Left-Ventricular Assist System Continues To Grow

More than 22 million people suffer from heart failure worldwide with approximately one million new patients diagnosed annually. In the setting of an aging global population, heart failure is the number one reason for hospitalization. The most severely ill patients need heart transplants in order to recover. More than 8,000 people worldwide are on the list of eligible candidates for heart transplants annually, but less than 3,000 receive a transplant each year. A large number of people who suffer from severe heart failure do not qualify for transplantation due to other health issues. An alternative for these patients is access to artificial mechanical assist.

A Left Ventricular Assist Device or LVAD is a surgically implanted mechanical device that helps the heart pump blood. In other words, they are “heart pumps” or “heart assist devices.” If both your heart’s pumping chambers are failing, 2 heart pumps may be used, one for each ventricle.  An LVAD either takes over or assists the pumping role of the left ventricle – the heart’s main pumping chamber. Newer LVADs are meant to be permanent in people with severe heart failure.  Part of the device is implanted in your heart and abdomen, and part remains outside your body. You carry the external part of the device on a belt around your waist or on a shoulder strap. Most LVADs right now have an electric pump, an electronic controller, an energy supply (usually a battery weighing about 8 pounds) and 2 tubes. One tube carries blood from your left ventricle into the device. The other tube takes blood pumped from the device into your aorta (artery) to be circulated throughout your body.

Terumo Heart, Inc., announced this week that another patient implanted with the DuraHeart™ Left Ventricular Assist System (LVAS) has surpassed four years after receiving the mechanical circulatory support device. Helga Gieseke, 66, who lives in the south of Saxony-Anhalt, Germany is now one of the longest-living heart failure recipients of this device designed to aid the pumping action of the heart in order to circulate blood throughout her body.

Mrs. Gieseke received the DuraHeart LVAS as an investigational device in May of 2006 after suffering from heart failure for many years. She was treated by the Physicians at The Deutsches Herzzentrum Berlin as part of the DuraHeart LVAS clinical study that ultimately lead to CE Mark and commercialization in Europe.

Mrs. Gieseke has had a long history of heart problems; her first heart surgery was performed in 1994. Since then, Mrs. Gieseke had undergone several procedures including implantation of stents, pacemakers and implantable defibrillators in an attempt to manage her condition. Despite all these treatments, Mrs Gieseke’s condition continued to deteriorate until she found herself unable to walk or carry out simple activities around the house without getting chest pain. It was after admission to the local hospital in April of 2006 that Mrs. Gieseke was told by her cardiologist, also a school friend, that she required additional treatment. It was then that she was referred to The Deutsches Herzzentrum Berlin.

The DuraHeart LVAS can be used as a bridge to heart transplant in patients with end stage heart failure. Due to the scarcity of donor organs, patients can sometimes be on the waiting list for many months until a suitable donor becomes available. During that time, a patient’s condition can deteriorate dramatically until no other alternative is available to them. The left ventricular assist systems offer the patient a second chance while waiting for a suitable donor.

The DuraHeart LVAS is currently being studied in the DuraHeart Pivotal U.S. Trial for Bridge-to-Transplant (BTT), a multi-center, prospective, non-randomized study, involving 140 patients. The study, which granted unconditional approval in early 2010 by the U.S Food & Drug Administration (FDA), will evaluate the safety and efficacy of the device in helping to sustain patients awaiting heart transplant who are at risk of death due to end-stage heart failure. 

For more detailed information about the DuraHeart BTT Trial, visit www.clinicaltrials.gov, and for more information about the DuraHeart LVAS, visit www.terumoheart.com.

Women & Heart Disease Across the Lifespan (Part 3): Older Women

During this final installment of our 3 part series about women and heart disease we will be focusing on heart problems older women are more likely to experience. Some of the things we will discuss are heart failure, diastolic dysfunction, atrial fibrillation, aortic valve disease and sudden cardiac death.

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Finding the Right Cardiologist for You

            One of the most important parts of your journey to a healthier heart is deciding who will be your regular heart doctor. Heart doctors (cardiologists) can vary greatly. Even though most adhere to the standard of care, their interpretations can lead to a wide range of treatment styles. Some may be more conservative by suggesting very minimal medicines and follow-up. Others tend to be more aggressive in their treatment of heart disease by recommending more medicines and frequent follow-up. Both conservative and aggressive styles are perfectly fine but you need to find a cardiologist with the style you prefer. It should ideally be someone you trust undoubtedly. When it comes to your heart care, you do not have time to second-guess every move your doctor makes!

