History of the Department of Cardiology, Assam Medical College & Hospital

The Cardiology unit of Assam Medical College & Hospital, Dibrugarh was established in April, 1978 with appointment of an Assistant Professor, namely Dr Bhadreswar Das, who had completed his specialized training in cardiology from the National Heart Hospital, under British Post Graduate Medical Education Cardiothoracic Institute, University of London. He was also trained at the Royal Victoria Infirmary and Newcastle General Hospital. Dr B Das was the first Head of the Cardiology unit, Dr Ratan Kumar Kotokey being the registrar.

In 1979, Dr Amrit Kumar Barooah joined as an Associate Professor after completing the WHO Overseas Cardiac Fellowship at the University of Minneapolis Hospital, Minnesota and become the Head of the Cardiology unit. During that time, a six-bedded ICU was established followed by an OT for pacemaker implantation.

Temporary pacing and permanent pacemaker implantation started at Dibrugarh in 1979. The first permanent pacemaker implantation (PPI) in AMCH was done by epicardial surgery method by the team of Professor N Zaman, Professor HK Dutta and Professor Amrit Kumar Barooah. In the same year, Dr Barooah performed the first endocardial PPI through left subclavian vein puncture without the use of IITV fluoroscopy machine. He was assisted by Dr Ratan Kr Kotokey, Registrar. Permanent pacemaker through endocardial approach continued till a new set of IITV fluoroscopy and six monitoring equipments were procured. Since then, PPI has become a routine in AMC.

Thus, under the leadership of Dr. Amrit Kumar Barooah, AMCH started its first journey in the field of cardiac intervention supported by a young and vibrant team, consisting of Dr Ratan Kr Kotokey, Dr Mrinal Kanti Das, Dr Gautam K Purkayastha, Dr Sadananda Bora, Dr Mrinal Sutradhar and Dr Ajit Phukan. At the same time, the Cardiology Department also excelled in the field of research. The results of one interesting research work related to electrophysiology in sick sinus syndrome were ably presented in national CSI, international conference which were also published in the Indian heart journal.

Dr Hem Chandra Kalita was the first cardiology faculty with a DM degree which he had obtained from PGIMER, Chandigarh. He joined as an Assistant Professor in December, 1990. Dr Bhadreswar Das, meanwhile got promoted to Professor of Cardiology in 1987 and continued as Head of the Department. Dr BK Das served as an Associate Professor during this time. The Cardiology Department was declared as an independent department in 1992. Dr Hem Chandra Kalita became the Head of the Department (I/C) in 1994 when Dr B Das was transferred to the Silchar Medical College. Dr BK Das got transferred to the GMCH. Dr HC Kalita officially took the charge of Head of the Department in 1995 when he got promoted as Associate Professor.

Professor HC Kalita took up cudgels for further development of the Department of Cardiology in AMCH. Being an excellent academician and cardiologist, Dr HC Kalita managed to strengthen the department in both education and cardiac care. The IITV being out of order at that time, he had to make laborious arrangement for pacemaker implantation procedures as the patients had to be shifted to the Department of Radiology where there was a fixed IITV for doing barium enema etc. A new IITV fluoroscopy in cardiology could only be procured in 2005. Subsequently, other important equipment like Echocardiography machine, TMT Machine and Holter were added to the Department. A new ICU unit and a new building were inaugurated in the year 2003. Subsequently, another 7-bedded ICCU was added in the year 2018 with the help of NHM. Dr Kalita worked for the overall growth of the department, including development of quality manpower. So under his academic umbrella a group of young cardiologists emerged who not only enriched AMCH, but some of them later enriched other medical colleges like the Guwahati Medical College and Hospital. The members of this group included Dr Dibyajyoti Dutta (DM from PGI, Chandigarh), Dr Mriganka S Chaliha (DM from PGI, Chandigarh), Dr Bornali Dutta (DM from PGI, Chandigarh) and Dr Farhin Iqbal (DM from GMC). Dr Bornali Dutta and Dr Farhin Iqbal were transferred to the GMCH. For a long period of almost 20 years, the trio of Dr HC Kalita, Dr Dibyajyoti Dutta and Dr MS Chaliha served together in the department in arguably the most dynamic era of the department - the era in which the department moved to the phase of coronary and other cardiac intervention besides the regular pacemaker implantation procedures. This period of growth of the department bears testimony to the fact that an outstanding camaraderie and coordination amongst the doctors of a department can help it to develop immensely. Dr MS Chaliha is now Professor and Head of Cardiology in AMCH. Dr Alok Jyoti Malakar, who was also a Registrar here, completed his DM from GMCH and joined the department as Assistant Professor in the year 2018. He is now being allowed to work in JMCH. Another brilliant registrar, namely Dr Reja Md Wasif Bora, also completed his DM course from Burdwan Medical College, West Bengal in the year 2021.

