Interesting item

I found a news item in the Scottish news about the first digital pacemaker being implanted in Scotland.

The gentleman who had the pacemaker fitted was the third in the country as whole to have a digital PM.

It was in 2003.

Here's a link to the item

http://news.bbc.co.uk/1/hi/scotland/3089587.stm 

I found another item about a girl who had a PM fitted at a few days old. Instead of the minor op we adults have, usually, she had to have a major open thoracic procedure.


7 Comments

digital pacemaker

by new to pace.... - 2023-04-29 08:49:22

Thanks Piglet22 for this article and also to make it easier at least for me to open an read. That said, it never said where this was placed in the body.  And what was that attached to the body.  If that is where one has that wire and.  Would be concerned it would come loose or catch on clothes.

new to pace

Digital pacemaker?

by AgentX86 - 2023-04-29 22:44:11

There was nothing in that article that differentiates it from a run-o-the-mill pacemaker. They're "digital" too. ..Confused

Has it really been 20 years of digital?

by Gemita - 2023-04-30 00:42:32

Hello Piglet, has it really been 20 years of digital?    No doubt we have progressed since then in tailoring our pacemakers to suit our individual needs. 

Not sure though that the comment in the link:  “The pacemaker also analyses rhythm disorders and suggests changes in programming, to help improve the quality of life for patients” was altogether accurate.  If our pacemakers could really suggest changes in programming to help improve quality of life for arrhythmia sufferers, I feel we would have been better able to control our arrhythmia symptoms by now with our pacemakers and this is clearly not the case.  I suggest they still have work to do in this area and perhaps it was just a goal/dream back in 2003?  What do you, New to Pace and AgentX86 think?

digital pacemaker

by new to pace.... - 2023-04-30 08:00:53

Am pretty sure would not like this way of a pacemaker.  From previous readings i recall this is place in your heart.  that in it self makes me hesitint.  Also to me means you can not lay on your heart.  i still do not know how this works??  I do not understand how this can reprogram our pacemaker as it is in the moment .I would not want to be resprogramed without some kind of warning.

new to pce

 

Morning all

by piglet22 - 2023-04-30 08:49:58

Here's an opportunity to get into some real hot water.

Yes, I agree that the headline is misleading. I think what they really mean is that it was a significant new generation device, an improvement on previous digital pacemakers.

Pacemakers as we know them have always been digital.

In electronics and electrics, there is a broad distinction between digital and analogue (analog).

A traditional lightbulb can be analogue or digital. You can switch it on or off, digital, or you can vary the brightness with a resistor, analogue. Digital works as on or off or in steps, analogue is smooth changes.

Dyson's whacky adverts amuse me. The V11 digital motor. What's that all about? Probably means digital control. Most motors are analogue with coils and magnets, but can be operated digitally. The stepper motor is an example. It doesn't rotate smoothly but has defined steps. The steps are controlled by switching coils on an off. Robotic arms use steppers, surgeons use robotic arms. The hard disk drive in your computer uses stepper motors for precise control.

Pacemakers go back a long way. You could knock one up to give a timed pulse with just a few components like resistors and capacitors.

Digital PMs probably evolved through very early, maybe 1959 logic chips that would time and control pulses and detect existing natural pulses like the sinus PQRST complex.

The real advances came with the the introduction of microprocessors and microcontrollers in the 1970's and 80's. A processor does maths and that, but a controller does real world things like inputs and outputs. A microcontroller has a processor in it.

AgentX86. Is your user name a nod to Intel 8086 processors? The X86 architecture?

The microcontroller is ideally suited to PM operation. It picks up signals, alters them then outputs new pulses as the ones that provide our heartbeats.

The key is in the software, the set of instructions. Take a thermostat, ideal microcontroller stuff. It has a temperature sensor and maybe a relay to switch the heat, or cold, on.

The software says "if the temperature is below 20-C, switch on the relay" That's all there is.

In code, it would be something like "if{temp<20, DigitalWrite(relay) on}.

Your PM does much the same but far more complex.

 

Microcontrollers are everywhere, form your gas boiler to your modern car. They are dirt cheap. One microcontroller in my house collects temperatures, reads all the meters, records it all in memory, transmits it all via WiFi to a computer. Cost, huge amounts of time, pennies for the chips. I’m an amateur, anyone could write code to switch a light on, just think what an expert could do.

I bet that most of the work that goes on in PM development is in software.

What I think the article is all about is a device that had considerably more power than a simple digital device. Memory and processing speed is what it's all about, plus the size of the numbers it can handle. You might have heard of 32-bit computers, early 8-bit models and modern 64-bit. An 8-bit number is 2 multiplied by itself 8 times, 256. A 64-bit number is huge. It’s the grain of rice doubling on the squares of a chess board. The big numbers allow huge amounts of data to be processed.

The next real advance, probably in PMs, will be Artificial Intelligence, or complex programming.

Gemita's point about analysing is already going on in the way PMs adjust modes etc. Suggesting is another matter.

I had an ECG in January at the GP surgery. The GP might not be a cardiologist, but the ECG software came up with possible causes for the abnormal ECG, everything from infarctions to enlarged heart. That information was for the GP, not the cardiologist, who can look at the trace and interpret it. Of course, the software didn’t take into account the PM, or it might have said “don’t worry”

The clever bit is being able to translate what the cardiologist can see in the shape of the curves to a diagnosis.

An advanced PM could do the same, and suggest to a paramedic what might be going on in the back of an ambulance. From my experiences recently, a “smart” PM might be a whole lot better than some physiologists I can think of. Who knows, it might cut waiting times down. I for one, would like to see a lot more information about what goes on my airwaves.

I don't think that the truly intelligent PM is far away. In the last decade, there have been enormous advances in “smartness”, automous vehicles, facial recognition. It’s all down to software.

But, get it wrong and you are in deep doo-doo. That wrong full stop in the wrong place could wreak havoc when the clocks change.

new to pace

by piglet22 - 2023-04-30 09:47:08

Looking at the image in the item, it looks like a gash attempt to simulate a pacemaker when you haven't got a decent image.

It looks to me like a stethoscope diaphragm superimposed on a dummy. Must have scared the life out of patients.

Pre Getty Images.

picture

by new to pace.... - 2023-04-30 10:52:05

Thanks Piglet22 for clearing that up for me.

new to pace

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