Forgot your password?
typodupeerror
Medicine

Tiny Pacemaker Can Be Installed Via Catheter 57

Posted by Unknown Lamer
from the welcome-blood-robot-overlords dept.
the_newsbeagle writes "About four million people around the world have pacemakers implanted in their bodies, and those devices all got there the same way: surgeons sliced open their patients' shoulders and inserted the pulse-generating devices in the flesh near the heart, then attached tiny wires to the heart muscle. ... A device that just received approval in the EU seems to solve those problems. This tiny pacemaker is the first that doesn't require wires to bring the electrical signal to the heart muscle, because it's implanted inside the heart itself, and is hooked onto the inner wall of one of the heart's chambers. This is possible because the cylindrical device can be inserted and attached using a steerable catheter that's snaked up through the femoral artery."
This discussion has been archived. No new comments can be posted.

Tiny Pacemaker Can Be Installed Via Catheter

Comments Filter:
  • This is exciting.. (Score:5, Insightful)

    by mulvane (692631) on Wednesday October 16, 2013 @01:31PM (#45145081)
    The things we can do now adays in medicine are shocking...
    • by Anonymous Coward

      The things we can do now adays in medicine are shocking...

      I had a technique similar to this done almost 8 years ago. It was a radio catheter ablation done to correct atrial fibrillation. They went up through my groin and burned scars around my exiting heart valves to stop "Stray Voltage" in my heart. My heart hasn't skipped a beat since, and I was out of the hospital in just a day or two. This seems like a very logical next step, I can't imagine how much pain this is saving the patients.

    • The things we can do now adays in medicine are shocking...

      Sadly there's no cure for junctural metanalysis [wikipedia.org]

    • The things we can do now adays in medicine are shocking...

      The article claims the thing can last "up to 13 years" before having to be replaced.

      In the past, we used Pu-238 RTGs called "Plutonium cells", and the pacemakers never had to be replaced.

      I guess this step backwards, towards treating pacemakers as a treatment, rather than a cure, guarantees a recurring revenue stream. One wonders, given the industry that surrounds it, whether we will ever get a cure for anything that started out with just a treatment, such as diabetes, when there's so much money tied up in

      • Maybe, perhaps, it's easier to treat a discrete problem (fast / slow/ intermittent ) heart rate than to solve the rather difficult problem of aging.

        Think about it. They're not really after you.

      • by joseph90 (193138)

        The things we can do now adays in medicine are shocking...

        The article claims the thing can last "up to 13 years" before having to be replaced.

        In the past, we used Pu-238 RTGs called "Plutonium cells", and the pacemakers never had to be replaced.

        I guess this step backwards, towards treating pacemakers as a treatment, rather than a cure, guarantees a recurring revenue stream. One wonders, given the industry that surrounds it, whether we will ever get a cure for anything that started out with just a treatment, such as diabetes, when there's so much money tied up in "recurring revenue streams" and so little in "pay for it once". The whole SAS field itself is based on it.

        The problem with the plutonium cells was that when you died you had to be buried as nuclear waste (or so I was told).

        • by CastrTroy (595695)
          Why not just have the batteries removed after you're dead. It's not like the operation would kill you. You could probably get it done for free if you let med students do the task for you.
  • Whew! (Score:5, Funny)

    by DaTroof (678806) on Wednesday October 16, 2013 @01:35PM (#45145121)
    Ah, through the femoral artery. My imagination went to a much more horrifying place when I read "catheter."
    • Re: (Score:3, Funny)

      by Anonymous Coward

      I bet there's a market for electrostim prostate implants, though.

    • by Keith111 (1862190)
      I thought that science had finally proven that the path to a man's heart isn't through his stomach once and for all... :(
      • I thought that science had finally proven that the path to a man's heart isn't through his stomach once and for all... :(

        Yes, that was an old wives tale started to deny and suppress the "Happy Penis, Happy Man" axiom...
        Old Wives be bitches sometimes...

      • by mcgrew (92797) *

        I thought that science had finally proven that the path to a man's heart isn't through his stomach once and for all... :(

        That old canard is misunderstood. The best way to a man's heart is through his stomach if you're trying to stab him to death.

    • It's bad enough. Ever had a catheter go to your heart?

      It starts out fine. In my case, it was to pull a clot out of a coronary artery, and the heart attack pain just stopped very abruptly. Great.

      Then there was the staying still for ten hours. I really don't know why it was so bad, but after about seven it hurt more than the heart attack had. When I talked about it to the nurses, they said they'd heard that a lot.

      If there is a next time, I'm asking for the painkillers earlier.

