Indian-origin doctor in US implants first leadless pacemaker inside patient's heart

February 9, 2014

Pacemaker_inside_patients_heartNew York, Feb 9: An Indian-origin doctor in the US has implanted the first miniature-sized, leadless cardiac pacemaker directly inside a patient's heart without surgery.

The leads-free pacemaker is implanted directly inside the heart during a catheter-guided procedure through the groin via the femoral artery.

The device implanted by Vivek Reddy from The Mount Sinai Hospital, resembles a small metal silver tube, and is only a few centimetres in length, making it less than ten per cent the size of a traditional pacemaker.

The Nanostim device, made by St Jude Medical, is being tested for safety and efficacy in an international, multicentre clinical trial called LEADLESS II, which is planning to enroll 670 patients at 50 centres across the US, Canada, and Europe.

"This clinical research trial will be testing the latest innovative, non-surgical pacemaker option for patients experiencing a slowed heart beat," said Reddy, the study's co-investigator.

"This new-age, tiny pacemaker may ultimately be safer for patients because it doesn't have leads or have to be inserted under the skin of a patient's chest, like a traditional cardiac pacemaker," Reddy said.

Similar to other cardiac pacemakers, the Nanostim device treats a heart rate that is too slow called bradycardia.

It works by closely monitoring the heart's electrical rhythms and if the heart beat is too slow it provides electrical stimulation therapy to regulate it.

More than 4 million patients globally have a pacemaker, and 700,000 new patients receive one each year, researchers said.

The possible advantages of the leadless pacemaker include the elimination of a surgical pocket and no visible pacemaker device under a patient's chest skin, no incision scar on the chest, no connector wires or leads, and no restrictions on a patient's activities.

The device's benefits may also allow for less patient discomfort, infections, and device complications and dysfunction.

In addition, the free-standing, battery-operated pacemaker device is designed to be fully retrievable from the heart.

"The same cardiac pacing results for patients may be available with this smaller leads-free device with the added benefits of a non-surgical procedure and less complication risks," said Srinivas Dukkipati, who is the study's principal investigator.

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Agencies
June 24,2020

New Delhi, Jun 24: Expanding the testing criterion for coronavirus, the Indian Council of Medical Research has said it should be made widely available to all symptomatic individuals across the country.

"Since test, track and treat' is the only way to prevent spread of infection and save lives, it is imperative that testing should be made widely available to all symptomatic individuals in every part of the country and contact tracing mechanisms for containment of infection are further strengthened," it said in an advisory on 'Newer Additional Strategies for COVID-19 Testing' on Tuesday.

In its revised testing strategy for COVID-19 issued on May 18, the Indian Council of Medical Research (ICMR) had advised testing for all symptomatic Influenza-like illness (ILI) among returnees and migrants within seven days of illness.

All hospitalised patients who develop ILI symptoms, symptomatic individuals living within hotspots or containment zones and healthcare and frontline workers involved in containment and mitigation of coronavirus were also advised testing.

The apex health research body has also advised authorities to enable all government and private hospitals, offices and public sector units to perform antibody-based COVID-19 testing for surveillance to help allay fears and anxiety of healthcare workers and office employees.

The earlier advisories on rapid antibody testing advisories had focused on areas reporting clusters (containment zones), large migration gatherings/evacuees centers and testing of symptomatic ILI individuals at facility level.

Besides, the ICMR on Tuesday also recommended deployment of rapid antigen detection tests for COVID-19 in combination with RT-PCR tests in all containment zones, all central and state government medical colleges and government hospitals, all private hospitals approved by the National Accreditation Board for Hospitals and Healthcare (NABH), all NABL-accredited and ICMR approved private labs, for COVID-19 testing.

All hospitals, laboratories and state governments intending to perform the point-of-care antigen tests need to register with ICMR to obtain the login credentials for data entry.

"ICMR advises all state governments, public and private institutions concerned to take required steps to scale up testing for COVID-19 by deploying combination of various tests as advised," the advisory added.

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Agencies
July 21,2020

New Delhi, Jul 21: The Centre has written to all states and union territories warning against the use of N-95 masks with valved respirators by people, saying these do not prevent the virus from spreading out and are "detrimental" to the measures adopted for its containment.

The Director General of Health Services (DGHS) in the Ministry of Health, in a letter to the Principal Secretaries of health and medical education of states, said it has been observed that there is "inappropriate use" of N-95 masks, particularly those with valved respirators, by the public other than designated health workers.

The DGHS referred to the advisory on the use of homemade protective cover for face and mouth available on the website of the Ministry of Health.

"It is to bring to your knowledge that the use of valved respirator N-95 masks is detrimental to the measures adopted for preventing the spread of coronavirus as it does not prevent the virus from escaping out of the mask. In view of the above, I request you to instruct all concerned to follow the use of face/mouth cover and prevent inappropriate use of N-95 masks," DGHS Rajiv Garg said in the letter.

The government had in April issued an advisory on the use of homemade protective cover for face and mouth, asking people to wear it, particularly when they step out of their residences.

The advisory stressed such face covers must be washed and cleaned each day, as instructed, and stated that any used cotton cloth can be used to make this face cover.

The colour of the fabric does not matter but one must ensure that the fabric is washed well in boiling water for five minutes and dried well before making the face cover. Adding salt to this water is recommended, it said.

It also listed the procedures of making such homemade masks, asking to ensure it fits the face well and there are no gaps on the sides.

It urges people to wash hands thoroughly before wearing the face cover, switching to another fresh one as the face cover becomes damp or humid, and never reusing it after single use without cleaning it.

"Never share the face cover with anyone. Every member in a family should have separate face cover," the advisory stated.

India's COVID-19 case tally crossed the 11-lakh mark on Monday, while the total number of recovered patients increased to over seven lakh, according to Union health ministry data.

The death toll due to the disease rose to 27,497 with 681 fatalities reported in one day.

The ministry data updated at 8 am on Monday showed that a record single-day jump of 40,425 COVID-19 cases had taken the total number of cases to 11,18,043.

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Agencies
May 2,2020

Clinician-scientists have found that Irish patients admitted to hospital with severe coronavirus (COVID-19) infection are experiencing abnormal blood clotting that contributes to death in some patients.

The research team from the Royal College of Surgeons in Ireland found that abnormal blood clotting occurs in Irish patients with severe COVID-19 infection, causing micro-clots within the lungs.

According to the study, they also found that Irish patients with higher levels of blood clotting activity had a significantly worse prognosis and were more likely to require ICU admission.

"Our novel findings demonstrate that COVID-19 is associated with a unique type of blood clotting disorder that is primarily focussed within the lungs and which undoubtedly contributes to the high levels of mortality being seen in patients with COVID-19," said Professor James O'Donnell from St James's Hospital in Ireland.

In addition to pneumonia affecting the small air sacs within the lungs, the research team has also hundreds of small blood clots throughout the lungs.

This scenario is not seen with other types of lung infection and explains why blood oxygen levels fall dramatically in severe COVID-19 infection, the study, published in the British Journal of Haematology said.

"Understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high-risk groups," O'Donnell said.

"Further studies will be required to investigate whether different blood-thinning treatments may have a role in selected high-risk patients in order to reduce the risk of clot formation," Professor O'Donnell added.

According to the study, emerging evidence also shows that the abnormal blood-clotting problem in COVID-19 results in a significantly increased risk of heart attacks and strokes.

As of Friday morning, the cases increased to 20,612 cases in Ireland, with 1,232 deaths so far, according to the Johns Hopkins University.

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