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Updated on January 27, 2014


My brother in law has an enlarged heart and has for many years been fitted with a Pacemaker to aid his condition and regulate blood flow around his body.

The device is a small but a bit bulky, rectangular shaped item that is clearly seen in outline under his skin above his heart on the left side of his chest. Having said that, let me add it is far from being generally obtrusive and when the weare is clothed cannot be noticed and does not restrict mobility in anyway. My brother in law has a gross addiction to Golf and Bowls, so clearly the presence of the unit has no problems for him in carrying out his normal activities.

Pacemakers such as his are standard throughout the world and have been pretty much the same since the 1950"s, which,in medical research terms is remakable and points to the benefits that have been given by them to so many, over the years.

Pacemakers work by regulating the wearers pulse by means of electrical impulses into the heart. As such they are effectively battery packs that ,as indicated, can be seen in outline under the skin of the wearer. The impuses are transmitted by leads connected to the pack directly into the heart.

The procedure to insert the device takes around 45 minutes and as with other usual but invasive procedures does carry some risk of infection. However, the risks are small enough to have withstood around 50 years of use and thus, the big question has to be "Why change"? Clearly the answer lies in the size and wireless function of the new pacemaker and also the comparitive ease of fitting it to the patient.

NANOSTIM. The New Kid On This Block.

The new pacemaker , called Nanostim, has key advantages for the patient. Firstly it is only the size of one AAA battery, a big reduction on the previous equipment. Secondly, it is wireless and so no leads are involved. Thirdly, because of the previous 2 reasons, it can be fitted in less than 10minutes. In fact, 7 minutes is given as standard

The fitting is done via a vein after an incision is made in a leg. From there., under only local anaesthetic, the device is threaded all the way up the body via the femoral artery from the point of entry at the top of the leg ,to the heart, using a flexible tube.

Once it reaches the heart, a careful probing by the Consultant inserts the device into the muscular wall of the heart. A screw at one end of the device is then turned through one and a quarter revolutions to fix it permanetly to the wall at the right ventricular chamber and solidly into place. The fixing is then confirmed by gentle tugging on the the delivery tube. Following that, the tube is carefully withdrawn back down the femoral artery and finally from the leg leaving no scar and little or no chance of either infection or clotting which can sometimes occur using the old traditional method.

Patients are often suprised at the speed of the operation and often express amazement at both the speed of it and that they felt no discomfort at all. They are delighted at that and the small size of the device and not having a scar to remind them . Doctors however, view the lack of leads as the biggest plus factor as it negates the chances of infection and clotting. The inserted battery has an estimated 13 years of life during which it releases tiny electrical pulse action when required and identified by silence emanating from the heart. Patients forget that they are equped with the device, save for the beneficial effects it gives to them.

Those benefits are , of course ,similar to those enjoyed by those fitted with the older method and equipment and the use of these box type pacemakers is still ongoing. Whatever is used, mobility of the patient is generally enhanced and users find they can move further without the need to pause and rest. This, and the attendent peace of mind about their heart function are the key elements for patients.

It is estimated that problems of dislodging the device once fitted are low, though some medical opinion warns of possible leaking could be a possibility with the potential there for complications ,though on balance the lack of wires, the reduced size of the unit and the infection risk of the traditional procedure makes the NANOSTIM an advance welcomed in this key health area.

In 2013 estimates stated 40.000 people in the UK alone were fitted with pacemakers. From now on each case requiring a pacemaker here will be determined as before according to clinical assessment, by the Medics with them now having to make an additional choice of the tradional box or the new NANOSTIM to best fit the rquirements of the individual patient.

The heart, as we all recognise, is the pump from which flows life and advances which serve to allow it to function normally are vital to us all. This advance whilst not changing or necessarily advancing the function of the older method moves the equipment and the speed with which it can be fitted into the computer age.

Somewhat graphically, one source pointed out to me the comparison here to the mobile phones of the 1980"s which were the size of a House brick.Those we use today, show how we can now make things smaller and easier to handle all round whilst at the same time adding benefits to them for the user.

That maybe a bit removed from the Medical arena but nevertheless makes the point on size and ease of fitting, whilst not forgetting that there are other benefits, such as no infections and clotting built in to this advance. Something to be sure to give pleasure and confort to many who need important "pump maintenance" regardless of their age.


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