Pacemaker, defibrillator combined in one device

December 23, 2010 7:28:03 PM PST
A new generation of heart implants is changing lives and according to a new study, saving them as well. The devices are actually a combination of two technologies.

For congestive heart failure patient Chet Consolazione even a short walk around his Petaluma garden would have been a challenge a year ago.

"I'd sit down on the floor and rest. Then I'd go back to bed again and take a nap," says Consolazione.

But he says that all changed dramatically, when doctors fitted him with a new generation heart device known as a cardiac resynchronization therapy defibrillator, or CRT-D.

"It's right there, under the collarbone. The procedure itself takes a minimum amount of time," says Consolazione.

The device is part pacemaker, part internal defibrillator. As shown in an animation, provided by the manufacturer -- Medtronic -- it can resynchronize the output of weakened heart chambers to squeeze maximum efficiency from a patient's heartbeat.

"And all of a sudden, I had all of the energy again. I wanted to go out and play tennis, ride my bike," says Consolazione.

While both pacemaker and defibrillator technologies have evolved over the decades, there is new evidence the combined device not only improves quality of life, but for some patients, can extend it as well.

A clinical trial sponsored by Medtronic focused on patients suffering from mildly symptomatic heart failure. That research recently published online in the New England Journal of Medicine, found the CRT-D device reduced deaths by 29 percent compared to other devices.

"The defibrillator is like having an ICU in your chest. It watches every heart beat 24 hours a day, 7 days a week," says Steven Hao, MD, FACC, from California Pacific Medical Center.

Hao explains how he device both charts and transmits a stream of critical information from the patient's body to a wireless receiver in the home. Information that's passed along over the phone lines to doctors and nurses. The device also intervenes in an emergency.

"If the heart ever goes out of rhythm into a life-threatening heart rhythm, it can detect it and stop that heart rhythm with an internal shock," says Hao.

Consolazione says his condition, since the device, has been steady with no serious issues. Still, he feels an extra sense of security knowing his data is being monitored.

"They automatically do it and send it into San Francisco. If there's a problem, I'll get a telephone call saying, 'Hey, you'd better get in to see your doctor,'" says Consolazione.

Now, beyond heart rhythm, doctors say the implants can collect data on breathing patterns and other issues that might predict when a patient's condition is getting worse.

Tim Didion wrote and produced this story.


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