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The Lipid and Atherosclerosis Society of Southern Africa (LASSA) is affiliated with the South African Heart Association (SA Heart) as a Special Interest Group (SIG) and with the Society for Endocrine and Metabolic
Disease of South Africa (SEMDSA).
LASSA is a small group. The orientation of LASSA is mainly academic with an emphasis on teaching hospitals but covers a wide area of interest in inherited disorders of lipid and lipoprotein metabolism, atherosclerosis, nutrition, epidemiology and pharmacotherapy. There is concern that the support for research in the fields of interest of LASSA is diminishing, especially at a time that atherosclerosis is acknowledged as one of the leading causes of morbidity and mortality in the country. Expertise in severe dyslipidaemias remains mainly at a few
teaching hospitals where facilities and staff are shrinking.
The LASSA meetings are in conjunction with SEMDSA every two years and meetings or sessions are intended for the interval year along with the SA Heart meetings. The meeting for 2006 was postponed until 2007 because
SEMDSA is hosting the International Diabetes Federation meeting in CapeTown in December 2006. The next LASSA/SEMDSA meeting is being planned in Bloemfontein. The SEMDSA meeting will be from the 30th of June to the 2nd of July and the LASSA meeting from the 2nd of July to the 3rd of July in 2007.
The chief activities for this year for LASSA were to review the application of the European Guidelines for Atherosclerosis with SA Heart. These guidelines were circulated with the journal in July 2006. LASSA
also provided input on this issue to the Council for Medical Schemes in Cape Town in September.
The finances of LASSA are sound as there is little demand for administrative needs. The educational account is currently R78399. LASSA currently has R71616 in a current account and R113000 in a
32-day notice deposit with Standard Bank. It is anticipated that significant expenditure will be required for LASSA meetings but it is hoped that there will be no need to raise subscription costs.
AD Marais, Groote Schuur Hospital & University of Cape Town
FJ Raal, Johannesburg Hospital & University of Witwatersrand
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Nuclear Cardiology Group
Members: Professor P Manga, Professor A Doubell, Professor A Ellman.
Unfortunately the Nuclear Cardiology group has remained dormant for the year. I have had little input from nuclear physicians and my initial feeling was that this interest group should cease to exist. However, with the newer imaging technologies (CT, MRI) coming to the fore this interest group could possibly be broadened to include members interested in these technologies. Thus the new wider group could be called "Cardiac Imaging Group". Discussions are planned with various individuals as how to develop this new expanded group.
Professor P Manga
Cardiac Arrhythmia Society of Southern Africa (CASSA)
At a “Bosberaad” held in February, CASSA policy and main direction was discussed and defined.
Education and awareness: It was decided to hold a series of “roadshows” at smaller cities and towns throughout South Africa and Namibia, with the aim of increasing awareness of electrophysiology and arrhythmia management among GP’s, physicians and emergency personnel, and to provide practical training in ECG interpretation and treatment of patients with arrhythmias, as well as advice regarding referral for more sophisticated procedures. A core programme and content was agreed upon to ensure consistency of the message to be conveyed. This consists of some didactic instruction, followed by case-based interactive teaching. Electronic responses ensure audience participation.
Three roadshows have been held so far, at Worcester, Witbank and Rustenburg. The experience gained so far will be used to improve future events. I would like to thank the EXCO members for their willingness to give up their weekends without reward for these ventures.
A comprehensive ECG library is in preparation. This will consist of high-quality 12 lead traces, for use in education, such as the roadshows. Selected ECGs will appear on the CASSA website, and it is planned to make copies available to CASSA members who request them.
Training in Electrophysiology: South Africa needs more electrophysiologists. While excellent EP training programmes are available overseas, there is a need for local training. Currently, the only accredited Cardiology training centre in SA offering EP training is at Groote Schuur Hospital, under Professor A Okreglicki (AO). It is planned to offer a formal one year course in EP, centred at GSH, to suitable candidates who have completed their general training in Cardiology (3 years + Cert. Cardiol. SA). The 2 recognised EP labs in private would also participate. A second programme will be offered in Johannesburg, centred at Dr IWP Obel’s lab at Milpark Hospital, with participation of 2 other private EP labs. The issue of trainees working in a private institution should not be too much of a problem, since they will be registered cardiologists. It is hoped to incorporate hospital patients into the scheme.
