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Medicine Biotech Science

Artificial Heart Recipient Has No Pulse 465

Posted by Soulskill from the just-a-low-pitched-hum dept.
laggist writes "A heart patient in Singapore has been implanted with an artificial heart that pumps blood continuously, allowing her to live without a pulse. From the article: '... the petite Madam Salina, who suffers from end-stage heart failure, would not have been able to use the older and bulkier models because they can only be implanted in patients 1.7m or taller. The 30-year-old administrative assistant is the first recipient here to get a new artificial heart that pumps blood continuously, the reason why there are no beats on her wrist.'" The story is light on details, but an article from last year in MIT's Technology Review explains a bit more about how a pulse-less artificial heart works.
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Artificial Heart Recipient Has No Pulse More

Artificial Heart Recipient Has No Pulse

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  • First pulse. (Score:5, Funny)

    by Anonymous Coward on Wednesday September 30, 2009 @10:16AM (#29593049)

    First pulse.

  • Should sleep with a sign on chest/back.. (Score:5, Insightful)

    by walmass ( 67905 ) on Wednesday September 30, 2009 @10:18AM (#29593069)
    "Paramedics/Doctors: Do not write me off as dead. Try to resuscitate"

  • Interesting concept... (Score:5, Insightful)

    by curmudgeous ( 710771 ) on Wednesday September 30, 2009 @10:18AM (#29593075)

    ...but I definitely see the need for a special Medic Alert badge for this.

    • Re: (Score:3, Insightful)

      by StikyPad ( 445176 )

      It's got an external power supply with a cable going into the chest is pretty much its own badge right there.

      Seriously, what do you think would possibly happen without a bracelet? The EMT's going to arrive and say "Oh hey, here's the problem.. there's a *cable* going into her chest. I'll just yank that out and.. [tug, grunt] There we go!"

  • All logic aside.. (Score:5, Funny)

    by faux978 ( 1554709 ) <shanecram@gmail.com> on Wednesday September 30, 2009 @10:18AM (#29593079)
    This probably wouldn't happen cause of medical history and all that jazz, but that aside, it'd be priceless to see a nurse unaware of the circumstance trying to take her pulse..

  • Any systems depend on a pulse (Score:5, Interesting)

    by MyLongNickName ( 822545 ) on Wednesday September 30, 2009 @10:18AM (#29593081) Journal

    With hundreds of millions of years of evolution, are there any systems in the human body that are dependent on the pulse to function properly?

    • Re:Any systems depend on a pulse (Score:5, Insightful)

      by Anonymous Coward on Wednesday September 30, 2009 @10:21AM (#29593117)

      We'll find out pretty soon now, won't we?

    • Re: (Score:3, Interesting)

      by Danathar ( 267989 )

      Good question. And it's one (according to the article links) they are asking. Note that just because something has had hundreds of millions of years of evolution does not mean it's very good or could not be improved upon. Look at the Sinus cavity for example.

    • Re:Any systems depend on a pulse (Score:4, Informative)

      by dsanfte ( 443781 ) on Wednesday September 30, 2009 @10:24AM (#29593149) Journal

      Most of these artificial heart patients end up dying of strokes, caused of course by blood clots. It's theorized that such clots are easier to form in a pulse-less environment of steady-flow than in an environment where the blood is being "shaken" a bit, ie the pulse with each heartbeat.

      • Re:Any systems depend on a pulse (Score:5, Interesting)

        by MBGMorden ( 803437 ) on Wednesday September 30, 2009 @10:43AM (#29593459)

        Well if we're in there redesigning the system anyways, it seems that there should be some way to filter or shake the blood as it passes through this thing to prevent clotting. Heck in some distant future it'd be interesting to see if it could be designed to filter out unwanted levels things like cholesterol and the like. Or for diabetics, directly monitor blood-sugar levels and inject insulin as needed to keep things under control.

        Or with it being in such directly contact with so many of the body's essential systems, perhaps enough monitors could be built in that it could via wifi or the like send signals to the local dispatch office if the blood stops flowing, or if the blood pressure crosses a certain threshold.

        Of course I'm playing armchair medical engineer here with no real knowledge whatsoever, but that's what most "futurists" do anyways :D.

