Cardiac Technology: Changing Lives
Heart disease is always scary, but it’s not necessarily as scary as it was in past generations. Babies born with congenital artery or valve defects frequently have corrective surgeries that allow them to live normal lives, or at least relatively normal ones. People who are diagnosed with blocked arteries in midlife survive triple and even quadruple bypass surgery. And patients who have heart beats that are either too slow or too fast, or that respond abnormally to exertion, can often be helped by a relatively minor surgery – and by the insertion of an amazing little machine.
People with various cardiac issues are living longer, thanks to technological advancement – and also thanks to the people who develop, insert, and run these lifesaving machines. The team includes far more than just doctors and nurses. There are technicians, engineers, and allied health practitioners with a variety of specialized roles.
The Pacemaker
The pacemaker is a corrective device that a person can actually wear. It is capable of not only sensing when the heart’s rhythm is amiss, but using electricity to fix it. There are three main types of pacemaker, those that correct for a slow heartbeat, those that correct for a fast one, and those that are rate-responsive; these can be helpful for people with atrial ventrillation.
People who require pacemaker insertion don’t have to undergo the scary ordeal of general anesthesia; instead, the procedure is performed under local anesthesia. There is a lot of testing that has to take place, though, and sometimes repositioning is necessary. Patients also must be monitored on a regular basis. Some medications can interfere with pacemaker functioning and, even if conditions remain unchanged, the battery does eventually wear down.
Electrophysiologists are the highly trained cardiologists who orchestrate the procedure. The actual surgery may be performed by either a heart specialist or a surgeon. There’s a whole team of medical professionals who are involved with the process. Some nurses have roles that are far more specialized than just “cardiology nurse”. They may be designated as electrocardiology nurses or even pacemaker nurses. Their job can include assisting with the insertion itself and also providing follow-up care at a pacemaker clinic. Many have certification through the International Board of Heart Rhythm Examiners in Cardiac Rhythm Device Therapy and/ or Cardiac Electrophysiology. These certifications are also available to physician assistants, technicians, and even engineers who are involved at various stages of the process.
The Heart-Lung Machine
We’ve all heard of bypass surgery – but many have never thought about what the word refers to, or just what is being bypassed: the body’s own circulation system. The heart is actually stopped during coronary bypass surgery, and the circulation system is run by a heart-lung machine. Oxygen depleted blood is collected and treated so that it doesn’t clot. It is run through a machine that oxygenates it; then it is pumped back into the body.
The first heart-lung machine was used more than fifty years ago. In the time since, it’s seen a lot of improvement. Today’s heart-lung machines can carry out multiple functions, including administer anesthesia. More importantly, they’re far less likely to damage the blood – or the patient.
As technology grows more complex, so do the roles of its human operators. While the cardiologist is performing surgery, the perfusionist is monitoring and running the machines that keep the patient alive. Perfusionists are responsible for the heart-lung machine at all stages of surgery.
Perfusion is a licensed profession. It requires graduation from an accredited program at the master’s level. Perfusionists need stamina and stress tolerance as well as scientific knowledge. Some surgeries last for hours. They are physically grueling and adrenaline pumping hours, but potentially rewarding ones.
