Artificial Heart Recipient Has No Pulse 465
laggist writes "A heart patient in Singapore has been implanted with an artificial heart that pumps blood continuously, allowing her to live without a pulse. From the article: '... the petite Madam Salina, who suffers from end-stage heart failure, would not have been able to use the older and bulkier models because they can only be implanted in patients 1.7m or taller. The 30-year-old administrative assistant is the first recipient here to get a new artificial heart that pumps blood continuously, the reason why there are no beats on her wrist.'"
The story is light on details, but an article from last year in MIT's Technology Review explains a bit more about how a pulse-less artificial heart works.
First pulse. (Score:5, Funny)
First pulse.
Re: (Score:3, Funny)
Beat me to it.
Re:Oblig quote (Score:4, Funny)
It's life, Jim, but not as we know it.
It's worse than that, she's dead Jim!
No wait.
Should sleep with a sign on chest/back.. (Score:5, Insightful)
Re: (Score:3, Interesting)
Or misdiagnose her if she isn't.
Re:Should sleep with a sign on chest/back.. (Score:5, Funny)
Miracle Max: Whoo-hoo-hoo, look who knows so much. It just so happens that your friend here is only MOSTLY dead. There's a big difference between mostly dead and all dead. Mostly dead is slightly alive. With all dead, well, with all dead there's usually only one thing you can do.
Inigo Montoya: What's that?
Miracle Max: Go through his clothes and look for loose change.
Re:Should sleep with a sign on chest/back.. (Score:5, Insightful)
Or don't try to resuscitate. Wouldn't CPR's compressions be both worthless and potentially damaging?
Re:Should sleep with a sign on chest/back.. (Score:5, Informative)
Re:Should sleep with a sign on chest/back.. (Score:5, Funny)
Re:Should sleep with a sign on chest/back.. (Score:5, Insightful)
I think the giant battery with a cable running into her chest might be enough of a clue for most trained medical professionals to figure out that her case is unusual.
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"Paramedics/Doctors: Do not write me off as dead. Try to resuscitate"
The correct phrasing is, "I'm not dead yet!"
Re:Should sleep with a sign on chest/back.. (Score:5, Funny)
How about:
"Paramedics/Doctors: USB port for resuscitation and diagnostics is located under left breast. Use clean power supply when connecting to heart."
Interesting concept... (Score:5, Insightful)
...but I definitely see the need for a special Medic Alert badge for this.
Re: (Score:3, Insightful)
It's got an external power supply with a cable going into the chest is pretty much its own badge right there.
Seriously, what do you think would possibly happen without a bracelet? The EMT's going to arrive and say "Oh hey, here's the problem.. there's a *cable* going into her chest. I'll just yank that out and.. [tug, grunt] There we go!"
All logic aside.. (Score:5, Funny)
Re:All logic aside.. (Score:5, Funny)
Re:All logic aside.. (Score:4, Interesting)
Well, considering that my sister (she's a physician) tells me that life as a resident is a lot more like Scrubs and a lot less than ER, Grey's Anatomy, et. al., I am sure she would end up being the "newbie prank" for all new residents and nurses.
Re:All logic aside.. (Score:5, Funny)
For added humor, start yelling out BRAAAIIINNNNNS with a glazed over look in your eyes.
Any systems depend on a pulse (Score:5, Interesting)
With hundreds of millions of years of evolution, are there any systems in the human body that are dependent on the pulse to function properly?
Re:Any systems depend on a pulse (Score:5, Insightful)
We'll find out pretty soon now, won't we?
Re: (Score:3, Interesting)
Good question. And it's one (according to the article links) they are asking. Note that just because something has had hundreds of millions of years of evolution does not mean it's very good or could not be improved upon. Look at the Sinus cavity for example.
Re:Any systems depend on a pulse (Score:4, Informative)
Most of these artificial heart patients end up dying of strokes, caused of course by blood clots. It's theorized that such clots are easier to form in a pulse-less environment of steady-flow than in an environment where the blood is being "shaken" a bit, ie the pulse with each heartbeat.
Re:Any systems depend on a pulse (Score:5, Interesting)
Well if we're in there redesigning the system anyways, it seems that there should be some way to filter or shake the blood as it passes through this thing to prevent clotting. Heck in some distant future it'd be interesting to see if it could be designed to filter out unwanted levels things like cholesterol and the like. Or for diabetics, directly monitor blood-sugar levels and inject insulin as needed to keep things under control.
Or with it being in such directly contact with so many of the body's essential systems, perhaps enough monitors could be built in that it could via wifi or the like send signals to the local dispatch office if the blood stops flowing, or if the blood pressure crosses a certain threshold.
