اردو(Urdu) English(English) عربي(Arabic) پښتو(Pashto) سنڌي(Sindhi) বাংলা(Bengali) Türkçe(Turkish) Русский(Russian) हिन्दी(Hindi) 中国人(Chinese) Deutsch(German)
Wednesday, February 12, 2025 22:23
Question of Palestine Eternal Wisdom: Iqbal Building Futures: Empowering Pakistan's Youth for Tomorrow Tourism: An Essential Element for Sustainable and Inclusive Growth Connecting Youth to Global Opportunities Algorithms: The Silent Architects of Warfare Pakistani Youth: The Driving Force for National Progress Investing in Future Generations: Pakistan Army Lost Voices: The Systematic Marginalization of Indian Muslims Parallel Struggles: Examining the Palestinian and Kashmiri Quests for Self-determination Emergence of BJP as a Hindutva Force The Fourth Industrial Revolution: Transforming Pakistan Building Sustainable Cities: Urban Search and Rescue Preparedness Simulation Exercise In the Pursuit of Happiness: Understanding Hedonia, Eudemonia, and Naikan COAS’ U.S. Visit: Strengthening Ties and Fostering Collaboration A Biological Marvel of Human Heart Educational Empowerment: FC Balochistan (North) Initiates Literacy Program for Soldiers Digital Pakistan Journey: Pioneering Towards a Connected Future Driving Digital Transformation: Pakistan CJCSC Calls on His Majesty King Abdullah II Ibn Al Hussain During His Visit to Jordan COAS' Peshawar Visit Highlights Security, Socioeconomic Development and National Unity Unity in Diversity: COAS Joins Christmas Celebrations with Christian Community in Rawalpindi Chief of the Naval Staff Attends Indian Ocean Naval Symposium in Bangkok Strengthening Bonds and Elevating Collaboration: Combat Commander Turkish Air Force Calls on Chief of the Air Staff Closing Ceremony of Multinational Special Forces Exercise Fajar Al Sharq-V Strengthens Counterterrorism Collaboration Off the Beaten Track: Exploring Jiwani's Coastal Marvels and Heritage Special Investment Facilitation Council: A Game Changer for the Economy of Pakistan Rising Stars: Pakistan’s Youth Shines Bright in 2023 Indian Supreme Court’s Decision and the International Law Challenges to Justice: The Indian Supreme Court’s Fallacy in IIOJK Belt and Road Initiative: Strengthening Global Ties with Unhindered Trade and Connectivity The Media Matrix: Unraveling How Technology Shapes Our Perception Decoding Human Interaction: The Comprehensive Guide to Reading Body Language The Magic of Moscow On the Same Wavelength: Suno FM's Impact on Community Empowerment, Diversity, and Social Progress in Pakistan The Journey of SAIL: A Beacon of Hope for Autism in Gilgit-Baltistan Pakistan National Youth Convention 2024: COAS Stresses Youth's Vital Role, Urges Unity, and National Strength Vice Foreign Minister of the People’s Republic of China Calls on COAS COAS Attends Inauguration Ceremony of the Second Chapter of NASTP Silicon PAF's Induction and Operationalization Ceremony Showcases Technological Advancements and Operational Excellence COAS Witnesses Firing of Different Air Defense Weapon Systems During Exercise Al-Bayza-III, 2024 COAS Visits POF Wah, Highlights Importance of Indigenous Defense Industry Exercise Sea Guard-24: Strengthening Maritime Security Al-Noor Special Children School and College Celebrates International Day of Persons with Disabilities 2023 in Multan Garrison Exercise BARRACUDA-XII: Strengthening Global Cooperation for Maritime Safety and Environmental Protection Pakistan-Qatar Joint Aerial Exercise "Zilzal-II" Held in Qatar From Breakthroughs to Global Leadership—The Next Chapter Keeping the Promise Alive: Self-Determination for the Kashmiris Pakistan in 2025: Challenges and Opportunities One Year of Unwavering Resolve: Performance of SIFC in 2024 Changing Global Dynamics and Pakistan Addressing Pakistan‘s