Here are some Cardiac Patient Stories from the Saint Barnabas
Health Care System.
Augustine’s small collection of old cardiac pacing
devices is not artifacts from a medical museum; it is part
of his personal medical history.
Augustine, of Ocean Grove, NJ, who had his first pacemaker
implanted when he was just two years old, received his 17th
pacemaker. Fifteen of the devices were implanted at the Pacemaker
and Defibrillator Center at the Saint Barnabas Heart Center
at Newark Beth Israel Medical Center. The Pacemaker and Defibrillator
Center is directed by Victor Parsonnet, MD, a world renowned
pioneer in the field of cardiac pacing.
Augustine was born with congenital heart block, in which
the normal electrical impulses that travel a path through
the heart to make it beat are delayed or totally blocked. Throughout
his life, pacemakers have provided the electrical impulses
that signal his heart muscle to contract in a steady rhythm.
His experience with the devices is like a history in the
evolution of pacemakers.
“Over the decades pacing devices have gotten progressively
smaller with more functions and programmability,” said
Dr. Parsonnet, who implanted the first pacemaker in New Jersey
in 1961 and the first nuclear-powered pacemaker in the United
States in 1973. Another significant leap forward in the application
of these devices was the move from open heart surgery to
a minimally invasive procedure for implantation, he noted.
“I remember showing off the first one to anyone who
would look,” said Augustine. “It was as big as
a cigarette box.” In contrast, the small state-of-the-art
combination pacemaker and defibrillator implanted this month
is invisible under his skin. “This was the first time
I was able to go home the same day,” he added.
Augustine says he always knows when a device needs replacing. “I
start feeling lethargic and nauseous. Because I was so active
when I was young, I burned them out. Most of them ran their
course in two years,” he said. His 16th pacemaker had
a life of five years and the device implanted this month
is projected to support his heart for six to eight years.
Dr. Parsonnet explained that the latest generation of devices
combines a pacemaker and a defibrillator in one small implantable
unit. The pacemaker provides electrical impulses that prompt
the heart muscle to beat in a steady rhythm. The defibrillator
monitors the rhythm and if a dangerously rapid rhythm occurs
it delivers a strong jolt to correct it. Augustine’s
new device also delivers electrical pulses to both lower
chambers of the heart, improving the synchronicity of the
heart’s beat. With both ventricles pumping simultaneously,
each beat of the heart is more efficient and improves blood
circulation to all the body’s organs.
Like many people born with complete heart block, Augustine
has also developed cardiomyopathy, a progressive weakening
of the heart muscle that can result in heart failure. Over
time, even with the pacemaker and defibrillator, his heart
may not be able to pump enough blood to meet the needs of
his body. “The heart transplant team
is watching over me carefully too,” he said. In addition
to one of the world’s foremost Pacemaker and Defibrillator
Centers, the comprehensive Saint Barnabas Heart Center at
Newark Beth Israel Medical Center includes the Heart Failure
Treatment and Transplant Program that ranks among the nation’s
top ten heart transplant centers by volume.
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