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The pacemaker of the future might be made of heart cells

The pacemaker of the future might be made of heart cells | healthcare technology | Scoop.it

Cardiologists in Los Angeles have developed a gene-therapy technique that allows them to transform working heart-muscle cells into cells that regulate a pigs’ heartbeat. This procedure, described today in the Science Translational Medicine, restored normal heart rates for two weeks in pigs that usually rely on mechanical pacemakers. The experiment, researchers say, could lead to lifesaving therapies for people who suffer infections following the implantation of a mechanical pacemaker.


"We have been able for the first time to create a biological pacemaker using minimally invasive methods and to show that the new pacemaker suffices to support the demands of daily life," Eduardo Marbán, a cardiologist at the Cedars-Sinai Heart Institute and lead author of the study, told the press yesterday. The approach is practical, added Eugenio Cingolani, a cardiogeneticist also at Cedars-Sinai and a co-author of the study, because "no open-heart surgery is required to inject this gene."


In the study, researchers injected a gene called Tbx18 into the pigs’ hearts. This gene, which is also found in humans, reprogrammed a small number of heart-muscle cells into cells that emit electrical impulses and drive the beating of the heart. The area in which this change occurred — about the size of a peppercorn — doesn't normally initiate heartbeats.


"We were able to get the biological pacemaker to turn on within 48 hours," Marbán said. To get the gene to the heart, the researchers sent a modified virus into the right ventricle through a catheter. The viral vector isn’t harmful, the researchers said, because the virus they employed was engineered to be "replication deficient" — meaning that it will not reproduce and spread beyond the heart.


Overall, the results of the study demonstrate that the pigs who received the gene therapy experienced an increase in heart rate that allowed them to be much less dependent on backup pacemakers. In contrast, the backup pacemakers were responsible for more than 40 percent of the beats in pigs who didn’t receive the gene therapy, but still underwent surgery.


more at http://www.theverge.com/2014/7/16/5906563/biological-pacemakers-gene-therapy-heart-muscle-cells


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From Scans, Doctors 3D Print Custom Heart Wraps to Deliver Treatments

From Scans, Doctors 3D Print Custom Heart Wraps to Deliver Treatments | healthcare technology | Scoop.it

The buzz about 3D printing can at times give the impression that the technology is a panacea that makes all manufacturing cheaper. The truth is 3D printing has one very specific use case: It makes prototypes and custom, one-of-a-kind items cheaper and faster to make.


Medicine would seem like a prime beneficiary of this technology, potentially using 3D printing to provide patients with custom-made implants and stents. Yet, to date, medical researchers have focused on the most ambitious goals for the technology, such as replacement organs printed from a patient’s own stem cells, which need years of development before they reach average patients.


Recently, a somewhat more modest medical device — and one that could find its way relatively quickly into treatment protocols — was created using 3D printing. Researchers Igor Efimov from Washington University in St. Louis and John Rogers from University of Illinois at Urbana-Champaign used MRI and CT scans of rabbit and human hearts to 3D-print custom-fitting flexible mesh sacs that fit each heart perfectly and stayed in place as it beat.


“Each heart is a different shape, and current devices are one-size-fits-all and don’t at all conform to the geometry of a patient’s heart,” said Efimov.


Inside its fabric, the mesh can also hold sensors that monitor for signs of trouble and deliver electrical pulses, if needed. The sensors are embedded in the fabric using technology similar to what Google has said it will use in sugar-monitoring contact lenses, only more nuanced.


Doctors can position the sensors or electrodes more precisely using the wrap than by attaching them directly to the heart with sutures or adhesives, Efimov and Rogers state in a recent paper in Nature Communications. They demonstrate in the paper that sensors attached to the mesh (or multifunctional integumentary membrane) accurately measure temperature, mechanical strain and pH, and could deliver pulses of electricity.