Meanwhile, Dr Darpan Gogoi joined the department as GDMO in the year 2013. Dr Krishna Narayan Dutta Baruah joined as GDMO in the year 2015. Both Dr Darpan Gogoi and Dr Krishna Narayan Dutta Baruah are providing quality support and service to the department, which is running with very minimal manpower.

In March, 2007, the department in association with IGNOU started a 2-year course of Postgraduate Diploma of Clinical Cardiology (PGDCC) which continued for six years. This course was the first course in cardiology in entire Northeastern states and many trained doctors were produced. These trained doctors are giving excellent service in periphery where there is paucity of qualified cardiologists. Moreover, the Department of Cardiology has also been running a Diploma Course in Cardiac Care Technology (DCCT) under Srimanta Sankaradeva University of Health Sciences since 2008. Currently, DCCT Course has 6 seats in AMCH.

The effort was always on to have a full-fledged Cardiovascular Institute (CVI) and installation of a cardiac catheterization laboratory. Due to unavailability of Open Heart Surgery facility and Heart Lung Machine, all the efforts were put on hold. Two separate proposals sent to NEC by the HOD Dr HC Kalita in the period from 2005 to 2012 were not granted. But finally, a proposal for Cath Lab and facility for open heart surgery submitted to ONGC in 2012 under CSR scheme was accepted. An order of Cardiac Cathlab and Heart Lung Machine approved on July 5, 2014 and a Cardiac Cathlab (Siemens Artis Zee Cardiac Cath Lab) was finally installed on August 10, 2014. The first Angiography was done on the same day. The first Coronary Angioplasty was done on July 1, 2015, EPS was started on June, 10 2016. The first PDA closure was done on October 29, 2016. First Radio Frequency Ablation procedure was done on February 22, 2017. The first ASD closure was done on March 27, 2017.

As icing on the cake, three (3) DM seats were approved to Department of Cardiology by NMC on January 10, 2022. This was a great achievement for the Department of Cardiology as this has been relentlessly tried for many years. Dr Shekharjyoti Gogoi (who was working as Assistant Professor of Medicine in AMCH), Dr Suman Prakash from Patna, and Dr Pradeep Singh from Jodhpur joined as the first Batch of DM students in the department. The first academic session for DM course started from May 1, 2022. It is a matter of pride that in the 75 years since its inception of AMCH, the Cardiology Department became the first department to start superspeciality (DM/ Mch) education and training. In another major boost to the Department, it got shifted to Super Specialty Building (SSB) in June, 2022. Inside this New Super Specialty Building, Cardiology Department has its OPD, 12-bedded Cardiac Critical Care Unit, 40-bedded Indoor Ward and a state-of-the-art Cardiac Cath Lab, echocardiography lab and TMT lab. The earlier cathlab presently stationed in the old Cardiology Building is in the process of being shitfted to the Super Specialty Block.

Presently, besides regular non-invasive cardiology services like Echocardiography, TMT and Holter services, the department runs 24-hour emergency services and round-the-clock ICCU services. At present, more than 200 temporary and 300 permanent pacemakers are being implanted every year. Coronary and other cardiac interventions have been routinely carried out in cardiac cathlab.

The journey of cardiology in AMCH is a remarkable journey from "an old bulky Philips ECG machine kept inside the steel almirah in the Department of Physiology, under the custody of the HOD" and without any cardiac care unit, to a full-fledged interventional cardiac unit with two cardiac cathlabs and all non-invasive investigative facilities, state-of-the-art coronary care unit. It is also a journey of a department without having any independent existence to a full-fledged superspeciality training department. This journey has been made possible due to the efforts of many people. But it will be a travesty of justice if the three-decade-long sacrifice, dedication and sincere efforts of Dr Hem Chandra Kalita are not appreciated in the context and perspective. It was a stroke of destiny for AMCH and department of cardiology that a young and energetic just-passed-out DM cardiologist got his appointment in Assam Medical College and Hospital, Dibrugarh in the year 1990 who decided to devote the best decades of his life for the betterment and growth of a nascent department. Dr HC Kalita took a decision to stay back in Dibrugarh ignoring the lure of going back to his native place and alma mater in Guwahati and the rest is history for AMCH and the Department of Cardiology.

Dr Mriganka S Chaliha

(The writer is Head of the Department, Cardiology, AMCH)