Climate Crisis: A Security Perspective Subsurface Competition in the Indian Ocean Sands, Sea, and Stories: Why Pakistan’s Coastline Deserves the Spotlight Strategic Diplomacy, Tariffs, and Global Implications Obligations of the Parties to the Genocide Convention Empowering Future Generations: Education as a Catalyst for Progress in Pakistan’s Context Building a Sustainable Future Integrating ESD into Pakistan’s Education System Integration of Cultural Intelligence into Strategic Decisions for Export Promotion From Battlefields to Exhibits: The Story Behind the Army Museum Lahore The Forgotten Melodies: Legacies of Pakistan’s Musical Maestros CJCSC Visits Iraq to Strengthen Defense Ties COAS Visits Field Training Exercise Near Narowal and Sialkot 17th Chief of the Naval Staff Amateur Golf Cup 2024 Held at MGGC, Islamabad High Level Defense Delegation of Azerbaijan Calls on CAS International Day of Persons with Disabilities Celebrated at Al-Noor Special Children School, Multan 52nd National Athletics Championships-2024 Held at Ayub Stadium, Multan Garrison Counterterrorism Center Lehri Hosts Key Military Exercises Pak-China Joint Exercise Warrior-VIII Concludes Students and Faculty Experience a Day with Pakistan Army at Malir Garrison Al-Barq Punjab Hockey League Organized at Okara Garrison PNS Zulfiquar Enhances Regional Maritime Security through Humanitarian Assistance and Bilateral Exercises The Fifth Generation War and Propaganda Against the Armed Forces IIOJK: The Unbroken Cycle of Occupation and the Quest for Self-Determination The Cost of Silence: Global Implications of Ignoring Kashmir Indian Illegally Occupied Jammu and Kashmir: The Continuous Legacy of Imperial Boomerang The Need for Accountability: Indian Actions in Violation of International Law The Ideological Roots of India’s Political Shift: RSS, Hindutva, and Nationalism Public Value, Innovation, and the Digital Economy: Advancing National Development in Pakistan Foreigners Who Made Pakistan Their Home (Part I) The Sea of Opportunity: How Pakistan Can Leverage its Maritime Strength Cultural Connections: Enhancing Public Diplomacy Between Pakistan and Azerbaijan Gwadar‘s First Flight: A Gateway to Balochistan‘s Prosperity Through CPEC Strategic Vision: Jinnah‘s Global Knowledge and Its Role in Pakistan‘s Founding The Ordeal of Lieutenant Wain The Visionary Politician Who Helped Shape Pakistan‘s Destiny: Sir Sikandar Hayat Khan (Part I) The Collapse of Certainty: Fake News and the Erosion of Truth (Part I) Digital Shadows: The Hidden Threat of Disinformation Targeting Pakistan Defending the Digital Pakistan: Strengthening Cybersecurity in a Growing Online Ecosystem Armed Forces of New Uzbekistan: Strengthening National Security and Global Defense Readiness Guardians of the Seas: Pakistan Navy CJCSC Engages with Kuwait’s Leadership to Enhance Bilateral Defense Relations Chief of General Staff of the Iranian Armed Forces Calls on COAS Principal Staff Officer of the Armed Forces Division of Bangladesh Calls on COAS COAS Reaffirms Commitment to National Security, Praises LEAs’ Efforts in Counterterrorism Operations CNS’ Visit to Bahrain Focuses on Expanding Defense and Maritime Collaboration CNS’ Visit to Oman Reinforces Historic Defense and Naval Ties Defense Delegation of Bangladesh Calls on CAS Faculty and Students of Bahauddin Zakaria University Visit Multan Garrison Cochlear Implant Activation Ceremony Held for Children of Al-Noor Special Children School at Okara Garrison PNS MOAWIN Delivers Life-Changing Medical Aid to East African Nations PAF Contingent Joins 'Spears of Victory-2025' Exercise in Saudi Arabia Pakistan's Indigenous EO-1 Satellite Set to Revolutionize Agriculture, Urban Planning, and Disaster Management
Advertisements

