On the pulse: Dr Martin Thomas
An array of subtle information about slight changes in the body is now available at your fingertips – data that is then used to fine tune the patient’s pacemaker.
“A lot of people don’t realise just how closely connected the heart and fingertips are and, with modern technology, information from the fingertips can tell us a wealth of information about the function of the heart!” said Dr Martin Thomas, a consultant cardiologist at The Heart Hospital.
The Finometer ® device detects fluctuations in blood pressure and cardiac output per heartbeat via a probe attached to the patient’s finger. This information can be used to reprogramme or “optimise” the pacemaker or defibrillator accordingly to make it work as efficiently as possible.
The fluctuations in these measurements are recorded at the finger using a pressure monitor and light sensor and these directly reflect the function of the heart.
Dr Thomas said: “It is much more comfortable for patients and can be done very shortly after the pacemaker has been implanted into the body. If patients have severe heart failure their prognosis is poor with only 50% surviving their first year.”
“Optimising their cardiac resynchronisation device as soon as possible helps improve their outcome. Normally, the device is fine-tuned six weeks following the procedure using a scan of the heart – which can be uncomfortable if undertaken any earlier. This device solves that problem.”
A complex pacemaker revolutionised the life of 54-year old patient Mr Reuben Naidu who was left housebound and on oxygen for 16 hours a day after suffering heart failure. He is one of many who would benefit from the new device. Under the traditional chest scanning method, he had to wait four weeks after surgery before his pacemaker could be fine-tuned.
He said: “My defibrillator made me feel like a new man, reborn – it was as if someone had cast a magic spell over me. The fine-tuning several weeks later made me feel even better – my heart beat was rhythmic and smooth. It would have been brilliant if this device had been available when I had my treatment then I could have had it done even earlier.”
European Heart Failure Awareness Day is launched for the first time on 7 May and aims to make people aware of this dangerous condition. It is led by the European Society of Cardiology and supported by the British Society for Heart Failure.
Unlike heart attack, many patients can mistake the symptoms for other conditions until it is too late.
Dr Thomas added: “Patients can present with acute heart failure but often the onset of the condition is insidious. The symptoms include breathlessness and swollen ankles which can be a sign of other conditions. That is why it is so important to get checked out at a dedicated clinic.”
The Heart Hospital offers an advanced heart failure service. The service has expanded in the past year and now offers an even more streamlined approach to identifying and treating those patients at risk of heart failure and works closely with other heart failure specialists across North Central London.
Mr Naidu suffered a number of complex health problems after having his first heart attack at just 32-years old. He underwent a heart by-pass operation at another London hospital and after years of relative good health suffered heart failure. Breathless and unable to walk, he asked to be referred to Dr Thomas at UCLH and underwent a pacemaker implantation in February.
Mr Naidu, whose father was just 25 years old when he died from heart failure, said: “It was incredible - an hour later I had no pain. I felt like a human being again after years of breathlessness and being unable to walk or communicate easily. Dr Thomas was like an angel in disguise.”
Mr Naidu's story has been covered by the BBC. Their coverage can be seen here (TV) and heard here (radio).