Cardiology
As an electrophysiologist, Dr Viwe Mtwesi specialises in treating conditions that impact the heart’s electrical system. Since there aren’t many experts like her in the country, she brings a new dimension of cardiac care to Mediclinic Heart Hospital.
Understanding electrophysiology
Electrophysiology is a specialised branch of heart care that deals with the heart’s electrical system, which controls the heartbeat. It mainly focuses on irregular heart rhythms (arrhythmias), where the heart beats too fast, too slow, or unevenly due to faulty electrical signals. “We focus on inherited or congenital conditions of the heart, and inherited or acquired electrical conditions of the heart,” Dr Mtwesi says. “We then do procedures to cure, or at least halt, the progression of the disease.”
Electrical heart problems that develop over time are often linked to lifestyle choices. Dr Mtwesi explains that these conditions are becoming more common in Africa due to unhealthy diets and inactive lifestyles. This can lead to obesity, which increases the risk of heart rhythm issues.
Dr Mtwesi treats irregular heart rhythms by performing both simple and complex procedures. One of these is ventricular tachycardia ablation, where heat or cold energy is used to create small scars in the heart to stop faulty signals that cause irregular heartbeats. She also screens families with a history of sudden cardiac death for electrical abnormalities of the heart to see if they have inherited heart conditions.
In addition, Dr Mtwesi is researching sarcoidosis, a disease that causes inflammation in multiple organs. While not specific to heart rhythm issues, it can affect the heart’s electrical system. She explains that patients with sarcoidosis may also have problems with their lungs, liver, and heart.
Career trajectory
Dr Mtwesi is one of South Africa’s few electrophysiologists. She earned her medical degree from the University of Transkei (now Walter Sisulu University) and completed her internship in Cape Town and East London. She then pursued internal medicine and cardiology at Wits, graduating in 2017. During this time, she was also a member of former President Nelson Mandela’s medical team.
While studying cardiology, Dr Mtwesi became concerned at the lack of electrophysiology training in the country. “During my training, it was an area of weakness for most of us. We were never exposed to the field as there were no electrophysiologists in the public sector,” she says. She then pursued electrophysiology studies abroad to bring this much-needed expertise to South Africa. “Patients are dying when they’re not supposed to be just because there’s no-one qualified to help,” she says.
Dr Mtwesi went to Canada to study this specialisation. “I did two electrophysiology fellowships, one at McMaster University, and another at Western University,” she says. Since early 2024, she has been in private practice in South Africa and now shares her expertise at Mediclinic Heart Hospital.
Saving lives
Electrophysiology is a much-needed service in Pretoria – one that Mediclinic Heart Hospital can now provide. At the hospital, Dr Mtwesi mainly does electrophysiological procedures but also sees patients in her rooms and in the wards.
Having her on staff decreases the waiting time before patients see an electrophysiologist, bringing the service to them. Patients also travel in from Limpopo and other places in the north, she says.
Dr Mtwesi explains the benefits of better access to care: “Many patients take medication for years for conditions that could actually be cured. When the procedure is successful, they no longer need the medication and can live a normal life.” This is why she is passionate about electrophysiology and raising awareness about this specialty.