        • Re: (Score:3, Funny)

          by theJML ( 911853 )

          So you want SNMP monitoring for your heart?

          Nothing like getting a page about your heart malfunctioning...

        • Re:Any systems depend on a pulse (Score:4, Interesting)

          by slack_justyb ( 862874 ) on Wednesday September 30, 2009 @12:20PM (#29595071)

          perhaps enough monitors could be built in that it could via wifi or the like send signals to the local dispatch office if the blood stops flowing

          Finally, a use case for IPv6. Give an address to every human organ in every human. I purpose that we use the 2001:911::/32 address space so that it is easy to remember your organs' IP address.

          Oh God! I think I'm having a heart attack, quick someone SNMP to 2001:911:34A:2F71::2 and send the restart command!

    • Re: (Score:3, Insightful)

      by sopssa ( 1498795 ) *

      Maybe human body isn't required to have a pulse, but it might lead to some weird situations when first-aid personnel or other people try to help you.

      Maybe they'll even declare you dead while you're just unconscious, because they nor the machines can feel your pulse.

      • Re: (Score:3, Informative)

        by gandhi_2 ( 1108023 )
        First-aid personnel cannot declare anything. Even a paramedic cannot diagnose. Once you start CPR or rescue breathing, you cannot stop until relieved by higher medical authority or too exhausted to continue.

        I would bet that an EMT, nurse, or doctor would realize something's going on in the chest upon auscultation of the apices, and in a triage situation you don't bother with the non-breathers until the bleeders are taken care of.

        • Re: (Score:3, Insightful)

          by TheLink ( 130905 )
          Well I hope they don't try the defibrillator ;).

          How do they power the heart though, and how long does it run "portable".

          It might well be that people/animals with artificial hearts are more likely to survive drowning since the artificial heart might still merrily pump away even if the blood oxygen drops low. And when someone finally does get the air into the lungs (and the water out first), there's no need to kickstart the heart - it's already pumping the oxygenized blood.

    • Re:Any systems depend on a pulse (Score:5, Funny)

      by 0x000000 ( 841725 ) on Wednesday September 30, 2009 @10:26AM (#29593175)

      Apparently not a single organ in the body does serial communication by having it clocked in or out on the rising or falling edge of the pulse.

    • Re:Any systems depend on a pulse (Score:5, Informative)

      by Myji Humoz ( 1535565 ) on Wednesday September 30, 2009 @10:27AM (#29593183)
      Speaking as a biomedical engineer, there are no significant systems that we know of that require a varying pressure of blood to function correctly. The pulse as the blood gets pumped stretches the arterial and capillary walls slightly, but that's about it. Very few cells in the body experience the effects of the pulsing pressure to begin with, and those tend to be ones that can function despite the pulse rather than because of it.

    • Don't worry, the penguin's kernel has evolved to pulseless a few years ago and is all fine and dandy :P

    • Re: (Score:3, Insightful)

      by dbet ( 1607261 )
      I don't know, but putting my head on someone's chest and not hearing a heartbeat would be pretty freaky. So -1 for cuddling.

  • Awesome... (Score:4, Funny)

    by pohl ( 872 ) on Wednesday September 30, 2009 @10:21AM (#29593105) Homepage

    ...now I only need to come up with the perfect crime that only a person with no pulse could get away with and I can cash-in on a screenplay for an episode of CSI.

  • Blood pressure issues? (Score:5, Interesting)

    by ShadowRangerRIT ( 1301549 ) on Wednesday September 30, 2009 @10:22AM (#29593125)
    The article doesn't address this, but I'm a little concerned by the idea of a pulseless system. On the one hand, there is no pressure spike, but on the other hand, the pressure never lets up. I'[m curious what effect this sort of device will have on strokes and other blood flow disturbances. The steady pulse-and-release rhythm constantly tugs at potential clots in different directions, presumably breaking up many incipient clots. Will a steady flow system do the same?

  • What about clotting? (Score:4, Interesting)

    by cyberjock1980 ( 1131059 ) on Wednesday September 30, 2009 @10:27AM (#29593197)

    I'm no med student. I'm just curious. I had heard that blood clotting relies on the blood remaining still for a period of time. Normally your pulse still allows for clotting because of the brief period of time that the blood doesn't flow. If you get a cut, you will bleed. In this case if the blood never stops moving will the individual bleed to death from something as simple as a papercut?

