AAA size PM

Hi All,

Don't know if you have seen this...

The AAA pacemaker: It's the size of a small battery and takes just seven minutes to fit... so could this revolutionary device give new heart to millions?
The first six Britons have been fit with no leads pacemaker Nanostim
The new pacemaker is the tenth of the size of a traditional pacemaker

It takes under ten minutes to fit, compared to the current 45 minutes


Read more: http://www.dailymail.co.uk/health/article-2545849/The-AAA-pacemaker-Its-size-small-battery-takes-just-seven-minutes-fit-revolutionary-device-new-hear-millions.html#ixzz2rVBSGobi
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http://www.dailymail.co.uk/health/article-2545849/The-AAA-pacemaker-Its-size-small-battery-takes-just-seven-minutes-fit-revolutionary-device-new-hear-millions.html

Len


8 Comments

Hi Len................

by Tattoo Man - 2014-01-26 01:01:06



.................it has been a while since we have heard from you so, welcome back..

I read about the Nanostim recently myself and an exciting development it is. The St Judes site shows that it is as you say, really tiny...here in the UK the size of a £1 coin..exactly the same as a Euro and an AAA battery.

I am currently the kind of low dependency patient that might one day benefiet from this kind of device.

After I had a new Tissue Aortic Valve in '07, my dear friend Prof Brian Hopkinson told me that they were already pretty advanced at Nottingham to do replacement tissue valves using Femoral access..I believe these have already been done for patients who might not survive major invasive cardiac proceedures.

Coming from a bit of a Luddite background I have to keep reminding myself that there are people breaking new ground in all manner of areas from Pacemaker via Formula One, via the fluid dynamics of sports wear via self-cleaning glass via...everything...

IAN is right..pricing and marketing play a big part. I remind myself that I bought a digital stopwatch in 1982...for £50..that was about half of my weekly income..now they come in expensive Christmas Crackers..!

Len, Inga, Patricia and IAN..we do live in very exciting times..how thrilling to be part of an era where, if you can conceive something, it may well become reality in our lifetime.

Tattoo Man

another slightly smaller

by Pacemum - 2014-01-26 01:01:20

Medtronic also have one under trial at the moment.

http://www.startribune.com/lifestyle/health/235094731.html?page=all&prepage=1&c=y#continue

No good for the younger ones but it will be interesting to see the follow up after the 10 year battery comes to end. May be a bit of an ouch if they have to retrieve them. My admiration goes out to those willing to trial these because without their help we couldn't move forward.

I Don't hang Crape...

by donr - 2014-01-26 01:01:22

...for a living, but consider the following.

These show some real promise for the future, regardless of their eventual form & capability.

They have only been placed in 6 people in the UK & a handful more in Germany, so there is not enough experience w/ them on a large scale to really know how well they will perform. Do we know if many have been implanted in The US or Canada yet?

Before we think of these as the be-all & end-all, I refer the group to the Thalidomide drug problem in the 1970's & the troubles accompanying Pradaxa recently. All sorts of unexpected consequences can jump up when a device is released to mass use.

They will evolve into something different, I'm sure, & nothing will stop it. It is the very nature of Man & its technology. We recently had a thread on a PM design that could function w/o a battery change by using the energy of the heart to recharge the battery.

For Inga - I can but say that in another ten yrs, you will be saying the same thing about another new nano-tech device.

Man's reach always exceeds his grasp

I base my statement on "Moore's Law" concerning the rapid changes in technology when it comes to micro (now nano) sized technology. Wish I had access to what people were saying ten yrs ago about sizes & capabilities of PM's so we could compare it w/ what is said today.

One reason I predict that the AAA sized device will not survive is that it takes up VOLUME in a ventricle. Volume is critical when looking at EF. Screw up EF & you create new issues that must be solved. This will cause an imbalance between the two ventricles & cause developers to veer off in another direction to solve the problem.

Let's examine this from two extremes - A PM the size of a mustard seed first. That, in a ventricle, will take essentially zero volume & have zero impact on EF. At the other extreme, take a PM the size of a D Cell. That will probably take up the entire volume inside the ventricle, hence completely stopping pumping action. Somewhere between those two sizes is the max sized PM you can insert & still have effective EF. Considering that the human heart is about the size of a fist & weighs about 10 Oz (about 300 Gms), there is a fair chance that in a large population the current AAA PM may not be the answer to our quest.

All I can give as a parallel example is the Cochlear implant to correct hearing for people whose cochlear microscopic hairs are destroyed by drugs or excessive loud noise exposure. In 1977, they were but a dream. Today they are a reality & many people sport TWO of them. A short ten yrs ago, they were beginning to be implanted, but only one per person, lest they develop further & offer better success. The aural community did not want to destroy the capability to install a second device in someone because both ears had been altered beyond recovery by installing a obsolete device.

I saw a cochlear implant device developmental model at an electronics conference in Vienna in 1980. One had been implanted in an Austrian man, giving some success, but needed improvement. The first one I heard of being implanted was in the ear of an American radio talk show host about ten yrs ago. Several months later, we saw one on a toddler about 2 yrs old in a grocery store in Atlanta, Georgia. Last year, a friend who was legally deaf received his second device. giving him back his hearing that he lost in 1970.

I expect to see the same thing happen w/ the nano technology for PM's.

Don

Don

by IAN MC - 2014-01-26 02:01:06

I had similar concerns to yourself re the relatively large sized object placed inside a relatively small heart chamber; no mentions of this in any of the blurb though !

Cheers

Ian

Nanostim

by golden_snitch - 2014-01-26 08:01:19

Thanks for sharing!

My EP is currently implanting these devices. He said that when I'll need my next replacement, in about 10 years, those little devices will be available as dual-chamber, rate responsive model, so that I might be eligible to get one. At the moment, that's what I understood, they are only single-chamber (ventricular) and are not given to patients who are pacemaker dependent, but only to those who have intermittent heart blocks.

It's nice to have this perspective of probably not needing another replacement. With subpectoral implant and epicardial leads, replacement of the unit or the leads is a little more invasive. So, it would be great, if this can be avoided in the future. I have about 50 years ahead of me, lots of time to benefit from progress in cardiac pacing :)

Inga

Wonderful.

by PatriciaB - 2014-01-26 09:01:21

I wonder how long it will be before these are available via private healthcare in the UK

Patricia

by IAN MC - 2014-01-26 10:01:40

As these have already been given EU approval i.e. St Jude can legally sell them here in the UK ; then I can see no reason why you couldn't have one privately NOW if you are persuasive enough.

I'm sure they will be quite expensive at the moment but prices will soon come down . It is of course a drawback that they are single chamber only as this means it will not be suitable for at least two thirds of current PM implant patients.

Thanks, Len, for passing this on .

Cheers

Ian

interview

by Pacemum - 2014-01-29 05:01:30

For the benefit for those who may have missed this and those in other countries, this link should take you to a short interview with the first lady to have the new pacemaker in her heart.

http://www.bbc.co.uk/news/uk-england-london-25921797

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