CASSA plans to establish a trust fund to assist with financing EP training.
A curriculum is being developed, and means of certification are under discussion.
Standards of Electrophysiology in South Africa: CASSA is concerned that practitioners are implanting devices, such as ICDs and biventricular pacemakers, and are performing complex ablations, such as pulmonary vein isolation for atrial fibrillation, without adequate training in electrophysiology. The expertise required for follow up of complex devices is often lacking.
To address this issue a voluntary list of CASSA members is being drawn up, in which participants submit details of their training and experience, together with evidence of their current practice and results. While CASSA is not a statutory body empowered to police EP practice, it is the only group, which is in a position to determine standards, and has an obligation to the profession and the public to do so.
Web site: A new web site is being implemented, which will feature the above projects and contain extensive education material on arrhythmias. Certain features and downloads (e.g. copies of ECGs) will be available only to CASSA members.
Conclusion: I am coming to the end of my final term as President of CASSA. It has been a great privilege to have been in office during a period of rapid advances in the field of electrophysiology, in which new techniques and devices for the management of arrhythmias and heart failure have become available. I am grateful to my fellow EXCO members and office-bearers for their hard work, enthusiasm and loyal support.
I wish my successor the strength and resolve to carry to fruition the initiatives referred to above.
Rob Scott Millar, Chairperson
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The Paediatric Cardiac Society of South Africa
1. INTRODUCTION:
The Paediatric Cardiac Society of South Africa (PCSSA) is a special interest group of the South African Heart Association (SA Heart), the umbrella body for cardiology and heart surgery in South Africa. PCSSA is a voluntary association of paediatric cardiologists, cardiac surgeons, cardiac anaesthesiologists and paediatricians, all with an interest in children with heart problems. The objectives of the Society are to improve quality of care for children with congenital and acquired heart disease though promoting research and supporting education and training of children’s heart specialists. PCSSA is the primary advocacy group for children with heart disease in South Africa.
The two year term of office of the current Executive of the PCSSA ends with fresh elections at the AGM on 31 October 2006. The period of stability has benefited the society and we have been able to give attention to important matters over and above our annual scientific meeting. As a Special Interest Group (SIG) of the South African Heart Association we developed and strengthened that relationship.
2. FINANCIAL STATEMENT FOR YEAR ENDED 31 MARCH 2005: We are pleased to report that the Society is in a healthy financial position. The Annual Financial Statement for year ended 31 March 2005 prepared by our Treasurer Dr Ray Dansky, is appended. Reserves at 31 March 2006 were R290577, representing a growth of 60 percent compared with 31 March 2005.
3. RELATIONSHIP WITH SA HEART : There was unfortunately no meeting of the National Council of SA Heart this year. Notwithstanding, we have consolidated our good relationship with SA Heart. For the first time, the annual effort made by PCSSA in organising the Paediatric component of the SA Heart Congress has received recognition. Our share of the profits accruing from the 2005 “Berg-rhythms” Congress amounted to R100,000 or 10 percent of the total profit. The extent of the profit share from future SA Heart Congresses is well documented and recognised and will contribute to some extent to the expanding activities and interests of the Society.
4. TRAINING GUIDELINES AND ADMISSION CRITERIA
Represented by Dr Antoinette Cilliers, the Society made representations to the Colleges of Medicine of SA which agreed to decrease the requirement for the number of observed trans-oesophageal echocardiograms necessary for certification from 30 to 15 and observed EPS studies from 2 to 1 for candidates writing the Paediatric Cardiology exam in 2007.
5. PRIVATE PRACTICE AFFAIRS : We are represented at the South African Medical Association (SAMA) by Dr Jeff Harrisberg. The major current issue is the SAMA challenge to the legality of the publication of the national reference price list (NRPL). Until such time as negotiations between SAMA, the Department of Health and the Board of Healthcare Funders have been concluded, we will be to some extent unsure how to bill in 2007. We will be informed of progress in this regard through the Paediatric Management Group. There is as yet still no code for 3D echocardiogram.
