Restoring Rhythm in Bangladesh

Author: Linda Harder

Cardiologist Rafique Ahmed, M.D., PhD, FACC, has quietly created the groundwork for thousands of Bangladesh residents with heart arrhythmias to live normally again, without fear of heart failure or death.

A native of Bangladesh, Dr. Ahmed has worked for more than a decade to develop the first electrophysiology (EP) services in this country of over 150 million people. In the capital of Dhaka, four heart hospitals provide many heart services and even heart surgery, but the country had no EP services until Dr. Ahmed intervened. Yet a common and treatable EP problem, supraventricular tachycardia (SVT), affects more than 400,000 people in the country.

In 2001, Dr. Ahmed began bringing donated EP equipment and other physicians to help establish two labs in Dhaka. But the critical component of training Dhaka cardiologists to perform these services themselves wasn’t begun until February, 2005, when he returned to Bangladesh with a fellow Maryland cardiologist to train local cardiologists in ablation, a procedure that uses electrode catheters and radio waves to return the heart to its normal rhythm.

“This is a highly cost effective form of treatment,” observes Dr. Ahmed. “Once an electrophysiology laboratory is established, the subsequent maintenance cost is low. Most of the materials can be used many times.”

Thanks to Dr. Ahmed, more than 2000 cardiac ablations have been performed to date in Dhaka. “The advantage of cardiac ablation is that, when successful, it’s a cure,” he notes. “It makes a tremendous impact in the patient’s life. We had one teen that couldn’t participate in any sports until he had the procedure. After the ablation, his life was changed. Another patient was a housewife who used to pass out from her tachycardia. The ablation changed her life so much that she came a long distance just to thank me the next time I returned.”

“We’ve had over a 90% success rate with our ablations,” he adds. “That’s comparable to rates in the U.S.“

Dr. Ahmed has also helped Bangladesh nurses, cardiologists and cardiac anesthesiologists come to the U.S. for training. He has contributed his home and his own funds to support many of these efforts, as well as soliciting donated equipment and catheters from Maryland hospitals. “When Western Maryland Health System was upgrading their EP lab, they donated their old equipment, which was in excellent condition, to the National Institute of Cardiovascular Disease, the main teaching hospital in Dhaka,” he recalls.

In addition to patients with supraventricular tachycardia, a growing number of Bangladesh residents suffer from coronary disease and cardiomyopathy.  EP services are necessary to evaluate these patients and reduce their risk of sudden death using defibrillators and/ or biventricular pacemaker defibrillators.

Dr. Ahmed continues. “As the team is now fully trained in ablation for tachycardia and pacemakers, for the last two years, I’ve begun focusing my training on the management of hypertrophic cardiomyopathy. And, I can expand to other areas of the country. I’m also working on developing the education curriculum so that it’s as close to what we get in the U.S. as possible.”


Rafique Ahmed, M.D., PhD, FACC, is an attending cardiac electrophysiologist with Chesapeake Cardiovascular Associates  

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