The implantation of this new cardiac resynchronization therapy system was performed Dec. 2 on an 84-year-old male patient by Glenn Brammer, M.D., assistant professor of cardiology, and assisted by Sidharth A. Shah, M.D., an electrophysiology fellow. The device had received U.S. Food and Drug Administration approval only three days earlier, on Nov. 29.
The defibrillator in this case is an electronic device designed to detect and correct out-of-sync contractions of the ventricles, the heart’s main pumping chambers. This arrhythmia is common in individuals with congestive heart failure, a progressive condition in which the heart weakens and loses its ability to pump an adequate supply of blood.
“The device resynchronizes the two ventricles to get them squeezing at the same time, which is good for heart-failure patients because it makes the heart a little stronger, makes them feel better and gives them more energy, more strength,” Brammer said.
The new system features a left ventricle lead with four electrodes instead of two, giving physicians more options for placing the lead, which increases the efficiency of the therapy.
“The four poles on this new lead allow for at least 10 different configurations so we can, even in patients with difficult anatomy, get to the right segment of the heart that allows patients to do better,” Brammer said. “We can also work around scar tissue, and avoid placement that would inadvertently stimulate the lungs, which can be very uncomfortable.
“All this this cuts down on overall procedure time, which is beneficial to the patient, and should reduce the need to re-operate to move or replace the lead, which in turn should reduce readmission rates for heart failure.”
According to the Heart Failure Society of America, approximately 4.6 million Americans are currently living with congestive heart failure and about 450,000 cases are diagnosed annually.
The new device now in use at Wake Forest Baptist – the Unify Quadra® CRT-D generator with Quartet® left ventricle lead — is manufactured by St. Jude Medical, Inc., of St. Paul, Minn.