Of course I'm playing armchair medical engineer here with no real knowledge whatsoever, but that's what most "futurists" do anyways :D.
Re: (Score:3, Funny)
So you want SNMP monitoring for your heart?
Nothing like getting a page about your heart malfunctioning...
Re:Any systems depend on a pulse (Score:4, Interesting)
perhaps enough monitors could be built in that it could via wifi or the like send signals to the local dispatch office if the blood stops flowing
Finally, a use case for IPv6. Give an address to every human organ in every human. I purpose that we use the 2001:911::/32 address space so that it is easy to remember your organs' IP address.
Oh God! I think I'm having a heart attack, quick someone SNMP to 2001:911:34A:2F71::2 and send the restart command!
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And when she moves super-fast with her cyborg powers, she has to make a "nuh-nuh-nuh-nuh" sound. Otherwise it's not real.
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The first in Singapore. The technology has been around and in use elsewhere for years, as evidenced by older articles explaining it (and I remember reading about this a while back).
Re:"Here" is not a pronoun (Score:4, Interesting)
I know English grammar because I studied Latin. In fact, it was very noticeable in English lessons that the six hands that went up whenever a question about grammar was asked belonged to the six people taking Latin.
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Maybe human body isn't required to have a pulse, but it might lead to some weird situations when first-aid personnel or other people try to help you.
Maybe they'll even declare you dead while you're just unconscious, because they nor the machines can feel your pulse.
Re: (Score:3, Informative)
I would bet that an EMT, nurse, or doctor would realize something's going on in the chest upon auscultation of the apices, and in a triage situation you don't bother with the non-breathers until the bleeders are taken care of.
Re: (Score:3, Insightful)
How do they power the heart though, and how long does it run "portable".
It might well be that people/animals with artificial hearts are more likely to survive drowning since the artificial heart might still merrily pump away even if the blood oxygen drops low. And when someone finally does get the air into the lungs (and the water out first), there's no need to kickstart the heart - it's already pumping the oxygenized blood.
Re:Any systems depend on a pulse (Score:5, Funny)
Apparently not a single organ in the body does serial communication by having it clocked in or out on the rising or falling edge of the pulse.
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Something tells me she won't notice.
Re:Any systems depend on a pulse (Score:5, Funny)
I can think of one organ that reacts visibly to blood pulses. Suck your gut in some time and you may see it too.
What, my toes? I'd have to move my massive genitals out of the way too to see those.
Re:Any systems depend on a pulse (Score:5, Informative)
Introducing tickless technology to vertebrates. (Score:3, Interesting)
Don't worry, the penguin's kernel has evolved to pulseless a few years ago and is all fine and dandy :P
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Re:Any systems depend on a pulse (Score:5, Funny)
+1 for necrophiliacs who get the best of both worlds.
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Because I'm sure they would love you laying on their power cord...
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Awesome... (Score:4, Funny)
...now I only need to come up with the perfect crime that only a person with no pulse could get away with and I can cash-in on a screenplay for an episode of CSI.
Re:Awesome... (Score:5, Funny)
Blood pressure issues? (Score:5, Interesting)
Re:Blood pressure issues? (Score:5, Insightful)
What about clotting? (Score:4, Interesting)
I'm no med student. I'm just curious. I had heard that blood clotting relies on the blood remaining still for a period of time. Normally your pulse still allows for clotting because of the brief period of time that the blood doesn't flow. If you get a cut, you will bleed. In this case if the blood never stops moving will the individual bleed to death from something as simple as a papercut?
But at the same time, if that were the case how did the patient survive the surgery?
Re:What about clotting? (Score:5, Insightful)
Re: (Score:3, Interesting)
Also, what causes blood to clot is contact with air.
Arterial contraction (Score:3, Insightful)
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Kinda like a rotary... (Score:5, Funny)
You know,
piston engine go boing boing boing... rotary go mmmmmmmmmmmmmm...
Re:Kinda like a rotary... (Score:5, Funny)
Re: (Score:3, Funny)
So, does it come with a boost gauge?
Does she feel any different? (Score:5, Interesting)
Having always had a heartbeat since birth, I can only assume that I can feel it beat, but am ignoring it. Obviously there are exceptions where I can very much feel and hear my pulse, and am very well aware of it.
She'll never feel that again.
Does she notice?
Re:Does she feel any different? (Score:5, Insightful)
Without the implant, she won't feel anything again. There's no way to put this other than that it's a life-changing event. Many things after this will be different from the way they were before. But generally a life-changing event is to be preferred over a life-ending event.