  • by The_Star_Child (2660919) on Wednesday October 16, 2013 @01:41PM (#45145203)
    The quickest way to a man's heart is through his catheter.
  • "Well, there's a delicate corneal inversion procedure... a multi-opti-pupil-optomy. But, in order to keep from damaging the eye sockets, they've got to go in through the rectum. Ain't no man going to take that route with me! "

  • Sign me up! (Score:5, Interesting)

    by Eggplant62 (120514) on Wednesday October 16, 2013 @01:54PM (#45145349)

    Around Christmastime 2011, I developed paroxysmal non-nodal reentrant supraventricular tachycardia, likely stemming from my maternal grandmother's history of similar cardiac problems, and underwent radiofrequency catheter ablation of the bad conducting circuit in my atrial tissue. I'm left with no fast pacing circuit to increase my heart rate on demand when I'm exercising. I know people with implanted pacer/defibrillators, and I work as medical transcriptionist and have typed a zillion of those procedures, and the things they despise about it is the problems with tissue pocket infections and interval battery replacements, requiring the site to be reopened, the equipment removed and replaced, antibiotic washout, reclosure, etc. I'll be bugging my doc at next visit to research it and determine if I can get one of these.

  • surgeons sliced open their patients' shoulders

    Shit. Under a local anesthetic?

    • They knock you out -- they have to test the automstic defibrillator part and you don't want to be conscious.

    • by joseph90 (193138)

      surgeons sliced open their patients' shoulders

      Shit. Under a local anesthetic?

      Yup. If you ask they will give you a valium (or equivalent). It does not really hurt.

    • Usually not, although the description is not entirely accurate - the shoulder joint isn't touched. The device is put just under the skin next to the collar bone.
  • If the pacemaker is in the heart, and it somehow got loose (maybe because of an imperfect installation), that could lead very quickly to a dead patient. Maybe they've tested for this, but the article doesn't say.

  • by cecst (2002578) on Wednesday October 16, 2013 @02:52PM (#45145965)
    The leadless pacemaker is indeed a real advance, but the summary needs a few corrections, and a comment can be made. I would not want a reader who needs a standard pacemaker to be frightened unnecessarily by the summary as written.
    "surgeons sliced open their patients' shoulders and inserted the pulse-generating devices in the flesh near the heart, then attached tiny wires to the heart muscle ... through the femoral artery."
    • 1. The incision is made in the skin, not a joint. The implant location is usually the left or right prepectoral region, which is an inch or two lower than the collar bone on the stated side. The pacemaker itself is placed in a "pocket" formed by separating the skin and its attached fat from the underlying muscle. If you have ever eaten chicken, you know that the skin and fat can be separated from muscle. In the uncooked human, of course, separation requires a bit of effort but not much, and a good surgeon will have the area complete numbed up so the patient doesn't feel anything. Thus, the pacemaker is not near the heart: it's outside the rib cage. There are variations on the implant location, but none of them is inside the rib cage.
    • 2. The tiny wires (well, pretty tiny) are long, and extend from the area where the pacemaker is through a vein (not an artery, hopefully!) to the heart. The method by which the wires are put in the vein is simple but outside the scope of this post.
    • 3. The access is always through a vein (femoral vein, in the case of the new device), not an artery. Blood clots (thrombi, when inside the body) will form on most foreign bodies. From the veins, they can spread only into the lungs, which is relatively safe. From the arteries, even tiny thrombi can cause trouble when they go the brain (strokes), heart (heart attack), gut (ischemic gut), limbs (ischemic arm, leg, etc). Not good.
    • 4. The new device can still get infected and still can run out of battery power. What I haven't yet understood is how it can easily be extracted if it gets infected, which is necessary because life-threatening infection can (and usually does) result if an infected foreign body remains in the patient. I guess it's small enough that a new one can be inserted without removing the old one when the battery runs out. There are more technical limitations too that will likely be overcome as the technology improves.
    • The video clearly shows it's venous access. I don't imagine you're want to be screwing a metal object into an active LV.
  • I'm more comfortable thinking about surgery where my shoulders are opened than thinking about something snaking up through my blood vessels from my leg. Though if I was to choose, the benefits would probably overcome my reservations.
    • I had an aneurysm (brain hemorrhage) a couple of years back. I can't remember anything about the operation, but they did such a procedure to install a platinum wire in the ruptured blood vessel. I must say, the alternative (sawing a part of my skull open and having a scar there for the rest of my life) seems way worse. If there had been an alternative, because the center of the brain is difficult if not impossible to operate on from the out side. From the inside it's relatively easy and you don't have to cu
  • I wouldn't want something implanted in my arterial system ready to shower clots in me. We don't put pacemaker leads in the arterial system, we put the leads through the venous system. Even a BiV pacer stunning the left ventricle does so through the venous coronary sinus.
  • Can't wait to start working on this.

A consultant is a person who borrows your watch, tells you what time it is, pockets the watch, and sends you a bill for it.

Working...