Monday November 19, 2018

Tiny Pacemakers Could Be Game Changers for Heart Patients

A pacemaker is a medical device which uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart

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The tiny pacemakers are not right for all patients, but as the technology develops, more people will be able to benefit from the procedure.
The tiny pacemakers are not right for all patients, but as the technology develops, more people will be able to benefit from the procedure. Wikimedia Commons
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Tiny, new pacemakers are making headway around the world. One type, the Micra, is keeping 15,000 people’s hearts beating in 40 countries, according to manufacturer Medtronic. One of those people is Mary Lou Trejo, a senior citizen who lives in Ohio.

A healthy heart has its own pacemaker that establishes its rhythm, but people like Trejo need the help of an artificial device.

Trejo comes from a family with a history of heart disease. Her heart skipped beats, and she could feel it going out of rhythm. Trejo wanted to do something to advance heart health, so in 2014, she volunteered to participate in a clinical trial for the Micra pacemaker. The device is 24 millimetres long implanted, one-tenth the size of traditional pacemakers.

Traditional pacemakers

Most pacemakers rely on batteries placed under the skin, usually just below the collarbone. Sometimes patients get infections after the surgery or have difficulty healing from the incision.

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Traditional pacemakers use leads with electrodes on one end that are threaded through blood vessels to connect to the heart. There can be problems with the leads as well.

A healthy heart has its own pacemaker that establishes its rhythm, but people like Trejo need the help of an artificial device.
A healthy heart has its own pacemaker that establishes its rhythm, but people like Trejo need the help of an artificial device. Wikimedia Commons

Dr Ralph Augostini at Ohio State’s Wexner Medical Center says a tiny pacemaker like the Micra avoids all of these problems.

“The electrodes are part of the can, and therefore it eliminates the lead,” he said. There’s no incision in the chest to become infected and no chance of complications with the leads.

Small and self-contained

Augostini implanted Trejo’s pacemaker in 2014. He threaded the entire device through an artery in her leg up to her heart. The pacemaker has small, flexible tines that anchor it into the folds of the heart muscle. Once it’s in place, the doctor gives it a tug to make sure the pacemaker is stable before removing the catheter used to place it in the heart.

The Wexner Medical Center was one of the sites that participated in the Micra clinical trial. Since the Micra received FDA approval in 2016, Medtronic has been training more physicians on the procedure. A company spokesman told VOA that this device is becoming available at other centres across the U.S. and countries throughout the world.

Traditional pacemakers use leads with electrodes on one end that are threaded through blood vessels to connect to the heart.
Traditional pacemakers use leads with electrodes on one end that are threaded through blood vessels to connect to the heart. Wikimedia Commons

Dr John Hummell, a cardiologist at the Wexner Medical Center, has studied the effectiveness of this new generation of pacemakers.

“We don’t leave any wires behind and the pacemaker, the battery, the wire is all just a tiny little piece of metal sitting down in the heart,” he said. Medtronic said the results of the clinical trial showed a success rate of 99.6 percent.

Dr Richard Weachter, with the University of Missouri Health Care, says the leadless pacemakers’ complication rates are about half the rate of traditional pacemakers.

The battery lasts for 14 years and after that, Weachter said, doctors, can implant another one in the same chamber of the heart. They can repeat the procedure a third time if needed.

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The pacemaker activates only when necessary to keep the heart beating normally. Studies show that the Micra and other leadless pacemakers are safe and effective.

These tiny pacemakers are not right for all patients, but as the technology develops, more people will be able to benefit from the procedure. Four years after her implant, Trejo’s doctors say she is doing fine. (VOA)

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Refugee Communities Can Be Built By Tech Industries

Mikkelsen said the initiative was a win-win as it would also benefit companies by slashing costs.

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Refugees
Congolese families sit at the Kyangwali refugee settlement camp, Uganda, March 19, 2018. A California company is testing an app in Uganda that lets refugees earn money for AI training. VOA

Companies could help refugees rebuild their lives by paying them to boost artificial intelligence (AI) using their phones and giving them digital skills, a tech nonprofit said Thursday.

REFUNITE has developed an app, LevelApp, which is being piloted in Uganda to allow people who have been uprooted by conflict to earn instant money by “training” algorithms for AI.

Wars, persecution and other violence have uprooted a record 68.5 million people, according to the U.N. refugee agency.

People forced to flee their homes lose their livelihoods and struggle to create a source of income, REFUNITE co-chief executive Chris Mikkelsen told the Trust Conference in London.

Rohingya, Myanmar, refugees
Rohingya refugees cross floodwaters at Thangkhali refugee camp in Bangladesh’s Cox’s Bazar district. VOA

“This provides refugees with a foothold in the global gig economy,” he told the Thomson Reuters Foundation’s two-day event, which focuses on a host of human rights issues.

$20 a day for AI work

A refugee in Uganda currently earning $1.25 a day doing basic tasks or menial jobs could make up to $20 a day doing simple AI labeling work on their phones, Mikkelsen said.

REFUNITE says the app could be particularly beneficial for women as the work can be done from the home and is more lucrative than traditional sources of income such as crafts.

The cash could enable refugees to buy livestock, educate children and access health care, leaving them less dependant on aid and helping them recover faster, according to Mikkelsen.

Rohingya, Myanmar, refugees
Rohingya refugee women wait outside of a medical center at Jamtoli camp in Cox’s Bazar, Bangladesh. VOA

The work would also allow them to build digital skills they could take with them when they returned home, REFUNITE says.

“This would give them the ability to rebuild a life … and the dignity of no longer having to rely solely on charity,” Mikkelsen told the Thomson Reuters Foundation.

Teaching the machines

AI is the development of computer systems that can perform tasks that normally require human intelligence.

It is being used in a vast array of products from driverless cars to agricultural robots that can identify and eradicate weeds and computers able to identify cancers.

Refugees
In this Aug. 27, 1994 file photo, U.S. Coast Guard crew from the cutter Staten Island are hindered by rough seas in the Florida Straits as they attempt to rescue Cuban refugees. VOA

In order to “teach” machines to mimic human intelligence, people must repeatedly label images and other data until the algorithm can detect patterns without human intervention.

REFUNITE, based in California, is testing the app in Uganda where it has launched a pilot project involving 5,000 refugees, mainly form South Sudan and Democratic Republic of Congo. It hopes to scale up to 25,000 refugees within two years.

Also Read: Rohingyas Repatriation to Myanmar Scrapped by Bangladesh

Mikkelsen said the initiative was a win-win as it would also benefit companies by slashing costs.

Another tech company, DeepBrain Chain, has committed to paying 200 refugees for a test period of six months, he said. (VOA)