    But at the same time, if that were the case how did the patient survive the surgery?

  • Arterial contraction (Score:3, Insightful)

    by angrytuna ( 599871 ) on Wednesday September 30, 2009 @10:29AM (#29593227)
    Wouldn't this cause problems with perfusion? As I understand it, the arteries absorb some of the force of the heart's contraction due to their elasticity, and reuse it when they contract in turn to send the blood to more distal points in the body. It's been suggested that increased arterial stiffness is associated with the development of cardiovascular disease, and it seems like this might cause a similar effect over time. If you're getting an artificial heart, perhaps this point is moot, and from the story, it sounds like she doesn't have a choice, but I wonder if it would be an issue.

    • Re: (Score:3, Informative)

      by matt4077 ( 581118 )
      The problem with stiff arteries is that they conduct the pulse wave a lot faster. As it is reflected at junctions and narrow passages in the arteries, it can then get back to the heart while the aortic valve is still open. The heart then has to work against the higher pressure, which increases the workload and eventually leads to heart diseases.

  • Kinda like a rotary... (Score:5, Funny)

    by Nexus7 ( 2919 ) on Wednesday September 30, 2009 @10:30AM (#29593251)

    You know,
          piston engine go boing boing boing... rotary go mmmmmmmmmmmmmm...

  • Does she feel any different? (Score:5, Interesting)

    by BobMcD ( 601576 ) on Wednesday September 30, 2009 @10:31AM (#29593281)

    Having always had a heartbeat since birth, I can only assume that I can feel it beat, but am ignoring it. Obviously there are exceptions where I can very much feel and hear my pulse, and am very well aware of it.

    She'll never feel that again.

    Does she notice?

    • Re:Does she feel any different? (Score:5, Insightful)

      by dpilot ( 134227 ) on Wednesday September 30, 2009 @10:56AM (#29593657) Homepage Journal

      Without the implant, she won't feel anything again. There's no way to put this other than that it's a life-changing event. Many things after this will be different from the way they were before. But generally a life-changing event is to be preferred over a life-ending event.

    • Re:Does she feel any different? (Score:5, Interesting)

      by PaganRitual ( 551879 ) <<splaga> <at> <internode.on.net>> on Wednesday September 30, 2009 @09:25PM (#29600917)

      I'll swap with her. I've had an artifical heart valve since very shortly after birth, and every single pulse of my life since I've been old enough to understand the concept of my heart beating is, so long as it's not overly noisy, completely audible. And because it's an internal noise, or because I know what to listen for, it's much easier to pick up than you would think. I'm sitting in an office with about 10 people all working at computers and I can hear it now.

      Allow me to assure you that the tick of your own heart beating audibly for every single fucking beat, will slowly but almost certainly drive you mad. I used to sleep with a radio every single night on for a period of virtually 10 years. Even now from time to time I go to bed with headphones on to not bother my wife but still drown out the ticking.

      I would swap an audible pulse for no pulse at all in a ... well, heartbeat.

  • No pulse? She's dead! (Score:3, Insightful)

    by Anonymous Coward on Wednesday September 30, 2009 @10:32AM (#29593287)

    Oh wait, no she's not. She's fucking BREATHING.

    You're all idiots to think doctors, nurses and paramedics can't see if a person is breathing or not.

  • Vonda N. McIntire, "Superluminal" (Score:4, Interesting)

    by argent ( 18001 ) <peter@slashdot . ... t a r o nga.com> on Wednesday September 30, 2009 @10:40AM (#29593405) Homepage Journal

    In Vonda McIntyre's novel "Superluminal" starship pilots had to have their hearts replaced with a rotary pump because the rhythm of the heartbeat caused a breakdown in their bodies during FTL flight.

    They called the pulse-less pilots "Aztecs".

  • New rules required. (Score:5, Funny)

    by ThatsNotFunny ( 775189 ) on Wednesday September 30, 2009 @10:44AM (#29593477)
    I shall now have to amend my requirements for women that I will have sex with.

    Pulse now optional.

