11 December 2014

Top 10 Medical Innovations according to the Cleveland Clinic (7)

Specialists of the Cleveland Clinic, Ohio, have compiled another annual list of innovations that, in their opinion, will have the greatest impact on the healthcare system in the coming 2015.

No. 7. Contactless heart rate driver

The heart of an adult at rest usually contracts from 60 to 100 times per minute. Slowing of the heart rate (bradycardia) indicates a violation of the functioning of the heart system conducting electrical signals.

In severe forms of bradycardia, the heart contracts so slowly that the blood it pumps is not enough to maintain the normal functioning of the body.

To solve this problem, surgically implanted pacemakers (heart rate drivers) are traditionally used, providing rhythmic myocardial contraction.

Since the implantation of the first rhythm driver in 1958, this technology has undergone only minor changes. An ordinary rhythm driver is a pulse generator the size of a dollar coin, placed in a subcutaneous surgical pocket under the collarbone. Thin wires stretched inside the vein – contacts – connect the pulse generator to the heart. The contacts register the patient's heart rate and transmit information to a generator, in which a chip adapts the electrical impulses emitted by it to the needs of the patient.

The contacts that lead to the myocardium causing it to contract electrical impulses are wires covered with insulating material, consisting of many thin wires. The end of this wire is implanted into the heart muscle, while the rest of it is freely located in the lumen of the vein.

Over time, contacts made of polyurethane or silicon oxide may break, and the insulating material covering them may become cracked. In 2% of cases, this leads to the formation of foci of infection. In about 3% of cases, there is a displacement of contacts. Replacement of damaged, worn out or failed contacts is possible, but it is a very complex and lengthy procedure.

Last year, approval for the use of a tiny contactless autonomous heart rate driver in clinical practice in Europe caused a great resonance among cardiologists around the world. The size of the heart rate driver of the new generation approximately corresponds to the size of a large tablet of a vitamin complex – 10 times smaller than the traditional one. The device is implanted directly into the right ventricle of the heart using a catheter inserted into the femoral vein. The duration of this non-surgical procedure is only 15-30 minutes.

The sensor electrode of the rhythm driver registers the heart rate and transmits the information to the generator, which provides the stimulation necessary to maintain a stable rhythm of contractions. The lithium battery built into the device is designed for at least 7 years of continuous operation. If it is necessary to replace the battery, the device is easily removed using a catheter and a new pacemaker is placed in its place.

This new technology makes it possible to avoid surgical interventions and all the side effects associated with them, as well as restrictions on physical activity and complications that develop when the contacts of traditional pacemakers are damaged. Currently, the US is undergoing the final stages of clinical trials of several variants of contactless heart rate drivers.

Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on the materials of the Cleveland Clinic: Top 10 Innovations for 2015.


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