Heart(y) News, May 28: updates on implants and devices

Mayo Clinic Discharges 1st SynCardia Total Artificial Heart Patient in U.S. History
This patient just made history when he became the first patient in the US to walk away from the hospital with a SynCardia temporary Total Artificial Heart . 43-year old Charles Okeke, husband and father of three could go home while waiting for a matching heart donor, thanks to the Freedom™ driver, the first ever U.S. portable driver designed to power SynCardia’s Total Artificial Heart both inside and outside the hospital. The driver weighs only 13.5 lbs and can be carried in a backpack or shoulder bag. Okeke is one of the lucky few to be part of the trial testing the driver.

Reused pacemakers safe, effective in meta-analysis
Almost everything is reused and recycled nowadays, so why not pacemakers? Just, that’s right. Those little implants that keep the heart ticking. Researchers at University of Michigan removed pacemakers from deceased patients, sterilized them, and used them in patients who cannot afford to pay for these devices. The results are very positive, with no increased occurrence of infection, device malfunction or other side effects were observed. According to the researchers:
“Pacemaker reuse is a safe, efficacious, and ethical alternative to address the medical needs for those in Third World countries who could not afford therapy otherwise.”
The study looked only at pacemakers but not at ICDs.

Henry Ford Hospital study: Fewer infections with new heart-pump implant
A new heart pump model indicated for end-stage cardiac patients significantly lowers  the risk for infection, according to researchers at the Henry Ford Hospital in Detroit. HeartMate II is a newer model of the left ventricular assist device HeartMate that is less invasive and thus the patient is less prone to infection. HeartMate was approved by the US FDA in February this year.

HRS issues guidance on tough device-withdrawal issues
The Heart Rhythm Society (HRS) has spoken and issued a first-of-its-kind consensus statement regarding the pacemakers or implantable cardioverter-defibrillators (ICDs) of terminally ill patients. The issue especially addressed the withdrawal or refusal of life-sustaining devices such as pacemakers or ICDs by dying patients. According to the guidance by HRS and its collaborators from other groups and countries:

“Patients (and their surrogates) have the right to refuse or withdraw any life-sustaining treatment including [cardiovascular implantable electronic device] CIED therapies based on their healthcare-related values, preferences, and goals. [Data suggest] that physicians are not necessarily comfortable with device deactivation—their understanding varies, and their comfort level varies as well.”

Some doctors believe that especially pacemaker withdrawal is tantamount to physician-assisted suicide or euthanasia.

There is a common misconception that such withdrawal is just like “pulling the plug” leading to instantaneous death. The guidance provides that doctors should carefully discuss and inform the patients and family members the consequences of cardiac device withdrawal.