Major Mushtaq Sadozai (R)

NAY

Advertisements

Hilal English

Advancing Cardiac Care: Why AFIC/NIHD is the Go-To Destination for Cutting-Edge Cardiac Care in Pakistan

October 2024

AFIC/NIHD in Rawalpindi stands at the forefront of cardiac care, celebrated for its groundbreaking research and cutting-edge healthcare services. With a passionate commitment to transforming patient outcomes, this pioneering institution is not just setting new standards for heart health; it’s redefining the future of cardiovascular medicine in Pakistan, offering hope and healing to countless individuals.



When Pakistan came into being, there were no cardiac facilities in the country. In 1953, a dedicated cardiothoracic center was established at Military Hospital (MH), Rawalpindi. Since then, it has become a Centre of Excellence in Cardiovascular Care. The first coronary angiography was performed in 1969, and the first open-heart surgery was conducted in 1970. In response to the exponential demand for cardiac services, the center was upgraded to the Armed Forces Institute of Cardiology (AFIC) in 1978. Just three years later, to extend services to fellow citizens, government servants, and underprivileged patients, the institute was upgraded to the National Institute of Heart Diseases (NIHD) under President of Pakistan Directive No. 216 of 1981. It was Major General Zufiqar Ali Khan who conceived and implemented the ideas of AFIC and NIHD.
In its current state, AFIC is a 400-bedded tertiary cardiac care hospital that addresses major aspects of cardiovascular medicine. The present building is the most beautiful and unique of its kind. Its foundation stone was laid by the former Chief of the Army Staff (COAS) and President of Pakistan, General Zia ul Haq, in 1983. It was later inaugurated by the former President of Pakistan, Mr. Ghulam Ishaq Khan, in 1988. Over the years, AFIC and NIHD have established themselves as major tertiary cardiac care hospitals in Pakistan, dedicated to cardiac patients from all over the country, including Armed Forces members, federal government employees, and the civilian population. The Institute is an extremely busy center with a state-of-the-art Emergency Coronary Care Unit, a Surgical Intensive Treatment Centre (ITC), a Department of Clinical Cardiac Electrophysiology (CCEP), and a Nuclear Cardiology department. Currently, there are six fully equipped catheterization laboratories and one hybrid catheterization laboratory, capable of treating complex coronary and cardiac electrophysiology interventions. It also has six surgical theatres equipped to handle all types of adult and pediatric cardiac surgeries. A new OPD complex was inaugurated by the former COAS, General Ishfaq Pervez Kayani, on November 25, 2010.
With a legacy spanning over 46 years, the institute stands as one of the nation's premier healthcare facilities, situated in the heart of Rawalpindi, adjacent to the federal capital, Islamabad. AFIC and NIHD take pride in their service to a diverse population across the country. The institute benefits from a cadre of extensively trained specialists and dynamic residency training initiatives in cardiology, interventional cardiology, cardiac surgery, and cardiac anesthesia. Through a strategic partnership with the International Children Heart Foundation (ICHF) USA, led by Prof. Dr. William Novik, a cardiac surgeon, the hospital has made remarkable strides in advancing its capabilities in surgical procedures and intensive care for complex congenital heart conditions in pediatric patients.



The institute contributes to the training of not only physicians but also nurses and a diverse array of healthcare professionals across multiple disciplines. This includes hosting international conferences on cardiology, cardiac surgery, electrophysiology, and pediatric cardiology. Through Continuing Medical Education (CME) and Continuous Professional Development (CPD) initiatives, the institution ensures the perpetuation of high-quality care for both current and future generations. AFIC encompasses departments in Adult Cardiology, Pediatric Cardiology, Adult Cardiac Surgery, Pediatric Cardiac Surgery, Cardiac Electrocardiography, Nuclear Cardiology, CT Angiography/Cardiac MRI, Research & Development, and Preventive/Rehabilitation.
Adult Cardiology. The Adult Cardiology department was established at AFIC/NIHD from the very beginning, where state-of-the-art procedures are carried out in addition to basic cardiology. The institute has attained excellence in the following complex procedures:
▪ Round-the-clock Primary Percutaneous Coronary Intervention was initiated in 2010.
▪ The first Transcatheter Aortic Valve Implantation (TAVI) was performed on March 28, 2015.
▪ The first Endovascular Aneurysm Repair (EVAR) was conducted on March 3, 2015.
▪ The first Thoracic Endovascular Aneurysm Repair (TEVAR) was carried out on May 21, 2017.
▪ Rotational Atherectomy (ROTA)
▪ Chronic Total Occlusion (CTO) procedure
▪ Intravascular Ultrasound (IVUS)
▪ Fractional Flow Reserve (FFR)
▪ Laser-Assisted PCI
▪ Percutaneous Transluminal Mitral Commissurotomies (PTMCs)



