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Protecting Your Heart
Regulating the Rhythms of the Heart The ‘Pacemaker Plus’: One Man’s StoryUntil last year, Charles Blackwell’s life was a battle for breath. The 73-year-old Mahanoy City man had advanced congestive heart failure and “couldn’t even walk two blocks to get the paper,” he says. Then Blackwell became the first person in the region to receive an experimental “pacemaker plus” that changed his life. The three-in-one device acts as a pacemaker to keep the beat steady and a defibrillator to shock the heart out of dangerous rapid rhythms. It also resynchronizes the ventricles for people like Blackwell whose heart muscle is so weak the two chambers don’t pump at the same time. Within days, Blackwell was feeling like a new man. “My wife and I took a 12-block walk,” he says, “and my blood pressure, pulse and even complexion were better.” The device he received, made by Guidant Corp., is now available commercially and others soon will be. “Basically, we’ve made a bionic heart,” says cardiologist Robert Malacoff, M.D. If your body were a piece of machinery, your brain would be the computer chip, your kidneys the filter, and your heart…? Yes, it’s a pump, but “the heart is also a big electrical generator,” says cardiologist Robert Malacoff, M.D., of Lehigh Valley Hospital and Health Network. That’s what keeps the pump contracting and moving blood through your body.Like any electrical system, the heart is subject to bad wiring and getting frayed around the edges. It can beat too fast, too slow or out of sync. In the past, you just had to live with such arrhythmias—and in many cases, you didn’t live long. Today’s technologies have changed that outlook dramatically. When your heart is too slowIt’s called bradycardia, and usually occurs in older people with a history of heart disease, says cardiologist Norman Marcus, M.D., of Lehigh Valley Hospital and Health Network. “Often, the cause is scar tissue that interrupts the circuitry,” he says. The signal goes out from the upper heart chambers but can’t reach the lower chambers.When your heart slows or periodically stops, too little blood reaches the brain and you feel faint and fatigued. Sometimes a heart monitor can diagnose the problem; sometimes a more sophisticated electrophysiologic study is needed. Specialists thread small wires into the heart through a vein in the leg. “It’s like an EKG from the inside,” Marcus says. Pacemakers are the solution for bradycardia. A small device is implanted under the skin of the chest, with a wire going into the heart to regulate the beat when needed. These devices “set the rate the heart can’t go below,” Malacoff says, “providing a stimulus each time there’s a missed beat.” Today’s pacemakers have come a long way from the early models of the 1950s. Sensors picking up on breathing rate or muscle movement automatically rev up the beat when you exercise, and the batteries can last 10 years or more. When your heart is too fastIt’s called tachycardia, and it’s a scary feeling: suddenly your heart races, you’re dizzy and can’t catch your breath. The symptoms are similar to panic-anxiety disorder, and studies show tachycardia sometimes is misdiagnosed as panic-anxiety and vice versa.Palpitations aren’t something you’re likely to ignore, but be sure to tell your doctor, especially if you have a history of heart disease. Some types of tachycardia are much more serious than others. Fast heartbeat in the upper chambers (atria) usually isn’t life-threatening. If medication doesn’t resolve the problem, there’s a new procedure called ablation. “We locate where the fast beat is originating and use high-frequency current to destroy that small area of tissue,” Marcus says. “Ablation is especially valuable for younger people who would otherwise face 40 to 50 years of medication.” Tachycardia in the lower chambers (ventricles) is a main cause of sudden cardiac death. “Usually due to a structural problem like scar tissue from a heart attack, the ventricles try to contract in a rapid, disorganized way,” Malacoff says. “There is no pumping action and the person loses consciousness.” Almost everyone with this type of rapid heartbeat needs an implantable defibrillator. When it senses the heart begin to race, the device delivers a shock to restore a normal beat. It does the same thing as the paddles used in the emergency room, but from inside the heart. “It feels like being kicked in the chest, but only lasts a fraction of a second,” Marcus says. Researchers are now working to identify people at risk for cardiac arrest, so they can receive a life-saving defibrillator before the problem occurs.
Want to Know More about how to tell if you are at risk for a heart rhythm disorder?
Call 610-402-CARE. This page last updated 3/30/08 02:50 PM
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