Pacemakers and ILRs
History – The first pacemakers were produced in the 1950’s with the first pacemaker placed inside a person was in 1958. Although at this point, they did not last a long time as it needed to be replaced 25 times. After this many pacemakers were made external from the body. This would be worn around the waist or the neck which wires connecting to the heart. Although with the creation of the lithium battery in 1969 the pacemaker became much more accessible to the general public [1]. Early pacemakers could only help with the pace of the bottom chambers within the heart. This could also only be done with a regular electrical pulse. This was then changed to only provide an electrical pulse when the heart did not beat of its own accord. From this point the pacemaker needs to be changed so that it would account for the upper chamber of the heart with the pulses being placed in two parts of the heart. This meant it would have a dual chamber beat making the pacemaker much closer to how a regular heart would beat. [2]
What is a pacemaker? - Within the health world there are many different examples of wearable tech. A prime example is a pacemaker. The Pacemaker is a small device inserted into the chest which allows for the controlling of heart rhythm. This is done using electrical pulse to cue the heart to beat, meaning there is a normal rate of beating [1]. Pacemakers are fitted to help with problems such as Arrhythmias which is a problem with irregular heart rates. Now pacemakers are made as much smaller devices played on the heart.
Risks – When having a pacemaker inserted the patient would need to have surgery. This like all surgery is usually safe but will always come with risks. Sometimes this can lead to swelling, infection and sometimes bleeding around the heart after the pacemaker has been inserted. It can also lead to the collapsing of a lung or nerve damage. Although there is risk the pacemaker can help people of all ages with heart problems which would affect their day to day life [1].
Cost – For people using free health care such as the NHS, Pacemakers can be fitted for free and will be regularly checked and maintained [2]. Although when going through private health care the treatment, device and stay in the hospital could cost around £4,950, which would not include the maintenance which is required to keep the tech working. For this price I would say that the pacemaker is definitely worth having if you have troubles with Arrhythmias. As this could lead to fainting, fatigue and even death if the problems are not treated properly [4].
Before the pacemaker – Before a pacemaker can be fitted the doctor will often need to measure the patient heart rate and check for any irregularities. To do this they use a device called an ILR. ILR stands for implantable Loop Recorder. An ILR can be implanted into the chest near to the heart and allows for readings to be produced of irregular heart beats which could cause fainting. These are about the size of a USB drive. Then the ILR connects to a central hub. To control and ILR the patient is often given a remote with a button to send readings from a set number of hours into the past. These are then uploaded to the hub, often kept in the home, then are submitted to the doctor or hospital. Then to be investigated by the doctor. These pieces of tech mean that patients do not need to continuously record heart rates or stay in a hospital as these heart irregularities are often quite spaced apart. Then the only part of data which needs to be recorded can be sent off and examined. An ILR can stay in the chest until the battery runs out or the device needs to be replaced for whatever reason. This allows for ease of use for elderly patients as they do not need to commute to the doctors or hospital as often. Fitting the device comes with a small risk of bleeding and bruising but can often be fitted with no problems [5].
References:
[1]
L. a. B. I. National Heart, "NHLBI," 27 Feburary 2020. [Online]. Available: https://www.nhlbi.nih.gov/health-topics/pacemakers.
[2]
D. M. Wish, "Inova Heart," 27 Feburary 2020. [Online]. Available: https://www.inovaheart.org/heart-care/pacemaker/history.
[3]
NHS, "NHS.uk," October 2020. [Online]. Available: https://www.nhs.uk/conditions/pacemaker-implantation/.
[4]
BUPA, "BUPA Health," Feburary 2020. [Online]. Available: https://www.bupa.com.au/health-insurance/surgery-cost-calculator/pacemaker-surgery-cost.
[5]
G. O. Street, "NHS Great Ormond Street," October 2020. [Online]. Available: https://www.gosh.nhs.uk/teenagers/your-condition/tests-and-treatments/living-implantable-loop-recorder.ers/your-condition/tests-and-treatments/living-implantable-loop-recorder.
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