Sunday March 24, 2019

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

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)

Next Story

Intel and Cray Collaborate With U.S. Government, Aims for Nation’s Fastest Computer

The world's current most powerful machine, the Summit supercomputer at Oak Ridge National Laboratory in Tennessee, contains chips from International Business Machines Corp. and Nvidia.

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Intel
This Jan. 1, 2018, file photo shows an Intel logo on the box containing an HP desktop computer on sale at a Costco in Pittsburgh. VOA

A U.S. government-led group is working with chipmaker Intel and Cray to develop and build the nation’s fastest computer by 2021 for conducting nuclear weapons and other research, officials said Monday.

The Department of Energy and the Argonne National Laboratory near Chicago said they were working on a supercomputer dubbed Aurora with Intel, the world’s biggest supplier of data center chips, and Cray, which specializes in the ultra-fast machines.

The $500 million contract for the project calls on the companies to deliver a computer with so-called exaflop performance — that is, being able to perform 1 quintillion (1,000,000,000,000,000,000) calculations per second.

Computer
It also heightens the stakes in a race in which the United States, China, the European Union and Japan have all announced plans to build exaflop-capable supercomputers. VOA

If the project succeeds, Aurora would represent nearly an order of magnitude leap over existing machines that feature so-called petaflop performance, capable of doing 1 quadrillion (1,000,000,000,000,000) calculations a second.

It also heightens the stakes in a race in which the United States, China, the European Union and Japan have all announced plans to build exaflop-capable supercomputers.

One of Aurora’s primary functions would be simulating nuclear blasts, a pillar of weapons development since the ban of live detonation testings.

Aurora will be built with artificial intelligence capabilities for projects such as developing better battery materials and helping the Department of Veterans Affairs prevent suicides, Rick Stevens, an associate lab director with Argonne overseeing the exascale computing project, said during a news
briefing.

The project is a win for Intel, which will supply its Xeon CPU chips and Optane memory chips for Aurora.

FILE - The Nvidia booth is shown at the E3 2017 Electronic Entertainment Expo in Los Angeles, June 13, 2017.
The Nvidia booth is shown at the E3 2017 Electronic Entertainment Expo in Los Angeles, June 13, 2017. VOA

Intel has been fending off rival U.S. chipmaker Nvidia Corp.’s rise in the chip content of supercomputers as the machines take on more artificial intelligence work. Nvidia’s chips are found in five of the world’s current top 10 supercomputers, though the Nvidia chips are found alongside chips from its rivals, according to TOP500, which ranks the machines.

The world’s current most powerful machine, the Summit supercomputer at Oak Ridge National Laboratory in Tennessee, contains chips from International Business Machines Corp. and Nvidia.

The source of chips for supercomputers has become a factor in trade tensions between the United States and China. The world’s third-fastest supercomputer — the Sunway TaihuLight in China — has chips developed domestically in China.

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Chirag Dekate, an analyst with Gartner who studies the supercomputing market, said that despite the small contract size relative to Intel’s overall revenue, the work done on Aurora will eventually filter down to the company’s commercial customers.

“It’s not just a jingoistic race between the U.S. and China,” Dekate said. “The innovations that Intel is developing here will percolate down to other parts of its business.” (VOA)