A doctor called the pacemaker company, furious that the newly implanted device was NOT pacing his patient's heart properly. As part of the troubleshooting, the technical services rep routinely asked the doctor what kind of wires were connected to the pacemaker as they then led into the heart.
The doctor said, "Wires? What wires?"
Sunday, February 7, 2010
Say what ? (jokes)
During a pacemaker implant, the pacemaker company rep saw the surgeon cut an arterial vessel, causing blood to squirt 15 feet away fom the patient's body. The surgeon quickly put light pressure on the area to stop the minor bleeding. He then looked at the rep and asked if he'd ever seen that before. The rep said, "No." "Good, and you never did ...." said the surgeon.
Which Brand of Pacemaker / ICD is Best ?
So your doctor has advised you to be implanted with a pacemaker or ICD based on your indications.
Should you be concerned as to which BRAND of device he / she implants ?
No. There are several fine medical device companies out there and all make great devices. All devices go through stringent quality control measures and thorough testing via U.S. FDA procedures before approval is given in the United States.
The major, top brands include: BIOTRONIK, BOSTON SCIENTIFIC, MEDTRONIC AND ST. JUDE MEDICAL
You'd be good with any of these.
Talk with your doctor as specific device features may be a priority to your situation.
Should you be concerned as to which BRAND of device he / she implants ?
No. There are several fine medical device companies out there and all make great devices. All devices go through stringent quality control measures and thorough testing via U.S. FDA procedures before approval is given in the United States.
The major, top brands include: BIOTRONIK, BOSTON SCIENTIFIC, MEDTRONIC AND ST. JUDE MEDICAL
You'd be good with any of these.
Talk with your doctor as specific device features may be a priority to your situation.
Holter Monitors
So your doctor has suggested that you wear a 24-48 hour holter monitor. This is okay provided you don't like to wear an item like this for more than 24-48 hours due to skin irritation, upcoming travel, work issues, etc.
But... research has shown that holter monitors are only 8-10% effective in catching whatever rhythm/symptom the doctor was wanting to investigate.
Why only 8-10% effective ? Because it's being worn for such a short amount of time. But let's be real, if you're having numerous symptoms on a daily basis, odds are you'll catch the rhythm with a simple holter monitor.
But if this is a "feeling" that you have periodically throughout the month, a 21 day cardac event monitor may be better suited in tying symptoms to an actual cardiac event ... if its cardiac related.
Talk with your doctor.
But... research has shown that holter monitors are only 8-10% effective in catching whatever rhythm/symptom the doctor was wanting to investigate.
Why only 8-10% effective ? Because it's being worn for such a short amount of time. But let's be real, if you're having numerous symptoms on a daily basis, odds are you'll catch the rhythm with a simple holter monitor.
But if this is a "feeling" that you have periodically throughout the month, a 21 day cardac event monitor may be better suited in tying symptoms to an actual cardiac event ... if its cardiac related.
Talk with your doctor.
Cardiac Event Monitors
So your doctor has suggested that you wear a cardiac event monitor for up to 21 days to determine what may be causing your fainting spells ?
Do it!
They're simple, don't get in the way of your lifestyle ... and you barely know that you're wearing it.
Besides, many are fully automated so you don't even have to press a button for transmissions.
Top provider companies include: eCardio, Cardionet and Lifewatch
Do it!
They're simple, don't get in the way of your lifestyle ... and you barely know that you're wearing it.
Besides, many are fully automated so you don't even have to press a button for transmissions.
Top provider companies include: eCardio, Cardionet and Lifewatch
Saturday, February 6, 2010
Do you have Chronic Atrial Fibrillation ?
Oftentimes the prescription of Warfarin (Coumadin) becomes a lifetime prescription. Patients are often asked to monitor the blood thinning capabilities of the drug via a "Coumadin" clinic at their doctor's office. It's all about stroke prevention ....
Follow your doctor's orders when it comes to this drug !!