6. CARDIAC CATHETERISTION LABORATORY REGISTRY AND DATA COLLECTION:
Dr John Lawrenson and Dr Jeff Harrisberg have contributed to the development of the cardiac catheterization laboratory registry project of the SA Heart. There is expectation that the project is nearing completion and should be available for demonstration before year end.
7. GUIDELINES ON ECHOCARDIOGRAPHY IN CHILDREN:
Over the last year, led by Ebrahim Hoosen, PCSSA has prepared a draft guideline entitled, “Standards of Practice for Echocardiography in Children in South Africa”. The template for this guideline is that of the Paediatric Cardiac Society of Australia and New Zealand who kindly granted permission for us to use their document for this purpose. The guideline will be submitted to SA Heart and South African Paediatric Association for comment in November 2006 and thereafter published in the Journal of the SA Heart Association.
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8. GUIDELINES FOR CARDIAC CATHETERIZATION IN CHILDREN:
In further recognition of our professional and ethical responsibilities, the PCSSA has considered the development of guidelines for cardiac catheterisation in children in South Africa. The scarcity of Paediatric Cardiologists in our country and the limitations on public sector financial resources compared with Asia, Europe and north America, makes a strong case for the development of such guidelines. The PCSSA, with guidance of Dr Shakeel Qureshi, is hosting a seminar on the development of these guidelines in Stellenbosch on the 28th of October 2006. Our thanks to Dr Jeff Harrisberg for the work he has done in preparing the draft and the programme. We are grateful to PARAGMED for there sponsorship for this meeting.
9. NETCARE PAEDIATRIC CARDIAC SYMPOSIUM, OCTOBER 2006:
Our annual scientific meeting will be held in Somerset West between Sunday 29 October and 1 November 2006 as part of the Annual Congress of SA Heart Association. This year, the Congress is organised by the Bloemfontein Regional Group of SA Heart with Prof Steven Brown representing the PCSSA. He has done an outstanding job in attracting an excellent scientific faculty with University of Witwatersrand graduate and echocardiography giant Prof Norman Silverman retuning to South Africa from San Francisco, the internationally acclaimed interventionist Prof Ziyad Hijazi visiting from Chicago and the outstanding scientist and surgeon, Prof Emeritus at Great Ormond Street Marc de Leval, from the United Kingdom. Unable to participate in our Congress last year due to his involvement with the Humanitarian support for earthquake victims in Pakistan, we are also fortunate to have the participation of Shakeel Qureshi, Consultant Paediatric Cardiologist at the United Medical and Dental Schools of Guy’s and St Thomas’ Hospitals, London. Now in its 5th year, we are grateful for sponsorship received from NETCARE toward the Symposium. That sponsorship has been passed directly across to the SA Heart Congress Committee from PCSSA.
10. PCSSA RESEARCH SCHOLARSHIP:
Although we have diverted funds and attracted additional direct support, there is not yet sufficient funding to launch the scholarship. Our year end activities will assist in this regard and we are in negations with a single major donor with whom we hope to jointly administer the scholarship.
11. SPONSORSHIP: The hospital group Netcare, has again been generous in its support of our annual scientific meeting, the NETCARE Paediatric Cardiac Symposium. Abbott Laboratories has supported the operations of our Society and our Research Scholarship initiative. Paragmed the medical supply company has funded our workshop on interventional cardiology.
12. THE YEAR AHEAD: Whilst one cannot determine the course of action to be followed by our new executive, it is hoped that they will build on the platform established for the PCSSA and continue to grow the activities with which we have engaged the Society. Particularly, the completion of the Catheterisation Guideline and the growth of the Research Scholarship initiative.
The Annual Congress of SA Heart in 2007 will be organised jointly by the South African Society of Cardiovascular Intervention (SASCI) and the PCSSA. This will be held in Sun City in the North-West Province.
