Rewind medical history about 60 years - A patient gets the first implantable pacemaker installed, but it fails within three hours of the procedure. Subsequent attempts were eventually more successful, and the patient ended up living more than 40 years – ultimately dying from melanoma at the age of 86.
The pacemaker was a major breakthrough in the medical world, and it saved the life of Arne Larsson, a Swedish engineer, the first recipient of the device. Larsson's heart's natural electrical circuit was disrupted by a viral infection – the pacemaker is designed to restore a natural cardiac rhythm. If the heart rate drops too low, the device can bring it back to normal speed.
Keeping Pace With Technology
These days, pacemakers are very common – more than 200,000 of them are installed across the U.S. each year. Modern versions are about the size of a pill.
Meanwhile, patients with congestive heart failure are having a battery-powered ventricular assist pump fitted. This unit can help keep a patient functioning while waiting for an organ, and in some cases it has become a life-saving approach when a transplant isn't an option.
But as Honglan Wang, a scientist with a PhD in cardiovascular pharmacology notes, these devices are just two examples of how technology has changed someone with a heart condition's life. Since the first pacemaker was successfully installed, there have been a number of other technological advancements that have extended lives and raised quality of life for patients.
Improvements to Heart Surgery
It's not just the devices being surgically implanted that have improved – technology has also allowed for cardiac surgery itself to be safer, says Honglan Wang. For patients that are older or are deemed to be at risk, surgeons can now replace heart valves through a catheter using a minimally invasive technique called transcatheter aortic valve replacement (TAVR).
This is beneficial for patients suffering from aortic stenosis, which prevents valves from opening property, restricting bloodflow that can have symptoms ranging from shortness of breath to cardiac arrest. Patients who undergo this type of surgery can expect to leave the hospital in as little as two days.
Machines have also taken over the function of the heart and lungs in some cardiac surgeries. Aptly called the heart-lung machine, this piece of technology connects to your heart to take over the job of pumping during surgery. In short, it allows a surgeon to work on the heart while it's not beating and there's no blood flowing through it. A mild electric shock restarts the heart, but it often restarts on its own.
There have been a number of improvements to these heart-lung machines since their beginning in terms of hardware – but also with the software interfaces. For example, doctors can communicate with some of the units using voice commands.
In the case of a heart bypass surgery that redirects blood flow around a blockage, doctors are seeing a much better success rate – as low as 2 percent of patients getting this procedure die before leaving the hospital. Contrast that with the fact that close to 10 percent of the initial 150 patients died before being discharged at one hospital in the mid 1960's.
The need for bypass surgery is also dropping thanks to the introduction of the stent in 1977 to open up clogged arteries (now known as angioplasty).
Better Therapeutic Approaches
As an experienced pharmaceutical industry team leader, Honglan Wang has seen first hand how medications have positively impacted heart patients. While there are newer drugs to treat heart failure, there's some promising evidence to show that anti-inflammatory medications may also be beneficial to those who have already sustained heart attacks.
For example, canakinumab is a drug that targets juvenile arthritis, but has also shown to reduce heart failure hospitalizations by reducing inflammation. Meanwhile, a blood thinning medication called Plavix is touted as being more effective than aspirin in reducing clots in diseased arteries.
High cholesterol is also a marker for heart problems, but a class of injectable drugs known as PCSK9 inhibitors (including evolocumab) has been found to reduce the risk of heart attacks and stroke when combined with statins.
Improving Technology is Heartening
Researchers and scientists like Honglan Wang continue to test new approaches to maintaining heart health that are changing the medical world. A heart attack is no longer a death sentence – in fact, the death rate has fallen sharply even since the mid 1990s, thanks to advances in treatments and technology.
