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VUMC implants state‘s first patient with a “Sentry” heart failure monitor

Feb. 11, 2005, 8:39 AM

NASHVILLE, Tenn. – Vanderbilt University Medical Center is the first
hospital in the state, and one of the first 20 in the world, to employ
a novel cardiac monitoring device implanted into the patient that can
predict the need for hospitalization of heart failure patients up to
two weeks in advance.

The device, the Medtronic Insync Sentry Heart Failure ICD, is the size
of a pacemaker and able to detect fluid accumulation in the chest,
which is a key sign that a patient‘s condition is worsening and
hospitalization is imminent. The Sentry ICD is a component of an
implantable cardioverter defibrillator.

Without advance warning heart failure patients who go into acute heart
failure often require hospitalization that can last as long as five
days, and cost thousands of dollars per day to manage their symptoms.

The Sentry device is an approach to care that Mark Wathen, M.D.,
associate professor of Medicine in the Division of Cardiology, said
will allow him to treat and manage heart failure at an earlier stage.

“When you have heart failure, you collect fluid in your chest, which
makes it difficult for a person to breathe because air can not
circulate,” he said. “This often is not known until most patients are
in dire need of hospitalization to remove the fluid and treat other
complications. This device can detect accumulation of fluid two weeks
prior to a patient‘s need for hospitalization.”

According to Wathen, congestive heart failure is the number one
Medicare admission cost in the country – causing nearly 250,000
hospital admissions annually. An estimated 5 million Americans are
affected with the disorder.

“Patients can now get a device that is going to prevent many of these
heart failure admissions,” Wathen said. “This may become a large
savings for the health care system.”

For nearly three years, Wathen has been involved in the development of
this device. On Feb. 2, he was able to see the outcome of the hard
work.

VUMC patient Emma Osborne, 75, was the first patient in Tennessee
to receive the new device. In December she was treated for breathing
problems and after a battery of tests, doctors found that fluid buildup
in her chest was the cause. A defibrillator to help with the heart
failure was recommended. Osborne was too weak to undergo the procedure
at that time and was given a diuretic to reduce the amount of fluid in
her chest until she was able to regain her strength for surgery.

That surgery took place Feb.2. The four-hour procedure required an overnight stay.

“She‘s really doing very well,” said Tonya Osborne Varnell, Osborne‘s
daughter. “We didn‘t even know she was the first Tennessean to receive
the device until the day after surgery.”

Just one day after receiving the device Osborne and her daughter walked
to the building where the elder Osborne lives and noticed that she was
not short of breath like before. Days after the surgery, Osborne said
she can tell a marked difference in her health.

“Many people have commented that my voice has changed since the
surgery,” said Osborne. “And I tell them, ‘no, it‘s not my voice. I‘m
not short of breath anymore when I talk and you can really tell a
difference,‘” she said.

“I wake up at 5:30 every morning and walk down my hallway. Before I
would lean against the wall and such. My daughter says I‘m moving too
fast and rushing things. “I feel so much better, I really do.”

Traditionally, patients like Osborne are hospitalized for treatment.
Wathen said the new component is threaded through a defibrillator and
has three leads with electrodes that touch the right atrium, the right
ventricle and the left ventricle of the heart.

The noteworthy aspect of the device is the monitoring capability that
can measure the amount of fluid in the chest. Over the next month,
Osborne‘s Sentry will begin to equilibrate and will be able to send
data via a telephone system.

“Patients will not have to come into physician offices, clinics or
hospitals,” said Wathen. “We are exchanging those visits with telephone
calls. ”

In the future, Wathen said the Sentry would be used in correlation with pacemakers.

Media contact: John Howser, (615) 322-4747
john.howser@vanderbilt.edu

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