The PCSSA has been invited to organise, chair and co-host the Paediatric component of the Joint Pan African Society Of Cardiology (PASCAR) / Kenya Cardiac Society - 1st All Africa Conference on Heart Disease, Diabetes, And Stroke in Africa which will be held in Nairobi, Kenya 13-16 May 2007. This is the first all-African iniative in Paedfiatric Cardiology an we hope, an opportunity to launch a paediatric group within PASCAR.
The PCSSA intends developing a South African parent orientated multi-lingual educational web-site on heart disease in children. Preliminary discussions have been held with potential private partners and it is hoped the new Executive will launch the project.
My thanks to my colleagues on the Executive of the PCSSA for their hard work and support.
Dr Christopher Hugo-Hamman,
President
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South African Society of Cardiovascular Intervention (SASCI)
The past year has seen the SASCI Executive full fill its mandate to establish a viable independent Working Group within SA Heart Association attending to the many needs of the community of interventional cardiology in South Africa.
The Executive Committee elected to a 2-year term of office ending in 2007 is: -
Chairman - Dr Tom Mabin,
Secretary - Dr Farrel Hellig,
Treasurer - Dr Clive Corbett,
Members - Dr Graham Cassel, Dr Jai Patel, Dr Steve Spilkin, Dr Adie Horak, Dr Mpiko Ntskhe, Dr Rob Kleinloog (surgical),
Dr Jeff Harrisberg (paediatric),
Mr Albert Denoon (industry),
Ms Heather Henry (industry),
Executive Officer - Mr George Nel.
During the year SASCI have been proactive in all areas of interest. In order to achieve in all areas we appointed a salaried Executive Officer, Mr George Nel. He has been instrumental in assisting us in promoting our activities during the past year.
Our aim to promote educational opportunities for our members have seen the establishment of
- The 2nd SASCI Annual Registrars Workshop was held at Albert Luthuli Hospital (February 2006) and was attended by 20 registrars from across the country (40 attendees in total). This annual event has become a highlight of the calendar for both private practitioners and public sector participants.
- Regular regional case presentations and meetings amongst colleagues and staff
- “Controversies in Cardiology Weekend” (sanofi-aventis), was hosted under the auspices of SASCI with as the international speaker, Prof. Jean-Pierre Bassand (University of Besançon Faculty of Medicine, Besançon, France). A distinguished local faculty had the opportunity to share the “stage” with Prof Bassand.
- Contributions towards congresses – SA Heart 2006 SASCI Satellite Symposium with an international faculty, live case transmissions and interactive Tips and Tricks sessions.
- The exchange programme between SA and UK for interventional cardiology registrars was continued in 2006 (Boston Scientific). Dr’s Sanjay Maharaj (2005) and Mbuyu Bushidi (2006) were the respective recipients and will receive the award during the upcoming AGM.
- SASCI actively contribute and participate in the launch of two important local training institutions. The Institute for Therapy Advancement | South Africa (Baroque Medical) and Carotid Artery Stenting Education System (CASES, Cordis Johnson & Johnson). These programs allow local interventionalists the opportunity to expand and enhance their skills with the help of international and local faculty, internationally developed material, virtual reality and hands-on proctorship.
- Cordis Breakfast Club meetings in Cape Town are well attended and provide an opportunity to interact and share experiences with colleagues.
- SASCI have been invited to host an afternoon Education Session at PCR 2007, which will be held in Barcelona instead of Paris. All members who wish to contribute to our efforts are encouraged to come forward.
SASCI as a Special Interest Group with in SA Heart has been actively participating in the structures created by SA Heart to address the issues of “Practice Cost and Tariffs”. Exco have contributed significantly to data pertaining to practice costs and tariffs but broad based participation has been disappointing. This “process” will impact substantially on our income and eventually patient care.
Practice Guidelines have been updated with reference to certain specific issues. As a member of ESC, through SA Heart, we do follow ESC Guidelines on PCI, but have added certain local adaptations.
The Cathlab Registry project has developed during 2006 and ready for launch. SASCI representatives have been actively involved in its development and giving full support to Elizabeth Schaafsma (SA Heart Registry Data Manager) in the planned roll-out.
SASCI’s role as recognised resource for liaison between members and health funders for information on best practice, guidelines and tariff issues continue to expand but can always be enhanced further.
