News Column

Making Utah medical history

August 12, 2014

Whitney Evans; By Whitney Evans Deseret News

SALT LAKE CITY -

Logan resident Susan Thomas is able to live more fully with the implant of a Bluetooth-like device in a chamber of her heart.

In 2010, fatigue set in. At times she was unable to walk distances more than 50 feet without resting, which limited her ability to travel and to tend her grandchildren. Thomas was diagnosed with atrial fibrillation, an irregular heart rhythm.

After years of cardiac ablations and cardioversions, doctors suggested that Thomas get a pacemaker to stabilize her heart rhythms. In July, doctors approached the Thomas family about her receiving the first Nanostim - a leadless, or wireless pacemaker that is in the midst of national trials - in the Rocky Mountain region. It is a one-chamber pacemaker, one-tenth the size of traditional models and does not require surgery.

On July 28, she was the first Utahn to have the device implanted.

"It's a little scary," her husband, Maurice Thomas, said. "We are optimistic that this will really give her the energy. She sure struggled. Every time we turned around she was out of rhythm again."

Intermountain Medical Center cardiologists implanted the pacemaker in Thomas, 72, by inserting a sheath - similar to an IV tube - containing the Nanostim in her femoral vein in her thigh. They guided the tube through the vein until it reached the right lower heart chamber, screwed the Nanostim into the muscle and removed the sheath.

She left the hospital one day after her surgery. Two days after that, she was vacationing with her family in Flaming Gorge.

"She's really a pioneer," said Jared Bunch, a cardiologist at Intermountain Medical Center who performed the implant.

Nanostim pacemakers are slightly larger than a quarter and slightly smaller than a AAA battery and are implanted directly into the heart chamber. Traditional pacemakers are a little bigger than a silver dollar and are placed on top of the muscle but below the skin.

The Thomas family, including their five children, researched the procedure before agreeing. They found that it had been researched in Europe and had made its way to the United States, where it began trials earlier this year. They were still hesitant up to the day the pacemaker was implanted.

Bunch was one of the first to review the European trial four to five years ago, so he has long known of the benefits of the pacemaker. Despite his confidence, he said he understood the family's hesitation.

"These are the cutting edges of the future. But sometimes the future, there's a lot of unknown and a lot of uncertainty," he said.

So far, Susan Thomas seems to be taking to the procedure well. According to her husband, he and their children could tell that her health had improved just days afterward.

Regardless of the type of pacemaker one receives, the patient is often released from the hospital the day after the surgery. A patient who receives a traditional model with wires would have to undergo surgery and limit their arm movement for up to a month. These pacemakers last up to 12 years.

Nanostim is less invasive and will last up to 15 years. It uses radio frequency to communicate data about the heart to another device that looks like a laptop. Bunch compared the pacemaker to a Bluetooth that is able to ping information over.

Thomas was an ideal candidate because she did not have advanced heart failure or lung disease and only had one affected chamber, according to Bunch.

Ultimately doctors hope to be able to place a small pacemaker in multiple chambers. However, upper chambers are thinner and their muscle patterns vary, which would require a different design of pacemaker and anchoring screw, he said.

Nanostim costs about $3,000 to $4,000 more than the traditional model, something Bunch expects will change as more competitors enter the market.

Thomas will return every three months for doctors to test how well the Nanostim can see her heart, capture heart rhythms, look at the effectiveness of the pace stimulus to the heart and check the battery life.

Thomas said she will use her newfound energy to travel, go on cruises and babysit her grandchildren.

"It's just been a lifesaver," Susan Thomas said. "I really don't even feel (the pacemaker). It's just part of my body now."

Email: wevans@deseretnews.com

Twitter: whitevs7


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Source: Deseret News (UT)


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