Pacemaker stimulates natural heartbeat
Decreasing cardiac output, cardiac insufficiency or cardiac insufficiency is a frequently observed long-term consequence in pacemaker patients. Cardiologists at the Department of Internal Medicine II - Cardiology, Angiology and Intensive Care Medicine at the St. Marien Hospital Siegen have now implanted an innovative pacemaker for the first time in patients.
The innovative pacemaker stimulates the so-called His-bundle, part of the internal stimulation conduction system. Thereafter, the signal spreads over many small fibers in the heart muscle sections and thus triggers physiological, i. natural heartbeats. In this stimulation, a pacemaker probe is placed in the vicinity of the bundle of His above the sails in the area of the forecourt septum to allow natural transmission of the electrical impulse of the pacemaker as possible to the chambers. The risk of developing heart failure is thus significantly reduced. The clinic of chief physician Prof. dr. med. Michael Buerke is one of the first heart centers nationwide to have established this new form of therapy, the His bundle pacemaker, in regular patient care. "The procedure is technically more complicated than the simple probe placement in the right ventricle and the operating time is longer," explains senior physician Dr. med. med. Christoph H. Blanke, who works together with senior physician Dr. med. Johann Mermi implanted the first pacemaker. The procedure is controlled by many ECG leads, and it may be useful to use an electrophysiology catheter from the right-hand panel.
Heart failure leads to premature fatigue, decreased performance and fatigue in many sufferers. But respiratory distress or water retention in the lungs or legs occur. Depending on the severity, the quality of life is noticeably affected. "With the help of the innovative His-bundle pacemaker, the pumping power of a previously damaged heart does not diminish after some time, unlike with normal pacemakers," reports Dr. med. Mermi. "The risk of patients having to be hospitalized again due to pacemaker-associated heart failure is therefore extremely low," continues the electrophysiologist. In addition, there is a trend towards a lower mortality in the long-term trend.
"The His bundle probe implantation means a global change in pacemaker therapy," says chief physician Prof. Dr. med. Michael Buerke. Because the Kammersonde traditionally in quite a different place and indeed attached near the top of the right ventricle. If they give off an electrical impulse there, it spreads "unnaturally" from the right into the left ventricle. This electrical and mechanical asynchrony of the heart chambers can lead to long-term heart failure.
The special position of the His bundle probe is also a particular challenge for the surgeons. Because the bundle of His, named after the German internist and cardiologist Wilhelm His (1863-1934), is only a few millimeters small structure in the heart septum between the atria and chambers. "Accurately localizing it requires complex technical prerequisites," says Dr. Johann Mermi. "At the Heart and Vascular Center in South Westphalia, we have a modern electrophysiology lab and OR equipped with the His bundle emitting an unmistakable electrical signal We know exactly when the catheter has reached it and can place the probe exactly."
"Pacemakers have been used in patient care for decades," explains Prof. Michael Buerke. But apart from advances in more personalized programming, longer battery life or the introduction of the pacemaker capsule implanted directly into the right ventricle, the His bundle pacemaker has for decades been the first fundamental advance that promises to reverse the drawbacks of conventional pacemakers. The new pacemaker will therefore be standard in patients who are medically indicated for use, concludes Prof. Buerke.
Pacemaker without batteries
This invention could greatly facilitate the lives of millions of people with a pacemaker. So far, the implanted device, which stimulates the heart to beat regularly by electric impulse, runs with batteries. And they have to be exchanged every few years. This requires a small surgical procedure.
But that might not be necessary in the future, if the invention of Chinese researchers prevails: The scientists have developed a pacemaker, which requires no batteries at all.
The energy needed to operate the pacemaker is generated from the movement of the heart, reports Wissenschaft.de, referring to the development of researchers around Han Ouyang from the Beijing Institute of Nanoenergy and Nanosystems, which is now described in the journal Nature.
Development has not progressed so far as to enable operation in the human body. For this, the system must be even smaller and more efficient, so the Chinese scientists.
Initial tests with pigs make them confident that this could succeed. Because, according to the study, enough energy could be generated to eliminate arrhythmias in the animals.
The researchers could have made a first important step: "The performance of the device is impressive, because it is four times as high as in previous approaches of this kind," quoted science.de the researchers Han Ouyang.
"The symbiotic pacemaker absorbs energy from the body to do its job. At the same time, the body gets electrical stimulation from the pacemaker to regulate the heart's activity, "says Ouyang, pointing out that the device developed by his research team is well tolerated and durable.
Pacemakers are implanted in people whose heart rhythm is disturbed.