One of the first standalone clinics in the Republic offering heart screening to families who have lost a loved one to sudden cardiac death was officially opened in Dublin yesterday.
The clinic at the Mater hospital will endeavour to cut deaths from sudden adult death syndrome by detecting and treating early any other family members who may also have heart conditions but have no outward symptoms.
If a family member is detected as having a condition which would put them at high risk of sudden cardiac death, they can have an implantable cardiac defibrillator fitted which would, in the event of a heart attack, deliver a shock to their heart to restart it within four or five seconds.
Eleanor Kelly (19) from Greystones, Co Wicklow, had one fitted just two weeks ago at the Mater. She was screened in the aftermath of the death of her brother, Darragh (21), from sudden adult death syndrome in October, 2003.
Her parents and two of her sisters were also screened, some of them in London, but she was the only one found to be at risk. An abnormality showed up on her ECG which is typical of Long QT syndrome, a rare heart condition which caused the sudden death of Tyrone football captain Cormac McAnallen in 2004.
Ms Kelly explained that she was diagnosed last June in Dublin so it was a relief to her now to have the defibrillator fitted. It has been inserted under her skin just down from her left shoulder and it means she can now resume playing camogie.
Consultant cardiologist Dr Joseph Galvin said the device monitors a person's heart rhythm for the rest of their life and enables them live a normal life. The battery just has to be changed every five years.
"So they have their ambulance crew sitting on their shoulder for the rest of their lives," he said.
"If someone has a defibrillator in and they want to go climb a mountain that's okay with me," he added.
He said understanding of sudden cardiac death had evolved dramatically over the past decade or so. "We now understand that in Ireland, for example, some 5,000 people die suddenly each year, about 18 deaths a day. The majority of these die because of coronary artery disease, particularly among those who are over 40 years of age.
"When you look at the under 40 age group, they are a little different. There are some coronary deaths but the majority of people don't die due to coronary disease. They die due to heart muscle disorders called cardiomyopathies or they die due to electrical malfunction in the heart muscle cells.
"We call these channelopathies . . . and, unlike coronary disease where family history is quite important, family history in these younger age groups is everything, because these are very often genetic diseases," he said.
Until now, he said, these high-risk families had been investigated and assessed in a somewhat haphazard manner. They had been screened as part of a general outpatient clinic at Blanchardstown hospital. Now they will have their own facility.
He said around 50 families were waiting for screening at present and the new clinic would be able to clear that backlog within the next 12 months.
The screening is provided to "first degree relatives" such as siblings and parents of a young person who dies, as well as their children if they have children.
But Dr Galvin said that in time he also expected the clinic to offer screening to the families of people living with cardiomyopathy.
"They are not as high a priority but they will be seen with time," he said.
It was not known, he said, how many young people were walking around and at risk of sudden cardiac death. It is estimated that around 100 people under 35 years die in Ireland each year from sudden cardiac disease.
Minister for Health Mary Harney, who opened the facility, said the screening of first degree relatives of victims of sudden adult death syndrome was one of the key recommendations of the taskforce report on sudden cardiac death.