Re:Does she feel any different? (Score:5, Interesting)
I'll swap with her. I've had an artifical heart valve since very shortly after birth, and every single pulse of my life since I've been old enough to understand the concept of my heart beating is, so long as it's not overly noisy, completely audible. And because it's an internal noise, or because I know what to listen for, it's much easier to pick up than you would think. I'm sitting in an office with about 10 people all working at computers and I can hear it now.
Allow me to assure you that the tick of your own heart beating audibly for every single fucking beat, will slowly but almost certainly drive you mad. I used to sleep with a radio every single night on for a period of virtually 10 years. Even now from time to time I go to bed with headphones on to not bother my wife but still drown out the ticking.
I would swap an audible pulse for no pulse at all in a ... well, heartbeat.
No pulse? She's dead! (Score:3, Insightful)
Oh wait, no she's not. She's fucking BREATHING.
You're all idiots to think doctors, nurses and paramedics can't see if a person is breathing or not.
Vonda N. McIntire, "Superluminal" (Score:4, Interesting)
In Vonda McIntyre's novel "Superluminal" starship pilots had to have their hearts replaced with a rotary pump because the rhythm of the heartbeat caused a breakdown in their bodies during FTL flight.
They called the pulse-less pilots "Aztecs".
New rules required. (Score:5, Funny)
Pulse now optional.
Re: (Score:3, Funny)
Normally I'd say that artificial hearts aren't designed for strenuous activity, but you're a slashdotter after all...
The perfect sniper (Score:5, Funny)
Heart Mate II Pump (Score:5, Informative)
She is holding a Heart Mate II pump...most of our patients get this model...and NONE have a regular pulse. Funny since this is just breaking news and St Lukes Heart Transplant do it day in and day out, for a loooong time.
Re:Heart Mate II Pump (Score:4, Informative)
Re:Heart Mate II Pump (Score:5, Interesting)
What's her blood pressure? (Score:3, Interesting)
Curious, honestly... I wonder what the long term ramifications of having a non-fluctuating bp are?
this is great, but why not just regorw the heart? (Score:3, Interesting)
Embodied Cognition (Score:3, Insightful)
Only the implant is new - maybe (Score:3, Informative)
My partner was an ICU nurse and used continuous flow VADs (Ventricular Assist Device) for years.
Here's an article from 2000: http://circ.ahajournals.org/cgi/content/abstract/circulationaha;101/4/356 [ahajournals.org]
There is some controversy about continuous flow, but the notion is that most of the body experiences nearly continuous flow, anyway.
Implanted continuous flow notes from April: http://www.ncbi.nlm.nih.gov/pubmed/19324130 [nih.gov]
And another from 2008 implying that pulseless does not matter:
http://www.ncbi.nlm.nih.gov/pubmed/18442710?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed [nih.gov]
"Superluminal", by Vonda McIntyre (Score:3, Informative)
Read "Superluminal", by Vonda McIntyre. It's a sci-fi story about a woman who gets a turbopump heart that doesn't beat -- not because she's sick, but because it's a necessary part of becoming a starship pilot. Romance and heartbreak ensue.
Re: (Score:3, Funny)
What are the drawbacks?
That when there's a bug, it's a Blue Screen of Death you wont be booting back from.
Re:In a movie (Score:4, Funny)
So what does the call center script say?
"If the patient has turned Blue, have them reincarnate and hope that solves the problem."
"If patient is unable to reincarnate, please reintroduce the four noble truths and the eightfold path. Then re-attempt to reincarnate."
Re:In a movie (Score:5, Informative)
Re:In a movie (Score:5, Informative)
This device is bladeless. In fact, one of the major advantages of this artificial heart compared to the traditional ones, is that this damages less blood cells than all other artificial "pulsed" devices. It has other benefits, like smaller size and less energy consumption. Overall, it's a greatly improved system.
Re: (Score:3, Insightful)
according to the MIT review article the continuous flow artificial harts are in fact turbomachines. If you have any details on the particular device used here, I'd be interested to read about it.
No pulse seems bad (Score:4, Interesting)
Re: (Score:3, Interesting)
I don't have all the facts (as I guess nobody in the world at this point does), but based on what I know, I will strongly disagree, and here is why: the purpose of the heart is to provide blood to the body's tissues, in order to keep them oxigenated. The rate of oxigenation depends on the average flux of the blood. Whether the blood flows continuously or pulsed, it is important to maintain an average flux of a given intensity. With continuous flux, the maximum pressure of the blood will be less than with pu
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Re:In a movie (Score:5, Informative)
the technical term for those wondering (this is/. afterall) is paristaltic pump [wikipedia.org]
Re:In a movie (Score:5, Funny)
What are the drawbacks?
