PITTSBURGH, March 8, 2005 – The University of Pittsburgh Medical Center (UPMC) today announced it has implanted the area’s first biventricular pacemaker/defibrillator that also monitors fluid build up in the heart and lungs, which is a primary indicator of worsening heart failure and often results in patient hospitalization.
The device, called the Medtronic InSync Sentry™ cardiac resynchronization therapy (CRT) defibrillator system, was implanted on Friday, March 4. It was approved by the U.S. Food and Drug Administration in November 2004.
Congestive heart failure afflicts 6 million Americans and is the number one cause of hospital admissions, with most of these admissions due to fluid accumulation in the lungs. Fluid buildup often goes undetected until the patient becomes critically ill, requiring hospitalization or urgent treatment at an emergency room for severe shortness of breath. With approximately 1 million hospitalizations each year for heart failure at a cost of an estimated $40 billion annually, heart failure management is a tremendous cost burden to the country’s health care system.
“We are excited to offer this device for many of those heart failure patients who have a tendency for fluid accumulation that results in repeated hospitalization. In addition to providing important therapies to treat heart failure and fast heart rhythms, this device has the ability to provide early notification of fluid accumulation in the lungs, which may signal worsening of the patient’s heart failure symptoms. Hopefully, this information will allow us to alter patient medications and keep patients out of the hospital,” said Srinivas Murali, M.D., professor at the University of Pittsburgh School of Medicine and director of the Heart Failure Network at the Cardiovascular Institute at UPMC Presbyterian.
The unique feature of this device that makes thoracic fluid measurement possible is called OptiVolิ Fluid Status Monitoring, which measures changes in impedance. Using very low electrical pulses that travel across the thoracic cavity, the system can measure the level of resistance to the electrical pulses, which indicates the level of fluid in the thorax. Since normal fluid levels may vary from patient to patient and fluid accumulation can be either slow or rapid, OptiVol’s ability to measure fluid status trends over time can provide important insights in conjunction with ongoing monitoring of other patient symptoms.
“This technology uses the CRT device and the wires within the heart to obtain information on the fluid status in the lungs. The information provided has the potential to lead to more effective patient care by giving physicians a ‘heads-up’ before problems may become clinically apparent,” said Raveen Bazaz, M.D., an electrophysiologist at the Cardiovascular Institute at UPMC Presbyterian and assistant professor of medicine at the University of Pittsburgh School of Medicine.
The device provides vital patient information to physicians who implant CRT defibrillator systems and also to physicians who manage the ongoing care of heart failure patients. In the future, physicians will be able to access data gathered by the system using the Internet and through wireless transmissions that won’t require direct patient interaction.
CRT resynchronizes the contractions of the heart’s lower chambers by sending tiny electrical impulses to the heart muscle, which can help the heart pump blood throughout the body more efficiently and reduce heart failure symptoms. The system’s defibrillation capability treats potentially lethal heart arrhythmias, thus saving lives.
Congestive heart failure frequently results from progressive weakening of the heart muscle and loss of its ability to efficiently pump blood to supply the needs of the body. The heart is enlarged and the normal electrical sequence that makes the heart beat efficiently is lost. The left and right ventricles of the heart beat in an irregular, uncoordinated manner. Because of this, an insufficient amount of blood is pumped from the heart into the body, causing fatigue and shortness of breath.
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