Follow your doctor's orders when it comes to this drug !!
FDA Probing RFID Interference in Pacemakers, ICDs
The FDA has done some basic research suggesting that radio frequency identification readers (RFID) may electronically affect Pacemakers and ICDs.
Extremely low risk of interference but ... worthy of an investigation by manufacturers for current devices and mitigating the issue for future devices.
For more information visit:
www.heartrhythmjournal.com
Extremely low risk of interference but ... worthy of an investigation by manufacturers for current devices and mitigating the issue for future devices.
For more information visit:
www.heartrhythmjournal.com
St. Jude Medical Sponsors SCD-HeFT 10 Year Study
St. Jude Medical has announced its intentions to support a 10 year follow-up for those patients previously enrolled in the SCD-HeFT Trial.
Many of those patients went on to receive an ICD.
The purpose is to follow those study patients since the close of the follow-up section of the trial dated October 31, 2003.
If you or someone you know may have been part of this study, contact your doctor. They may be looking for you regarding this additional research.
Many of those patients went on to receive an ICD.
The purpose is to follow those study patients since the close of the follow-up section of the trial dated October 31, 2003.
If you or someone you know may have been part of this study, contact your doctor. They may be looking for you regarding this additional research.
Psychology of a Pacemaker / ICD Patient
Once a person receives an implanted device, i.e., pacemaker or ICD, their life can begin to revolve around the fact that they have a device .... that they're somehow different from their friends and family.
Unique maybe. Different? No.
Hopefully, before implantation and definitely after, the patient needs to have in place an external positive influence such as a wife/husband/partner or Support Group, self-confidence in the technology implanted in them and a renewed attitude that the device should improve their quality of life.
If they do these little things, research has shown that both their longterm outcomes and quality of life typically improve.
Unique maybe. Different? No.
Hopefully, before implantation and definitely after, the patient needs to have in place an external positive influence such as a wife/husband/partner or Support Group, self-confidence in the technology implanted in them and a renewed attitude that the device should improve their quality of life.
If they do these little things, research has shown that both their longterm outcomes and quality of life typically improve.
Friday, February 5, 2010
GO RED FOR WOMEN !! Friday, February 5, 2010
Women, take care of your heart and demand that your loved ones listen to you when you have symptoms.
Among the many symptoms: chest pain, fatigue, shortness of breath ... tell someone.
Annually, more women die of heart disease than the next 5 causes ... COMBINED.
Did you wear RED today ? It's not too late.
Among the many symptoms: chest pain, fatigue, shortness of breath ... tell someone.
Annually, more women die of heart disease than the next 5 causes ... COMBINED.
Did you wear RED today ? It's not too late.
Pacemaker: when technology is questioned ...
a sample size of ONE is just that ... one. Patients should be concerned about more pressing issues .... such as take your heart medication as prescribed, exercise as directed by your physician, common sense stuff ...
But alleged Pacemaker malfunctions always lead the headlines ...
Weakened ICD Header Bond: Abnormality Not Limited to Subpectoral Implants
Joseph J. Germano, Alicia Darge, William H. Maisel
Introduction
In December 2009, Boston Scientific (Natick, MA) issued a Product Advisory reporting that mechanical stress associated with subpectoral ICD implantation may
weaken the bond between the header and the titanium case in Cognis cardiac resynchronization therapy defibrillators (CRT-Ds) and Teligen implantable cardioverter
defibrillators (ICDs). Boston Scientific specifically noted that the Product Advisory did not affect subcutaneous implants. This report contains the details of a patient with a Boston Scientific Cognis
CRT-D with a subcutaneous implant who experienced a weakened bond between the device header and case resulting in noise and inappropriate therapies.
http://www.heartrhythmjournal.com/inpress
(See attached file: Heart Rhythm_Subpectoral Implant_Boston Scientific_February 2009.pdf)
But alleged Pacemaker malfunctions always lead the headlines ...
