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alerts from a clockwork butterfly: New implant tells your doctor of symptom changes before you even notice them
An implant that alerts doctors to symptom changes before they are even noticed by the patient is to be given to heart failure sufferers, with the hope that they will have fewer episodes of illness and better quality of life.
Trials have shown that the device, shaped like a tiny clockwork butterfly and about the size of a 5p piece, could reduce hospital admissions by as much as 40 per cent.
The implant allows doctors to remotely detect fluctuations in blood pressure in the pulmonary artery, which supplies the heart with oxygenated blood from the lungs, and adjust medication accordingly.
How it works: The implant allows doctors to remotely detect fluctuations in blood pressure in the pulmonary artery and adjust medication accordingly
Until now, consultants have relied on blood pressure readings taken by external monitors, such as the old-fashioned inflatable arm cuff.
This device is fitted with a sensor that transmits a signal to a small receiver kept on a patient’s bedside table at home, for instance. The data is then passed on to an external website, translated into a blood pressure reading and monitored by clinicians.
The aim is to offer it to the tens of thousands of patients with the most severe forms of the condition.
The new CardioMEMS HF System has been proven in clinical trials to be extremely accurate, not only significantly reducing the need for hospital admissions but also improving quality of life, as patients are able to stay symptom-free.
The Royal Brompton Hospital, part of the Royal Brompton and Harefield NHS Foundation Trust, London, is the first to trial the £13,000-a-time procedure. So far, seven patients have had the device fitted.
Consultant cardiologist Professor Martin Cowie told how he was at a conference in Brazil but was able to see that one of his patients was dehydrated, thanks to the system, and contacted them to tell them to drink more water.
Trial hospital: The Royal Brompton Hospital in London is the first to trial the £13,000-a-time procedure
He said: ‘An admission to hospital often results in a stay of a week or more. If we can reduce the number of times a patients ends up on a ward by three, the device has paid for itself. Until now, monitoring has taken place during regular clinical appointments or at the patient’s request after he or she has started feeling unwell.’
Heart failure, also known as congestive heart failure, is a common condition that develops after the heart becomes damaged or weakened. It leaves the heart unable to pump blood out effectively.
In addition, the muscle may not relax properly to accommodate the flow of blood back from the lungs to the heart.
About 750,000 individuals are living with heart failure in the UK, with more than 27,000 new cases diagnosed each year. Numbers of patients are rising as more patients survive heart attacks and other acute heart conditions.
The congestion in the lungs and lack of oxygen causes symptoms including shortness of breath and fatigue. The abnormalities in heart function can cause fluid to build in the lungs and in other parts of the body such as the ankles, and lower back, causing swelling and weight gain.
Incidence is 60 per cent higher in men than in women. There is no cure, so treatment involves and slowing disease progression.
Medication controls blood pressure and the pumping action of the heart, and in some cases a pacemaker can be fitted.
Lifestyle changes such as cutting down on salt to help keep blood pressure low are also advised. However, problems can be frequent and until now they have been difficult to anticipate. Prof Cowie said: ‘Some patients can end up in A&E a dozen times a year, which is distressing, and a burden for the NHS.’
The CardioMEMS device is implanted during a procedure similar to that used to fit stents.
First, an incision is made in an artery in the groin and then a catheter carrying the implant is threaded through the vascular system until it reaches the pulmonary artery.
The device is held in place by two flexible metal loops on either side of the device – the butterfly’s ‘wings’.
The operation is carried out using only a local anaesthetic and mild sedation, and takes about 20 minutes. Patients can go home the same day, if there are no complications. The device does not require batteries or leads and is designed to last for the lifetime of the patient.
One of the first patients at the Royal Brompton Hospital to benefit is Reg Youngman, 76, from Chorleywood, Hertfordshire.
After living with heart problems since childhood, Mr Youngman was diagnosed with heart failure as an adult. In 1998 he had surgery and two years later received a pacemaker at Harefield Hospital.
In the past 12 months, Mr Youngman’s worsening condition has resulted in him being admitted to hospital, or attending outpatient appointments, some 40 times.
He said: ‘When I was told about this new device I thought, if it might help, I’m all for it. It’s amazing to think that if anything is going wrong with my heart, my doctors will know before I do. I’m hoping it will mean they’re able to spot problems really early, before I’m rushed into hospital as an emergency.’
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