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19 May, 2021

Gabriel Robles’ story: An internal defibrillator to prevent sudden death

An obstruction in the main artery of the heart of Mr. Gabriel Robles Flores caused him a ventricular dysfunction that had the risk of ending up generating malignant arrhythmias and causing him a sudden death. A fatal outcome that could be avoided with a defibrillator. The problem was that, in their hospital in Puebla (Mexico), they did not have the appropriate technology to be able to perform this intervention in a minimally invasive way. With this type of approach, the benefits obtained by the operation are maximized, while a faster complete recovery of the patient is achieved.

For this reason, Dr. Omar Gómez Monterrosas, his interventional cardiologist, advised him that the intervention would be carried out at the Grupo Hospital Clínic in Barcelona, where he himself had trained between 2013 and 2015 through a fellowship, a period of training for physicians who have already completed an internship or residency to specialize within medicine.

IMPLANTABLE DEFIBRILLATOR TO PREVENT SUDDEN DEATH

In this way, Mr. Gabriel Robles Robles and his wife, Mrs. Hilda Herrera Limón, traveled from Puebla to Barcelona to put themselves in the hands of the team led by Dr. Josep Brugada, head of the Arrhythmias section at the Hospital Clínic and at the  Hospital Sant Joan de Déu, barnaclínic+ specialist and professor at the Universitat de Barcelona. “In this case, the placement of an implantable defibrillator is a preventive treatment of what could happen. If the device identifies an arrhythmia of the heart, it would do the immediate treatment to prevent it from causing the sudden death of the patient”, explains Dr. Brugada.

“In this case, the placement of an implantable defibrillator is a preventive treatment of what could happen. If the device identifies an arrhythmia of the heart, it would immediately treat it to prevent it from causing the sudden death of the patient

Dr. Josep Brugada – barnaclínic+ Cardiologist

Minimally invasive diagnosis and treatment of arrhythmia

Once in the barnaclínic+ facilities, the first thing was to check the true state of the heart of Mr. Gabriel Robles. In order to do that, Dr. Ander Regueiro, cardiologist at Hospital Clínic and barnaclínic+, confirmed by catheterization the severity of the narrowing in the main artery of the heart by means of an intracoronary ultrasound. A catheterization is a procedure where a long, thin tube, the catheter, is inserted into a blood vessel in the groin or arm of the patient. The cardiologist then guides you down to the heart and surrounding vessels. It is a procedure that is used both for the diagnosis and for the treatment of many cardiac pathologies, and that has the advantage that it does not require a large incision, which allows a better and faster recovery.

Once the actual condition of the artery was verified, the internal defibrillator was implanted, also using a catheter. “We have performed this catheterization with the help of a ventricular support that is placed through a catheter as well, which gives us a lot of security and peace of mind at the time of doing the intervention. If there is any complication, it can be solved with the help of this ventricular assist device”, explains Dr. Regueiro.

Only 24 hours after the intervention, Mr. Gabriel Robles began to mobilize and his evolution was totally satisfactory. “I am very happy and they have treated me very well at barnaclínic+”, says Mr. Robles himself, while his wife, Mrs. Hilda Herrera, highlights the good treatment received. “We are very grateful to the hospital staff for their attention, because they have really done their best. Despite the process he has had, the pain that my husband has suffered has been minimal. Everything has been first rate”.

“I am very happy and they have treated me very well at barnaclínic+”

Mr. Gabriel Robles – Patient

“We are very grateful to the hospital staff for their attention, because they have really done their best. Despite the process he has had, the pain that my husband has suffered has been minimal. Everything has been first rate”

Mrs. Hilda Herrera – Patient’s wife

The Grupo Hospital Clínic, a world reference centre

The technological evolution of recent years has allowed a great development in techniques that are less and less invasive in the field of cardiology. The Grupo Hospital Clínic has state-of-the-art equipment, as well as professionals of proven prestige that make it an exemplary center, not only in Spain but throughout the world. “We have tools that allow us to visualize and see why the different arrhythmias and tachycardias occur. This allows us to focus and locate the point of interest in which we are going to act with a catheter to eliminate the problems that these arrhythmias are generating”, explains Dr. Brugada.

“We have tools that allow us to visualize and see why the different arrhythmias and tachycardias occur. This allows us to focus and locate the point of interest in which we are going to act with a catheter to eliminate the problems that these arrhythmias are generating”

Dr. Josep Brugada – barnaclínic+ Cardiologist

This has motivated other cardiologists to come from abroad to complete their training, as has been the case with Dr. Omar Gómez himself. “After my training here and when I returned to Mexico, we started a collaboration program with barnaclínic+. The objective of this collaboration is that patients in Mexico can be treated here, especially in cases where the technology there is limited”.



Dr. Brugada also highlights the importance of these collaborations. “It is an honor and a pleasure to collaborate with all these students and alumni who are doing a wonderful job around the world and who continue to see us as a reference centre to be able to solve the most complex and serious cases, those that they have not been able to solve and that we can, in the second instance, try to solve”.

“It is an honor and a pleasure to collaborate with all these students and alumni who are doing a wonderful job around the world and who continue to see us as an exemplary centre”

Dr. Josep Brugada – barnaclínic+ Cardiologist


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