            If you prefer a cardiologist who is proactive when it comes to national guidelines and standard of care, I would recommend you search several websites. First, go to http://www.ncqa.org which is the website for The National Committee for Quality Assurance. NCQA is a not-for-profit organization that promotes quality care for patients. You can search their physician database to obtain a list of doctors who have passed the Heart/Stroke Recognition Program requirements. The list contains both primary care physicians and cardiologists. 

If you cannot find a cardiologist in the NCQA list for your area, then look up cardiologists through a search engine on the internet (Google, MSN, Yahoo, etc). You will have to type in key words like “cardiologist” and the name of your city. You can also use your local phone directory or ask a friend.

            Once you have a list of possible cardiologists for your area, I recommend you check out their credentials. By internet, you can view all types of information about any licensed provider through your state’s medical board website. To find your specific medical board website you can visit the American Medical Association’s webpage (link http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure/state-medical-boards.shtml) and click on your state in their list. Physicians who have passed the cardiology board exam will generally have this listed on the Medical Board website under Specialty Board Certifications. The Medical Board website can also tell you if the doctor has had any lawsuits settled against them. If you prefer not to use the internet, you can call the American Board of Medical Specialties (1-866-ASK-ABMS) with questions about a doctor’s certification.

After checking out their credentials, the next step would be to call the cardiologist’s office for an appointment. You will have to ask if they accept your insurance and if they are taking new patients. Many offices have more than one doctor in their group. If you really want to find the perfect match, consider asking a nurse, physician assistant or nurse practitioner about the doctors. You might say to them, “I’m looking for a doctor who will see me often and treat my heart disease aggressively.” Or you could say, “I’d like to see a doctor who is personable and open to alternative treatments.” Chances are they can guide you to the right person! 

Submitted by: Sharon Masinelli, PA-C

Author of What To Do When You Have Heart Disease

www.TheHeartDiseaseGuide.com

http://keepyourhearthealthy.wordpress.com

The Christmas Coronary – Holiday Heart Attack

The Holidays are a joyous time to celebrate and spend time with family and friends. But they have also been found to increase the risk for heart problems. Heart related deaths and heart failure hospitalizations rise sharply around the winter holidays.

Several triggers for this increased risk have been reported in recent studies:

• Our normal routine is disrupted – we may be traveling, eating and drinking differently, under more stress and exercising less

• Cold weather can also be a trigger (especially when shoveling snow)

• Depression may be more prevalent – you may be missing a loved one more around the holiday season

For years I have been teaching people about the “5 E’s” these are five things that start with the letter E that can increase your risk for heart problems.

• EATING – heart attacks can be triggered by eating meals with a high fat content or eating heavy meals. Enjoy the holiday meals but remember moderation is key.

 • EXERTION – heart attacks can be triggered by too much exertion (again think about shoveling snow). Bundle up and take frequent rest breaks. Also if you are starting a new exercise routine – slowly increase your activity, don’t overdo it.

 • ELIMINATION – heart attacks can be triggered during straining to have a bowel movement. Remember to eat your fiber and drink plenty of water to avoid constipation.

• EXTREME EMOTIONS – heart attacks can be triggered by extreme emotions such as depression and anger. The holidays can be a stressful time, make sure you are taking time for yourself and your mental well-being.

• EXTREME TEMPERATURE CHANGES – heart attacks can be triggered by temperature changes, such as going out of your warm house out into the cold weather. Remember to bundle up and cover your mouth and nose with a scarf, breathing in the cold air suddenly can put stress on your heart.

So Enjoy the Holiday Season but remember to take care of your health – your heart will thank you for it!  Thinking about Healthy New Year’s Resolutions check out our books “Take Charge: A Woman’s Guide to a Healthier Heart” and “Take Charge: A Man’s Roadmap to a Healthy Heart” available at www.heart-strong.com

More bad news for overweight men

Data from the Physician’s Health Study published in the journal Circulation (2009) found that obese and overweight men are at an increased risk for heart failure.  (Heart failure is a weakening of the heart muscle)

Overweight men had a 49% higher risk of developing heart failure versus normal weight men

Obese men had a 180% higher risk of developing heart failure versus normal weight men

Exercise can help:

Men who did vigorous physical activity 5 to 7 times per week had a 36% lower risk of heart failure

While men who did vigorous physical activity 1 to 3 times per month had an 18% lower risk of heart failure

The combined effects of weight and physical activity were tremendous:

Normal weight men had a 19% risk of heart failure

Overweight but active men had a 49% risk

Overweight and inactive men had a 78% risk

Obese but active men had a 168% risk

Obese and inactive men had a 293% risk

Exercise helped decrease risk of heart failure in ALL men. So men Keep Lean and Exercise to protect your heart!!

For more heart healthy info visit www.heart-strong.com