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La coordinación de ambos impulsos se realiza mediante un miniordenador instalado en una especie de marcapasos que se coloca bajo la piel del paciente a la altura del pecho. Este dispositivo se programa para cada paciente en particular, ya que las causas de la descoordinación pueden ser muchas.

"Se trata de un tratamiento para casos de insuficiencia cardiaca muy grave, de personas que no pueden llevar la compra o subir a un segundo piso sin experimentar cansancio y dolor", indicó Zamorano.

Con los nuevos dispositivos se reduce el número de hospitalizaciones, una de las mayores mermas en la calidad de vida de los pacientes con insuficiencia cardiaca, afirmó el médico. Lo normal en un paciente con marcapasos es que tenga que ingresar más de dos veces al año. Con este nuevo sistema, el número de veces que debe ocupar una cama en el hospital se reduce, lo que además implica un menor coste para el sistema sanitario, explicó el médico.

Además del avance en el tratamiento de la insuficiencia cardiaca, los expertos reunidos el fin de semana pasado en Madrid estudiaron uno de los temas que más les preocupan: cómo reducir la tasa de fracasos, que llega al 20%.

"Primero es fundamental identificar bien a los pacientes que se pueden beneficiar", indicó el médico. Uno de los avances que se discutieron en el seminario fue la localización de los puntos donde aplicar los estímulos. Hasta ahora se hacía mediante electrocardiogramas (un método indirecto que registra la actividad eléctrica de las distintas zonas del corazón mediante la colocación de electrodos). Los expertos opinan que el futuro está en el uso de ecocardiogramas, que permiten ver el corazón en acción y observar las partes donde el impulso se descoordina.

Además de reducir el número de ingresos hospitalarios, el nuevo dispositivo tiene otra ventaja: permite alargar la vida de los pacientes hasta que estos pueden recibir un trasplante. "Hay que tener en cuenta que en casos de enfermos tan graves la tasa de mortalidad anual es del 35%", dijo Zamorano.

La técnica, que en España lleva algo más de un año de experimentación, comenzó a investigarse hace siete años en Estados Unidos. En la Clínica Mayo (Rochester, Minnesota), por ejemplo, se ha tratado ya a unos 250.000 pacientes.

"Se implantan unos siete dispositivos a la semana y se ha conseguido que la supervivencia sin ingresos hospitalarios posteriores llegue a los 36 meses", indicó el cardiólogo Bijoy Khanderia. "Además, consiste en un tratamiento ambulatorio, que no requiere ni un día de hospitalización", añadió el cardiólogo.

* Este artículo apareció en la edición impresa del Martes, 10 de febrero de 2004

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