Depending on the sensors used, the heart wrap could improve treatments for a range of disorders; it could also be used to deliver medication directly to where its needed. But the device was conceptualized specifically to treat ventricle deformities and arrhythmias. The arrhythmia atrial fibrillation affects about 4 million Americans; patients often undergo a surgery that destroys the heart’s own drummer, the atrioventricular node, and subsequently receive a pacemaker.

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mHealth patch bests Holter in cardiac monitoring

mHealth patch bests Holter in cardiac monitoring | healthcare technology | Scoop.it

New research indicates a wireless device could do a better job than the Holter monitor, the standard of care for mobile heart rhythm monitoring over the past half-century.


The Scripps Translational Science Institute compared the Holter monitor with the ZIO Patch, an FDA-cleared, non-invasive, water-resistant device worn on the chest for up to two weeks. STSI, based in San Diego, compared electrocardiograph data from 146 Scripps Green Hospital ambulatory care patients who were fitted with both the ZIO Patch and a Holter monitor.


In all, researchers said, the ZIO Patch, developed by San Francisco-based iRhythm, identified 96 arrhythmia events, while the Holter monitor detected 61.


“This is the first large prospective validation that this new technology superseded the device invented by Norman Holter in 1949,” said Eric Topol, MD, chief academic officer at Scripps Health and STSI's director.


Topol, a cardiologist and lead author of the study, continued in a prepared statement that over the course of tracking every heartbeat for two weeks “the ZIO Service proved to be significantly more sensitive” than the Holter, which consists of a cellphone-sized recorder usually worn about the waist and five to seven lead wires attached to the chest and can only be worn for 24 hours at a time.


“For millions of people who present each year with suspected arrhythmia, this may prove to be the new standard for capturing the culprit heart rhythm electrical disturbance, most commonly atrial fibrillation which carries a significant risk of stroke,” Topol added.


learn more about the ZIO Patch at http://www.irhythmtech.com/zio-solution/zio-patch/
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Case study: Big data improves cardiology diagnoses by 17%

Case study: Big data improves cardiology diagnoses by 17% | healthcare technology | Scoop.it

Big data analytics technology has been able to find patterns and pinpoint disease states more accurately than even the most highly-trained physicians.


The human brain may be nature’s finest computer, but artificial intelligences fed on big data are making a convincing challenge for the crown. In the realm of healthcare, natural language processing, associative intelligence, and machine learning are revolutionizing the way physicians make decisions and diagnose complex patients, significantly improving accuracy and catching deadly issues before symptoms even present themselves.


In this case study examining the impact of big data analytics on clinical decision making, Dr. Partho Sengupta, Director of Cardiac Ultrasound Research and Associate Professor of Medicine in Cardiology at the Mount Sinai Hospital, has used an associative memory engine from Saffron Technology to crunch enormous datasets for more accurate diagnoses.


Using 10,000 attributes collected from 90 metrics in six different locations of the heart, all produced by a single, one-second heartbeat, the analytics technology has been able to find patterns and pinpoint disease states more quickly and accurately than even the most highly-trained physicians.


more at http://healthitanalytics.com/2014/07/07/case-study-big-data-improves-cardiology-diagnoses-by-17/


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Left Atrial Pressure Monitoring To Optimize Heart Failure (Trial)

Left Atrial Pressure Monitoring To Optimize Heart Failure (Trial) | healthcare technology | Scoop.it
LAPTOP-HF is designed to investigate a new way to help treat heart failure. Since many heart failure patients are frequently hospitalized and often feel poorly, the hope is that this system may help your doctor adjust your medications before you develop symptoms or require hospitalization.


This is accomplished by measuring pressure in the heart and then each day providing you with your physician’s updated recommended medications and dosages. These may change daily depending on your condition. This is very similar to how diabetics manage their glucose levels. -


See more at: http://www.kumed.com/heart-care/clinical-services/heart-care-clinical-trials/laptop-hf#sthash.EfEC2fvM.dpuf


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