Heart Institute
Medical Technology For Heart Failure
Implantable devices hold promise in battling the silent epidemic
For More Information or to Speak With a Good Samaritan Hospital Cardiologist About This Technology, Please Call 213-977-2239.
Heart failure background
Heart failure affects approximately 5 million Americans and is responsible
for more hospitalizations than all forms of cancer combined. Total treatment
costs are approximately $40 billion annually. Demographic trends indicate
that the prevalence of heart failure is expected to double worldwide by
2012.
In healthy people, the four chambers of the heart contract in synchrony to move blood through the body (people experience this as their heartbeat). However, in many patients who have heart failure, the electrical impulses that coordinate the contractions of the heart's chambers may be impaired. As a result, in up to 50 percent of people who have advanced heart failure, the two lower chambers, called ventricles, no longer contract at the same time.
When the heart is not pumping properly, mild activity can cause shortness of breath or difficulty breathing, even when the person is lying down. The legs and ankles may swell (edema) as a result of increased water retention. People often feel weak and tired and may sleep more frequently.
What is the InSync®
system?
The InSync system is an implantable device and specialized leads designed
to provide resynchronization therapy for people who have heart failure and
problems with electrical conduction in their hearts.
In cardiac resynchronization therapy, the device sends tiny electrical impulses to both sides of the heart muscle of the lower chambers (ventricles). Resynchronizing the contractions of the ventricles is intended to help the heart pump blood throughout the body more efficiently. Cardiac resynchronization therapy, also known as biventricular pacing, is intended to complement, not replace, heart failure drug treatment and dietary modification.
- Benefits: For those patients with heart failure who have electrical conduction problems of the heart, resynchronization therapy is intended to improve the heart's efficiency and increase blood flow to the body. By improving blood flow, heart resynchronization therapy may reduce heart failure symptoms, improve quality of life and increase patients' ability to perform the tasks of daily living.
The InSync approved by the U.S. Food and Drug Administration in August 2001 provides resynchronization therapy for patients who do not require ICD therapies. The InSync ICD device provides both resynchronization therapy and defibrillation protection for those patients who are at high risk for potentially lethal ventricular arrhythmias.
Is surgery required to implant the InSync and system?
Yes. A specially trained cardiologist (an electrophysiologist) or cardiovascular
surgeon implants the InSync system. The devices are implanted under the
skin in the chest area, and three very thin insulated wires (leads), with
tiny electrodes on their distal ends, are maneuvered through a vein from
the device to the heart: One lead is placed to touch the interior wall
of the right atrium, another to touch the interior wall of the right ventricle
and the third lead is threaded through the coronary sinus and placed to
touch the outer wall of the left ventricle.
The implantation procedure is typically done with local anesthesia, so the patient remains conscious. However, the procedure takes longer than a typical pacemaker implant because of the need to implant the third lead to pace the left ventricle. Patients usually stay in the hospital overnight.