Industry Representation has assured a close liaison between us and we continue to actively pursue collaboration on issues of common interest. These include facilitation of education resources, advice on device applications, guidelines, liaison with hospital groups etc. We remain very grateful to the industry for the financial support received.
We believe the survival of a strong Working Group in interventional cardiology is in the best interest of all players in the field, physicians, industry vendors, health funders, hospital groups and patients. For this reason, we appeal to all to support SASCI and use us to fulfil all our objectives.
We aim to continue to develop our areas of influence and offer a HELPLINE through our Executive Officer George Nel, whereby any party can access us with enquiries, requests for assistance, lobbying etc. His direct line is 083-458-5954. These requests will be dealt with in a professional and efficient manner to provide a vital service to all.
George Nel, Executive Officer
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Heart Failure Society of South Africa (HeFSSA)
Inaugural Meeting: The Heart Failure Society of South Africa (HeFSSA) is an official special interest group of SA Heart. It was inaugurated during the 6th annual SA Heart congress in the Drakensberg in October 2005. Prof Willem Remme, a prominent European cardiologist welcomed the efforts to establish an African heart failure society and spoke of both, the European and World Heart Failure Societies.
46 attendees signed on as members during the inaugural meeting and together with messages of support from Australia through Prof. Simon Stewart, encouragement from Prof Bongani Mayosi of UCT and a clear enunciation of our aims and plans by Prof Karen Sliwa (Chairperson of HeFSSA) from WITS, the meeting was indeed a wonderful initial expression of the enthusiasm that appears to be present among interested members of SA Heart’s broad community of cardiologists, specialist nurses, technologists, allied disciplines and representatives of the pharmaceutical and device industry.
HeFSSA Workshop at Kloofzicht Lodge:
The first HeFSSA workshop was conducted in the beginning of February 2006 and elaborated on the ‘SA Heart Association’s ESC Guidelines Publication Project’.
All HeFSSA members were invited in our first newsletter that was distributed by email on 9th January 2006. The workshop was well attended and resulted in very fruitful discussions regarding the adaptation of the guidelines according to local practice. The Executive Committee and the Ethics and Guidelines Standing Subcommittee published the heart failure ESC guidelines as supplements to the SA Heart Journal with the May 2006 issue. The guidelines were accompanied by comments towards certain aspects of the ESC guidelines made by the HeFSSA guideline working group.
During the workshop we had the opportunity to listen to excellent lectures by two international speakers, Prof. A. Mebazza from Paris, France (management of acute heart failure), Prof. Simon Stewart from the Baker Institute, Australia (chronic heart failure management programs) and national speakers like Prof G Richards (haemodynamic monitoring in acute heart failure), Dr E Klug and Prof K Sliwa.
We are grateful for the support from Abbott Laboratory organizing the beautiful venue and inviting the speakers.
Registration: Olaf Forster (treasurer) organized the registration of HeFSSA as a section 21 company. Since August the organisation has an account with Standard Bank.
Alteration of members of executive committee:
William Stannix replaced Craig Smith as industry representative (device section), Eva Minkov replaced Kevin Frances as industry representative (ethical pharmaceutical) with Roger Moult co-opted as industry representative ( generic pharmaceutical).
George Nel joined us as executive officer in June 2006.
Industry Launch:
The launch to industry was very successfully organized by George Nel. We are glad to have 8 pharmaceutical companies as corporate members.
Website: The committee spend much time and energy preparing an exciting new HeFSSA website including detailed sections on guidelines, research projects, a new acute heart failure registry (THESUS) in preparation and case reports.
Fellowship program: In collaboration with the World Heart Failure Society HeFSSA has organized 2 fellowship programs supported by Medtronic and the STICARES foundation. Details about the fellows and the progress of their work can be found on our website.
We thank all our members from South Africa, Mozambique, Ghana, Kenya, Europe, America and Australia for showing their support towards the society! It is our hope that all members of SA Heart with an interest in heart failure from both, public and private health sectors, join this special interest group and become members of the first heart failure society on the African continent!
Prof Karen Sliwa
Chairperson Interim Committee
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