‘Eventually, every pacemaker will be digital’

Dr Thorsten Lewalter, associate professor of medicine – cardiology at the University of Bonn, Germany with specialisation in arrhythmias of heart has an extensive knowledge on digital pacemakers. He feels digital technology in medicine has ushered in a revolution helping both doctors as well as patients. In his recent trip to New Delhi to introduce the Vitatron T- series digital pacemakers, Dr Lewalter spoke to Sapna Dogra about the features, benefits and efficacy of digital pacemakers.

How are digital pacemakers different from their analog counterparts?

In digital pacemakers, Digital Signal Processing allows doctors to monitor the patient’s heart rhythm and adjust data settings almost instantaneously- much faster than their older analog counterparts. The Digital Signal Processing technology is similar to that found in cell phones, digital cameras and CD players. The problem with analog pacemaker is that it picks up signals from outside the heart, 50 per cent of them being incorrect and thus giving untrue diagnostic information.

What are the benefits of digital pacemakers?

The major benefits of digital pacemakers are the ease of use and speed. The technology available with the fully digital pacemakers allows accurate diagnosis with high storage capabilities. The stored electro grams can be used in all patients at no additional energy costs and finally, the Therapy Advisor automatically analyses the data, indicates which diagnostics need attention and gives recommendations for programming.

With digital technology, it is possible to analyse the form of heart signals, which results in better classifications and finally in better therapy for the patient. The lifetime of these new pacemakers is longer (about 10-11 years) than the older analog ones.

How have doctors in India responded to this technology?

The doctors I met in Delhi, Mumbai and Chennai were quite impressed and excited as digital pacemakers help complete a technical follow-up in three minutes. Due to this fast technical follow-up, physicians are able to work more efficiently.

How old is this technology and what is its price range?

The digital pacemakers have been available in Europe and the US for the past two years, so the technology is fairly new. As far as price is concerned, the difference of cost between the current device and digital pacemakers is not too high, but then cost is related to many other things. In Europe, it is available for about 3000 to 3,500 Euros (which is the cost of device minus the cost of implantation, and hospital stay and other things).

Please share your experience of being part of a research team for digital pacemakers.

As principal investigator in research for use of digital pacemakers, I was part of a nine-month trial on patients across Europe, started by the end of 2004. In this Morphology Analysis of Atrial Signals (MARS) trial, we compared the power and efficacy of the digital signal processing with analog pacemakers. We found out that in 40 per cent of patients, the sensing of a signal quality in digital pacemaker is much better than analog signals. And the quality of signals is determining all the reactions of the pacemaker.

What is the future of this technology?

Today, there are millions of people wearing pacemakers across the world. Since the old age population is on the rise therefore, the demand for pacemakers is increasing. The prevalence of Atrial Fibrillation increases with aging population and these pacemakers can contribute significantly in the fight against Atrial Fibrillation. They are also useful for bradycardia. I think, eventually every pacemaker will be a digital. Eighty per cent of digital pacemakers in German hospitals are digital and gradually old analog pacemakers will be completely phased out. I also foresee lot of automation wherein patients will be able transmit data from pacemaker directly to the doctors. Also, miniaturisation and implantation of biosensors are another important developments that will take place in the near future to monitor and measure many body functions.

sapna.dogra@expressindia.com