Welcome to the afterlife, Jean-Luc. You're dead.
Re:In a movie (Score:5, Funny)
Welcome to the afterlife, Jean-Luc. You're dead.
No, I am not dead. Because I refuse to believe that the afterlife is run by you. The universe is not so badly designed.
Re: (Score:3, Funny)
Reports of my assimilation are greatly exaggerated.
Re:In a movie (Score:5, Funny)
Welcome to the afterlife, Jean-Luc. You're dead.
No, I am not dead. Because I refuse to believe that the afterlife is run by you. The universe is not so badly designed.
Blasphemy! I should... cast you out, or smite you, or something.
Re:In a movie (Score:5, Funny)
Actually, it means you're a Slashdotter.
Whether that's good or bad is left as an exercise to the reader.
Re:In a movie (Score:5, Funny)
What are the drawbacks?
Well, I'm going to have to relax my "anything with a pulse" criterion...
Re:In a movie (Score:5, Interesting)
Or even more so, how do machines or the nurses/doctors see you're still living if you're temporary unconscious (maybe a few too many beers?) and your pulse is zero. Then they'll declare you dead and dig you to graveyard. Nice place to wake up after a night of partying.
Re:In a movie (Score:4, Funny)
Re: (Score:3, Interesting)
Re:In a movie (Score:5, Funny)
Re:In a movie (Score:4, Informative)
Breathing. One of the checks is not just a pulse, but breathing as well.
Re:In a movie (Score:5, Informative)
According to the MIT write-up, you still have blood pressure. The device would pump more or less blood based on your body's need at the time. What you would NOT have is a systolic/diastolic reading. You'd have one pressure reading. No more 110/70 reading, perhaps a 85mmHg in its place.
Re:In a movie (Score:5, Insightful)
And how would that be measured (non-invasively)? Blood pressure is read by squeezing off the artery and listening and watching for the various points in the pulse. If there is no pulse, there is no measurement.
Re: (Score:3, Informative)
Open one of your eyes and shine a light in it. If the pupil constricts, you're alive. Of course, if you have a condition that makes your pupils NOT constrict, you're in some deep trouble!
But these artificial hearts are NOT for permanent implantation, they're to keep you alive until a donor heart can be found. If you have an artificial heart you should NOT be drinking; you're WAY too ill.
My cousin contracted a virus of some sort in her heart, and had an artificial heart implanted for several months. She has
Re:In a movie (Score:4, Funny)
Re:In a movie (Score:5, Funny)
Almost as good as smoking through that little hole in your neck.
Oh damn! I thought that what it was for. A cigarette, after all, fits the hole perfectly.
I just made an appointment with my surgeon to have it fitted for cigars, too.
Re: (Score:3, Funny)
I would be partying all day and nights.
It is better to Rock n Roll all night, and party ev-er-y day.
Re:In a movie (Score:4, Informative)
Re:In a movie (Score:4, Insightful)
It might be bad. Or it might be better. Maybe your arteries are only flexible because your stupid heart can't provide a steady pressure, and you needed to have flexible blood vessels to help even out the dramatic change in pressures that could damage more sensitive tissues. Maybe plaque buildup is a result of the flexing, and would decreased if the arteries walls didn't contract and trap small bits of plaque. Maybe it is bad for artery health, but your brain and mussels function 47% better so you're willing to put up with it.
Since no one has lived very long on a continuous-flow heart I think any supposed side-effects (detrimental or otherwise) would just be wild speculation. In any case, given the much longer equipment lifetimes it seems like this technology is at least worth investigating; we're hoping to install it in people who would otherwise be dead, and there's a whole slew of detrimental side-effects that otherwise-dead people are willing to live with for the sake of not being dead.
Re:Recipe for disaster? (Score:4, Insightful)
Re:Recipe for disaster? (Score:5, Informative)
Automated external defibrillators, such as the Physio-Control LifePak 500, will only administer a shock if they detect a valid shockable rhythm, i.e. ventricular fibrillation [wikipedia.org]. This AED will not shock anyone or anything that does not have that rhythm present.
Manual external defibrillators, such as the Physio-Control LifePak 12, which may only be used by EMT-I or EMT-P (Paramedics) in my home state, can be used to administer a shock regardless of the presence or absence of any cardiac rhythm. This requires a manual override, and from what I have seen, is used even less often than the precordial thump [wikipedia.org].