  • The perfect sniper (Score:5, Funny)

    by isThisNameAvailable ( 1496341 ) on Wednesday September 30, 2009 @10:53AM (#29593627)
    Snipers have to concentrate to manage their heart rates and time their shots between beats. A little practice and we've now got the world's quickest shot at 1,000 meters.

  • Heart Mate II Pump (Score:5, Informative)

    by t00le ( 136364 ) on Wednesday September 30, 2009 @11:01AM (#29593733)

    She is holding a Heart Mate II pump...most of our patients get this model...and NONE have a regular pulse. Funny since this is just breaking news and St Lukes Heart Transplant do it day in and day out, for a loooong time.

    • Re:Heart Mate II Pump (Score:4, Informative)

      by tomdarch ( 225937 ) on Wednesday September 30, 2009 @01:17PM (#29595951)
      My father-in-law has a HeartmateII. In planning a family vacation after his recovery, we called the airline we were flying to review the issues with his having the implanted device. Someone took a bunch of notes and forwarded them to some sort of engineering staff at the airline. The response was "It's no problem. He just needs to turn off the device at takeoff and landing." Bwahahahahhah! (In the end, everything went fine, and, no, he didn't shut off his pump at takeoff or landing!)

    • Re:Heart Mate II Pump (Score:5, Interesting)

      by Spaceman Spiff II ( 552149 ) <gabe@gabedurazo.com> on Wednesday September 30, 2009 @03:17PM (#29597597) Homepage
      I was looking for this comment as the tech is not new. I was surprised to see it now on Slashdot. Ventricular Assist Devices have been around for a long time, and I know that at least Thoratec's Heartmate II and Heartware's HVAD are continuous flow. At least 50 [reuters.com] people in the US already have Heartware's device in them, and I think there's been a European study, too. One thing I've heard and would be curious to know if it's true, is that even though the device is a continuous flow pump many patients spontaneously develop a pulse anyway. Have you seen that?

  • What's her blood pressure? (Score:3, Interesting)

    by Assmasher ( 456699 ) on Wednesday September 30, 2009 @11:03AM (#29593777) Journal

    Curious, honestly... I wonder what the long term ramifications of having a non-fluctuating bp are?

  • this is great, but why not just regorw the heart? (Score:3, Interesting)

    by PJ6 ( 1151747 ) on Wednesday September 30, 2009 @11:05AM (#29593795)
    It's good that these devices can now last years, but why wouldn't they keep the heart they take out, remove all the cells from the heart's tissue scaffold, and then regrow it with her own stem cells? They've already done this successfully in animals. One would assume that putting the original back in would be a better, and in the long run, cheaper option.

  • Embodied Cognition (Score:3, Insightful)

    by commisaro ( 1007549 ) on Wednesday September 30, 2009 @11:19AM (#29594029) Homepage
    I wonder what effect this would have on emotional response. There is growing evidence that there is a two-way feedback loop between subjective emotion and bodily affect. In other words, not only does being nervous cause your heartrate to increase, but an increased heartrate makes you feel more nervous. I would be very interesting to see if this pulse-less heart would result in flatter emotional responses.

  • Only the implant is new - maybe (Score:3, Informative)

    by kwerle ( 39371 ) <kurt@CircleW.org> on Wednesday September 30, 2009 @12:25PM (#29595143) Homepage Journal

    My partner was an ICU nurse and used continuous flow VADs (Ventricular Assist Device) for years.

    Here's an article from 2000: http://circ.ahajournals.org/cgi/content/abstract/circulationaha;101/4/356 [ahajournals.org]

    There is some controversy about continuous flow, but the notion is that most of the body experiences nearly continuous flow, anyway.

    Implanted continuous flow notes from April: http://www.ncbi.nlm.nih.gov/pubmed/19324130 [nih.gov]

    And another from 2008 implying that pulseless does not matter:
    http://www.ncbi.nlm.nih.gov/pubmed/18442710?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed [nih.gov]

  • "Superluminal", by Vonda McIntyre (Score:3, Informative)

    by goodmanj ( 234846 ) on Wednesday September 30, 2009 @03:07PM (#29597521)

    Read "Superluminal", by Vonda McIntyre. It's a sci-fi story about a woman who gets a turbopump heart that doesn't beat -- not because she's sick, but because it's a necessary part of becoming a starship pilot. Romance and heartbreak ensue.

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