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June 28, 2011

Technology to keep heart in proper rhythm evolves

James Taylor, D.O.
San Angelo Standard-Times

SAN ANGELO, Texas — Technology is changing the world, particularly in the field of medicine. As a cardiothoracic and vascular surgeon, I've witnessed these changes firsthand.

When I began my training as a cardiothoracic surgeon in the early 90s, pacemakers were the only widely available technology for controlling a patient's heart beat. They were — and are — used to help control arrhythmias, particularly slow heart beats. Today's devices, which are about two-inches wide and a quarter-inch thick, have come a long way. Originally, they were external devices that had to be plugged into a wall socket.

Our cadre of tools increased with the advent of Implantable Cardioverter Defibrillators (ICD), which were coming on to the health care scene in the early 90s. In fact, I met my wife, Christine, who is a nurse practitioner and my first surgical assistant, at the Deborah Heart and Lung Center, where we were on some of the early teams using these devices. Originally, these devices were the size of a crackerjack box and had to be implanted in the abdomen. Today, they are about the size of a pacemaker and placed beneath a patient's collarbone.

The ICD is used in patients who have dangerous heart arrhythmias that can lead to sudden death. For instance, if the patient develops a dangerous heart rhythm the device automatically delivers an electrical pulse that restores the heart to a regular rhythm. When this happens, the device automatically notifi es the manufacturer's monitoring station that it had to defibrillate. It is anticipated that the next generation of devices will contain a GPS, so that any patients under duress can be located quickly and easily by EMS.

The most recent addition to our cardiac treatment toolbox is a Cardiac Resynchronization Therapy Device (CRT-D). Like the pacemaker and the internal defibrillator, the CRT-D is implanted under the collarbone. CRT-Ds are most commonly used for people who are su]ering from congestive heart failure or have damage from previous heart attacks that is a]ecting the way their hearts beat. The CRT-D has three separate leads, delivering electrical impulses to di]erent areas of the heart. Ultimately, it helps coordinate the top of the heart with the bottom of the heart as well as coordinating the ventricles so they function in concert.

Following the development of this technology has been of particular interest to me. I am happy to provide this service to patients in San Angelo. Now, regardless of whether you need a pacemaker, an ICD or a CRT-D, you can get it at San Angelo Community Medical Center. Providing access to these devices is part of my practice, which means that I'll get to know you before your surgery and be available for all of your follow-up care.

While I realize how important cutting-edge technology is in today's health care arena, I also know that it cannot replace personalized care. In my practice, I strive to bring all my patients the benefits of both.

This article is not intended to replace medical advice from your physician. Consult your physician if you have any questions.

James Taylor, D.O., is a cardiothoracic and vascular surgeon with Community Medical Associates and a member of the active medical staff at San Angelo Community Medical Center.

Copyright 2011 San Angelo Standard-Times

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