Weakened ICD Header Bond: Abnormality Not Limited to Subpectoral Implants
Joseph J. Germano, Alicia Darge, William H. Maisel
Introduction
In December 2009, Boston Scientific (Natick, MA) issued a Product Advisory reporting that mechanical stress associated with subpectoral ICD implantation may
weaken the bond between the header and the titanium case in Cognis cardiac resynchronization therapy defibrillators (CRT-Ds) and Teligen implantable cardioverter
defibrillators (ICDs). Boston Scientific specifically noted that the Product Advisory did not affect subcutaneous implants. This report contains the details of a patient with a Boston Scientific Cognis
CRT-D with a subcutaneous implant who experienced a weakened bond between the device header and case resulting in noise and inappropriate therapies.
http://www.heartrhythmjournal.com/inpress
(See attached file: Heart Rhythm_Subpectoral Implant_Boston Scientific_February 2009.pdf)
Pacemakers: self-adjusting to the heart ?
Pacemakers: don't you appreciate innovative technology and the new ideas as they emerge from the research labs ?
SELF ADJUSTING PACEMAKER CONCEPT
The Feasibility of Fully Automated Pacemaker Advise in Treating Atrial Tachyarrhythmias
JACOB H. RUITER, M.D.*, ELLES MULDER, Ph.D.†, ANDREAS SCHUCHERT, M.D.‡, HARAN BURRI, M.D.§, MARKUS C. STÜHLINGER, M.D.¶, JUHA HARTIKAINEN, M.D.**, SERGIO SERMASI, M.D.††, JITKA VLAŠÍNOVÁ, M.D.‡‡, GEORGES H. MAIRESSE, M.D.§§, EBERHARD BUB, M.D.¶¶, and THORSTEN LEWALTER, M.D.***, on behalf of the T-STAR Study Group.
From the *Medisch Centrum Alkmaar, Alkmaar, The Netherlands ; †Medtronic, PJ Heerlen, The Netherlands ; ‡Friedrich-Ebert-Krankenhaus, Neumünster, Germany ; §University Hospital Geneva, Geneva, Switzerland ; ¶University Clinic of Innsbruck, Innsbruck, Austria ; **Kuopio University Hospital, Kuopio, Finland ; ††University Hospital Rimini, Rimini, Italy ; ‡‡University Hospital Brno, Brno, Czech Republic ; §§Cliniques du Sud-Luxembourg, Arlon, Belgium ; ¶¶Cardiologic Clinic Bub and Habbel, Holzminden, Germany ; and ***University Clinic Bonn, Bonn, Germany
Correspondence to Address for reprints: Jacob H. Ruiter, M.D., Department of cardiology, Medisch Centrum Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. Fax: 072-5482157; e-mail: j.h.ruiter@mca.nl
Disclosures: Dr. Mulder is an employee of Medtronic. The other authors report no conflict of interest.
ABSTRACT
Background: Modern pacemakers continuously store significant cardiac-related events. Interpreting these data and reprogramming the pacemaker can be time-consuming and demands expert knowledge. A software-based expert system, the therapy advisor (TA), was developed, which analyzes stored data and provides reprogramming recommendations. This study addresses whether pacemaker experts consider the messages that are automatically generated appropriate in the management of atrial tachyarrhythmias/
atrial fibrillation (AT/AF).
Methods: This observational, international, multicenter study follows 150 patients with suspected or documented atrial arrhythmias who received a dual-chamber pacemaker (model Vitatron T-70, Medtronic Inc., Minneapolis, MN, USA) incorporating the TA . The TA summarizes technical and clinical data stored in the pacemaker into key messages and may suggest programming changes. Twenty-five cardiologists examined their patients per normal practice during two follow-up visits. They reported the therapy changes they deemed necessary without initially reviewing the TA messages. Next, they rated their satisfaction with and the clinical relevance of the TA messages and recorded the final therapy changes.
