The electrophysiology team at the Montreal Heart Institute (MHI) has implanted a new type of defibrillator with cardiac resynchronization system (Concerto^TM). This procedure was performed on July 6, 2006 by Dr. Bernard Thibault, cardiologist specialized in electrophysiology, in collaboration with Dr. Peter Guerra, chief of the electrophysiology department. This was the first implantation of its kind in Canada using wireless technology to treat patients at high risk for sudden cardiac death. The patient procedure was a success.

A new device for managing heart failure
This 67-year-old patient from Chénéville in the Outaouais region suffered from heart failure and was at risk for dangerous arrhythmias; his condition required the implantation of a defibrillator. Thus, the electrophysiology team at the MHI made him the beneficiary of the first device for managing cardiac rhythm disorders which uses the wireless technology and was approved by Health Canada on June 20, 2006. With this new Concerto^TM cardiac device, effective remote communication can be established between the implanted defibrillator and the programmer in the clinician’s office or operating room. Within a matter of months, another device will make it possible for medical personnel at the MHI to interrogate the patient’s defibrillator when he is at home. This completely wireless follow-up therefore improves patient management during the implantation itself and in subsequent routine examinations.

Remote warning signal optimizes patient management
“This new device facilitates follow-up and management of the symptoms of heart failure using technology that monitors pulmonary edema - water on the lungs - by measuring intrathoracic impedance several times a day; it provides us with critical clinical information on the patient’s heart failure condition,” says Dr. Peter Guerra. “Thanks to an early signal, we can then re-assess the patient’s status, modify the treatment as needed and prevent possible rehospitalization.”

This new device can also emit an electric shock to put an end to a dangerously abnormal cardiac rhythm thus resuscitating a patient in cardiac arrest. Furthermore, the resynchronization system stimulates the heart muscle, improving synchronized contractions of the ventricles so as to help the heart pump the blood more effectively to the rest of the body. For patients suffering from heart failure, the new device offers the possibility of a better quality of life.

Growing Demand
More and more patients require a defibrillator that includes a cardiac resynchronization system. More than 100 procedures of this kind were performed in the last year at the MHI, and the number is expected to increase significantly in years to come. In this context, the new device provides an interesting option in terms of diagnosis, monitoring and treatment, for it ensures easier and better documented communication between doctor and patient, as well as peace of mind for the patients themselves.