Pediatric Cardiology. The history of pediatric cardiology in Pakistan can be traced back to the early 1980s, specifically 1983-1984, when Dr. Shakeel Qureshi pioneered this specialty within the Pakistan Army. His journey began in a modest British-style cardiology unit located in MH, Rawalpindi. This humble beginning laid the groundwork for significant advancements in the field.
In June 1991, Major General Waqar Ahmed returned from the United Kingdom (UK) and formally commenced his work in pediatric cardiology. Under his leadership, the department achieved remarkable milestones, including the first-ever transcatheter patent ductus arteriosus (PDA) occlusion using Rashkind umbrella devices in Pakistan. Early procedures in pediatric cardiology included balloon atrial septostomy, balloon dilatation of the pulmonary and aortic valves, and interventions for native coarctation of the aorta. Over the years, the scope of procedures has expanded significantly. Today, the department handles a wide range of diagnostic and therapeutic cases with varying complexities, including transcatheter device closures for atrial septal defects (ASDs), PDAs, ventricular septal defects (VSDs), and percutaneous pulmonary valve replacements (PVRs).



Among the more complex interventions are stenting procedures for ductal patency in cyanotic patients and those with transposed great vessels. The department also performs stenting of the aorta and peripheral vessels, providing critical support to surgeons during intricate cardiac surgeries. Remarkably, these procedures are conducted on very small patients, some weighing less than 1.5 kg. Innovations in technique have led to the first successful VSD closure via a periventricular hybrid approach, as well as transcatheter closures of pulmonary valves and sinus venosus ASDs using advanced devices.
The department has successfully tackled complex surgeries, with the exception of hypoplastic left heart syndrome, and is currently exploring the feasibility of pediatric heart transplant procedures. Equipped with state-of-the-art technology, the department boasts advanced echocardiography capabilities, including 4D imaging and transesophageal probes, alongside comprehensive CT and MRI data acquisition facilities. This cutting-edge equipment enhances diagnostic accuracy and procedural outcomes, ensuring that the department remains at the forefront of pediatric cardiology in Pakistan.
Adult Cardiac Surgery. From its very beginning, AFIC and NIHD have provided state-of-the-art cardiac surgery supported by advanced cardiac anesthesia. The first closure of an atrial septal defect was performed on March 5, 1970, by Dr. Ali Masood Akram, and the first coronary artery bypass grafting was conducted in 1980 by a team of surgeons consisting of Dr. B.T. William, Dr. M.R. Kiani, and Dr. Syed Afzal Ahmed. The first bypass by an indigenous team from AFIC was carried out in 1982.
Currently, they have four state-of-the-art modular operation theaters equipped with the latest machines. In addition to routine cardiac surgeries, they perform valve replacements and repairs, congenital heart surgeries, aortic surgeries, aortic root replacements, aortic arch and descending thoracic aorta replacements, surgery on the pericardium, surgery for cardiac tumors, and minimally invasive surgery.
They also have future plans for an LVAD and heart transplant program.
Congenital Cardiac Surgery. The specialty of congenital cardiac surgery encompasses the treatment of individuals born with congenital heart defects, with an age spectrum ranging from neonates just a few days old to patients up to sixty years old. Pediatric and congenital cardiac surgery is a highly intricate specialty with a limited number of practitioners throughout the country. Foreign proctorship programs have been instrumental in the development of this specialty at AFIC, establishing it as the preeminent institute in Pakistan. Collaboration with Professor Dr. William Novick (USA) and his International Children Heart Foundation (ICHF) team included 15 visits to AFIC between 2005 and 2015 under a Memorandum of Understanding (MoU).
Periodic visits were conducted by various world-renowned surgeons, including Dr. David R. Anderson from the UK, Dr. Asif Hassan (a prominent cardiac transplant surgeon from the UK), and Dr. Zohair al Halees from Saudi Arabia. All these missions have significantly contributed to the strong reputation of pediatric and congenital cardiac services at AFIC.
Another groundbreaking development was the introduction of the Birmingham Children’s program, which commenced in 2014. This program has shortened the learning curves not only for surgeons but also for the entire team, including pediatric cardiologists, pediatric intensivists, and intensive care staff.



