Medical Devices & Technology Archive

People with heart disease will soon be able to transmit information about their heart rhythm to their doctor's office using an iPhone app.

Protect your brain with a sleep apnea diagnosis.

Controlling heart disease, cholesterol, and hypertension are all good ways to help prevent a stroke. Now doctors are also urging you to get obstructive sleep apnea (OSA) diagnosed and under control. The idea has been gaining favor for the past few years, and the latest to join the chorus are the participants of the Canadian Stroke Congress, who recently added OSA diagnosis to their stroke care guidelines. Harvard sleep expert Dr. Lawrence Epstein agrees. "A person with untreated OSA has an increased risk of having a stroke, a fatal stroke, and a second stroke compared to those without sleep apnea," says Dr. Epstein, who's also an instructor in medicine at Harvard Medical School.

The connection

A stroke occurs when an artery that supplies blood to the brain becomes blocked or bursts. Without blood, brain cells go without oxygen and begin to die.

A new procedure can help people who are too sick for surgery.

Earlier this year the FDA approved transcatheter aortic valve replacement (TAVR), but patients are just now starting to undergo the procedure. So is it making a difference? "Yes, TAVR is a dramatic development in the treatment of cardiovascular disease," says Dr. Deepak Bhatt, professor of medicine at Harvard Medical School. "Patients who previously would have died are now being saved by this procedure."

New approaches from Harvard offer hope.

Finding a way to prevent Alzheimer's disease (AD), or to reverse the damage it does, is one of medicine's great challenges as we enter 2013. Over the past 20 years, great progress has been made in understanding the changes in brain chemistry that lead to AD. Yet translating this knowledge into treatments has been difficult. Witness the collapse of two major AD drug trials this past autumn (solanezumab and bapineuzumab). But two Harvard doctors are forging ahead with entirely new approaches that offer hope for meaningful treatment in the near future.

Under-the-skin device meets the needs of a special population.

Implantable cardioverter-defibrillators (ICDs) are personal devices designed to jump-start the heart, like shock paddles do. A traditional ICD has two parts. A pulse generator about the size of a deck of cards is implanted under the skin just below the collarbone. It contains a battery and computer software and stores an electrical charge. The pulse generator is connected to the heart by wire leads that are threaded into a vein leading into the heart. The leads constantly sense the heart's rhythm and can deliver a shock if necessary to restore a proper heart rhythm. The wires, however, can lead to infections and other problems.

An implantable cardioverter-defibrillator (ICD) helps establish a healthy heart rhythm and prevent sudden cardiac death. But psychosocial support needed to adjust to life with an ICD is often overlooked after the devices are implanted.

New approach allows valves to be repaired from the inside.

A new way of repairing mitral valves without the need for open-heart surgery shows promise in improving the prognosis for people with severe mitral valve disease who are too sick for traditional surgery.

Q. My doctor suggested I consider getting a left ventricular assist device [LVAD], and I am overwhelmed at the idea. I have severe heart failure and get short of breath with virtually every activity—sometimes just sitting in a chair. But the idea of having a device inside me forever scares me. Should I do it?

A. While some people get an LVAD to help their heart recover from injury, or while waiting for a heart transplant, some people with weakened hearts use an LVAD simply to improve their quality of life. Multiple research studies have shown that improvements in quality of life can be seen as soon as one to three months after LVAD implantation. In one study, the distance patients could walk increased from 135 feet to almost 1,000 feet.

New research shows long-term benefits.

Deep brain stimulation (DBS) promptly improves movement problems in many people who have Parkinson's disease. Now, a study in the June 20 issue of Neurology finds that DBS continues to reduce symptoms for up to three years. It's no surprise to Dr. Alice Flaherty, co-director of the movement disorders DBS program at Harvard-affiliated Massachusetts General Hospital. "The technique has been around for 20 years, and many patients have had more than 10 years of benefit," says Dr. Flaherty. "I've seen it change people's lives."

DBS uses a surgically implanted medical device similar to a pacemaker to deliver electrical stimulation to areas of the brain affected by Parkinson's disease that control movement. DBS blocks the nerve signals that cause tremor and other symptoms. Implantation requires two surgeries and then 3–10 office visits to ensure the electrodes are adjusted to their ideal settings. The results can be impressive. "DBS helps some symptoms very quickly, such as tremor. It also helps involuntary movements called dyskinesias. DBS helps rigidity and walking too, but the effect is slower." The device also helps many people to reduce their medications.

Nerve stimulation can help many people walk normally again.

Stroke and other diseases can damage nerves that control motion, resulting in foot drop. People with this condition have difficulty controlling the affected foot when walking. Although a conventional below-the-knee leg brace can provide stability, it cannot help these people pick up their foot normally with each step. Harvard-affiliated Spaulding Rehabilitation Hospital offers two devices that can. Dr. Randie Black-Schaffer, medical director of the stroke program at Spaulding, says the devices are significantly helpful.