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Doctors broke new ground for Oklahoma medicine, implanting a Tulsa resident with a pacemaker that could make the office visit obsolete.
Oklahoma Heart Institute doctors implanted the patient with St. Jude Medical Inc.’s Accent RF pacemaker, an implantable device that sends electrical pulses to the heart whenever it senses the heartbeat is too slow, using wireless technology to communicate a daily data stream to MDs via a secure Web site.
“Basically, the pacemaker has an RF transmitter not unlike your laptop,” said Dr. Craig Cameron, a cardiac electrophysiologist at the Oklahoma Heart Institute. “The device transmits daily (through an antenna in a patient’s home).”
The FDA only just approved the device and similar technology the Anthem RF cardiac resynchronization therapy pacemaker July 21, but Cameron said the idea has been around much longer.
“The technology has been around for a few years, predominately in ICDs (implantable cardioverter defibrillator), because ICDs are more complicated devices with more potential for failure or malfunction,” he said.
The benefits of daily transmittal, Cameron said, are several-fold, not the least of which is monitoring for an irregular rhythm called atrial fibrillation — an often asymptomatic condition characterized by the quivering, opposed to coordinated contraction, of the muscles in the atria, the upper two chambers of the heart.
“Afib is the most common type of arrhythmia in adults but is hard to catch,” Cameron said. “Unfortunately, the first presentation of atrial fibrillation is usually for the patient to have a stroke.”
The system sends cardiologists an alert after detecting a substantial or repeated irregular rhythm. The
devices can also be programmed to notify the patient of episodes with an audible alert.
“If we find it quickly enough, we can put patients on blood thinners and hopefully prevent (stroke),” Cameron said.
The Accent and Anthem also allow the patient to do routine monitoring from home, providing improved patient convenience as well as a large quantity of data for the treating physician.
“What we used to do every three to six months in the office, they can do from home every day,” Cameron said. “Generally speaking, the more informed you are the better off you are.”
The new technology does carry a possible downside. Due to increased function, the devices’ battery life may suffer, though bench tests provided by St. Jude showed the Accent and Anthem’s battery life was comparable to other pacemakers. When an implantable medical device runs out of batteries, it must be surgically removed and replaced.
While St. Jude is one of two companies currently supplying wireless pacemakers, Cameron said he expects to see this technology become standard.
“What typically happens is one manufacturer comes up with a feature that is valuable like this and then the rest of the companies follow suit,” he said. “There is no reason in my mind not to use this piece of equipment.” ?



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