Clinical Cardiac Electrophysiology. Clinical Cardiac Electrophysiology (CCEP) was introduced at a very basic level during the late 1990s in Pakistan, and AFIC has been at the forefront since its inception. CCEP is a novel subspecialty of cardiology that is rapidly evolving to cater to the growing population of patients suffering from various types of rhythm disorders (arrhythmias) or advanced heart failure (HF). For arrhythmias, we have the capability to conduct procedures ranging from basic electrophysiology (EP) studies to complex high-density mapping procedures that eradicate complex arrhythmias. For HF and conduction disorders, cardiac devices are implanted, ranging from simple pacemakers to complex devices like cardiac resynchronization therapy (CRT).
CCEP is one of the few treatment modalities that is curative in more than 95 percent of cases. The latest addition to the EP armamentarium at AFIC/NIHD is the introduction of a laser lead extraction system, which is the first of its kind in Pakistan. AFIC is also a pioneer in the introduction of the College of Physicians & Surgeons (CPSP) EP Fellowship Program nationwide since 2014. Since then, the number of EP fellows has been increasing each year.
The first International EP Conference, themed “Rhythm for Life,” was held in 2001 at AFIC. It is the only conference that truly represents the education and research activities of the EP community in Pakistan. This conference is held at AFIC every year to address the educational needs of a wide spectrum of audiences, including medical students, cardiologists, and EP consultants. It provides an opportunity for the national EP community to gather and discuss common issues related to cardiac electrophysiology in Pakistan.
Nuclear Cardiology. Myocardial perfusion imaging (MPI) plays a critical role in the diagnosis and management of various cardiovascular diseases, including coronary artery disease. Traditionally, SPECT myocardial perfusion imaging has been limited in its ability to accurately assess myocardial blood flow dynamics. However, with the introduction of CZT-SPECT MPI, valuable insights into myocardial perfusion and function can now be obtained.
The successful commissioning of the country’s sole CZT-based dedicated cardiac gamma camera and the subsequent initiation of novel dynamic SPECT myocardial perfusion imaging, which measures myocardial blood flow and flow reserve, in March 2023 marked a significant accomplishment for the Nuclear Cardiology Services at the national level, on par with international best practices.
This achievement positions AFIC/NIHD as a pioneer and leader in Nuclear Cardiology Imaging, introducing this latest procedure in the country and underscoring our commitment to providing patients with the highest standards of care.   
Diagnosis. The first CT angio machine was donated to AFIC/NIHD by Mr. Shaukat Aziz, the Prime Minister of Pakistan, in 2008, and the first case was performed on December 31, 2008. Currently, AFIC has three CT angio machines where CT scans, CTPA, and CRT procedures are carried out. An MRI machine was also installed in 2018, which is used for cardiac MRI diagnostics.
Research and Development. This department was established in 2014, making it a pioneer in cardiovascular research. It is dedicated to advancing cardiovascular health through innovative, evidence-based research that aligns with our mission to improve clinical outcomes. The department focuses on clinical research, including oversight from the Institutional Ethical Review Board, journal publication, and clinical trials. We also engage in academic activities, conducting ongoing workshops, lectures, and conferences.
Prevention/Rehabilitation. AFIC has a dedicated Preventive & Rehabilitation department that addresses risk factor assessment, diabetes management, nutrition, smoking cessation counseling, lipid profile testing, and blood pressure monitoring. Moreover, in cardiac rehabilitation, we provide inpatient monitoring post-cardiac surgery, supervise exercise training, and offer psychological support.
Conferences. AFIC and NIHD hold annual conferences, such as the Cardiology Update, in collaboration with the Pakistan Cardiac Society, as well as cardiothoracic and electrophysiology (EP) conferences. Moreover, AFIC/NIHD has become a hub for conducting BLS/ACLS courses accredited by the American Heart Association (AHA).
Collaboration With International Institutes. AFIC and NIHD have collaborated with University Hospital Birmingham to provide young fellow cardiologists, cardiac surgeons, and cardiac anesthetists with on-the-job training to update their professional skills and meet international standards.
NEPCARD. Currently, AFIC is actively engaged in constructing the National Institute of Heart Diseases Center of Excellence for Preventive Cardiovascular Research and Development (NEPCARD). This facility will serve as the national hub for collaborative research, data analysis, and the eventual formulation of guidelines. These guidelines will help shape public policies aimed at benefiting the masses.
The hospital is recognized for its unwavering commitment to patient welfare, steadfast pursuit of professional objectives, drive for excellence, and a deeply compassionate and cooperative ethos. The institute is celebrated for delivering compassionate care that seamlessly integrates cutting-edge technology with a human touch.
The global burden of disease is shifting from infectious diseases to non-communicable diseases, with cardiovascular diseases being the leading cause of death worldwide. Cardiac diseases are rampant and epidemic in Pakistan. AFIC/NIHD is dedicated to treating individuals suffering from cardiovascular diseases, supported by an excellent team of professionals and state-of-the-art hospital facilities.


 
 

Major Mushtaq Sadozai (R)

NAY

Advertisements