Results: The TA generated (mostly AT/AF-related) main observations in 49% and programming advice in 33% of the patients. The experts rated 95% of the TA messages as satisfactory and deemed therapy changes necessary in roughly half the patients. Pacemaker changes in AT/AF therapy or general settings were prompted primarily by the diagnostic information stored in the device. Medication changes were mostly led by the symptoms reported by the patient.
Conclusion: This study demonstrates that experienced cardiologists agree with 95% of the observations and programming suggestions that the TA automatically generates. (PACE 2010; 1–10)
http://www3.interscience.wiley.com/journal/123269819/abstract
SELF ADJUSTING PACEMAKER CONCEPT
The Feasibility of Fully Automated Pacemaker Advise in Treating Atrial Tachyarrhythmias
JACOB H. RUITER, M.D.*, ELLES MULDER, Ph.D.†, ANDREAS SCHUCHERT, M.D.‡, HARAN BURRI, M.D.§, MARKUS C. STÜHLINGER, M.D.¶, JUHA HARTIKAINEN, M.D.**, SERGIO SERMASI, M.D.††, JITKA VLAŠÍNOVÁ, M.D.‡‡, GEORGES H. MAIRESSE, M.D.§§, EBERHARD BUB, M.D.¶¶, and THORSTEN LEWALTER, M.D.***, on behalf of the T-STAR Study Group.
From the *Medisch Centrum Alkmaar, Alkmaar, The Netherlands ; †Medtronic, PJ Heerlen, The Netherlands ; ‡Friedrich-Ebert-Krankenhaus, Neumünster, Germany ; §University Hospital Geneva, Geneva, Switzerland ; ¶University Clinic of Innsbruck, Innsbruck, Austria ; **Kuopio University Hospital, Kuopio, Finland ; ††University Hospital Rimini, Rimini, Italy ; ‡‡University Hospital Brno, Brno, Czech Republic ; §§Cliniques du Sud-Luxembourg, Arlon, Belgium ; ¶¶Cardiologic Clinic Bub and Habbel, Holzminden, Germany ; and ***University Clinic Bonn, Bonn, Germany
Correspondence to Address for reprints: Jacob H. Ruiter, M.D., Department of cardiology, Medisch Centrum Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. Fax: 072-5482157; e-mail: j.h.ruiter@mca.nl
Disclosures: Dr. Mulder is an employee of Medtronic. The other authors report no conflict of interest.
ABSTRACT
Background: Modern pacemakers continuously store significant cardiac-related events. Interpreting these data and reprogramming the pacemaker can be time-consuming and demands expert knowledge. A software-based expert system, the therapy advisor (TA), was developed, which analyzes stored data and provides reprogramming recommendations. This study addresses whether pacemaker experts consider the messages that are automatically generated appropriate in the management of atrial tachyarrhythmias/
atrial fibrillation (AT/AF).
Methods: This observational, international, multicenter study follows 150 patients with suspected or documented atrial arrhythmias who received a dual-chamber pacemaker (model Vitatron T-70, Medtronic Inc., Minneapolis, MN, USA) incorporating the TA . The TA summarizes technical and clinical data stored in the pacemaker into key messages and may suggest programming changes. Twenty-five cardiologists examined their patients per normal practice during two follow-up visits. They reported the therapy changes they deemed necessary without initially reviewing the TA messages. Next, they rated their satisfaction with and the clinical relevance of the TA messages and recorded the final therapy changes.
Results: The TA generated (mostly AT/AF-related) main observations in 49% and programming advice in 33% of the patients. The experts rated 95% of the TA messages as satisfactory and deemed therapy changes necessary in roughly half the patients. Pacemaker changes in AT/AF therapy or general settings were prompted primarily by the diagnostic information stored in the device. Medication changes were mostly led by the symptoms reported by the patient.
Conclusion: This study demonstrates that experienced cardiologists agree with 95% of the observations and programming suggestions that the TA automatically generates. (PACE 2010; 1–10)
http://www3.interscience.wiley.com/journal/123269819/abstract
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