Boi Mirim.

Until October last year, patients who needed the equipment admitted to the hospital were waiting in the ICU for a vacancy in another hospital unit for the procedure. They stand in line at Cross (Central for Regulation of Health Services Offerings), which could last up to 30 days.

In the program, Einstein proposed to the secretariat to incorporate a doctor who specializes in pacemakers in the M’Boi Mirim itself and to buy the equipment. From then on, the procedure was performed in the hospital itself, reducing the wait.

The insertion of the pacemaker is considered to be simple to perform, but with high technical complexity. “It demands a cardiologist who specializes in pacemakers and high-cost equipment. So, the availability of this type of procedure in the SUS is low”, says Mariana.

Currently, the demand for the municipality is approximately 25 pacemakers per month, according to the Municipal Health Department. M’Boi Mirim Municipal Hospital performs around 12 implants per month. To date, 53 pacemakers have been inserted through the partnership, which began in October 2021.

According to the secretary, to receive the pacemaker implant, the patient needs to undergo a medical evaluation. If the need for the procedure is identified, it is forwarded by the municipal network via Cross, which will follow order of clinical and chronological priority.

“With this proposal, we are able to meet not only our internal demand, but we also open up the entire city of São Paulo to receive patients who need a pacemaker if we have a vacancy and available resources”, says the hospital manager.

In the municipal network, the Hospital do Servidor Público also performs the procedure, but exclusively for public servants of the municipality and their dependents.

The state network has 46 hospitals qualified for pacemaker implantation. According to the State Department of Health, 5,979 implants were carried out in the state and affiliated units from 2021 to August this year. “There is an increase of 20% when comparing this year’s data with the same period last year”, informs the note.

Two years ago, administrative assistant Marcelo Maia da Silva, 50, during tests, discovered that he had a problem with one of his heart valves. At the time, according to him, the cardiologist who saw him said he could live a normal life, with annual medical follow-up. But in July of this year, the alert was turned on.

“I passed out in the kitchen at home and hit my head. I went to the emergency room, but they didn’t do an electrocardiogram, they medicated me and sent me home. But then I went to a UBS near the Hospital do M’Boi Mirim. and they found that my heart rate was very low and sent me to the hospital. I went straight to the ICU.”

Maia says that she received a temporary pacemaker in the first week, but she caught a bacterium and had to wait a few more days to receive a new device. “For the efficiency of the doctor who referred me to the hospital and the medical team in doing the procedure in a week, for my clinical condition, I was lucky.”

Pacemaker implantation is necessary to regulate heart rate. With a size a little larger than that of a coin, the equipment has electrodes that give rhythmic frequency shocks to the heart muscle for the heart to continue beating regularly and the patient to return to a normal life.

According to Einstein, based on data from the World Census of Pacemakers and Defibrillators, about 300,000 Brazilians use the equipment in the country and approximately 49,000 perform the device implant every year.

“It’s a reasonable number compared to other heart diseases. Still the heart disease that kills the most is systemic arterial hypertension, which needs essential care in primary care, which is going to the family doctor, the clinic, measuring blood pressure frequently , take the medications, which are low cost”, says Mariana.