Advances in Cardiac Resynchronization and Implantable cardioverter/defibrillator Therapy: Medtronic Cobalt and Crome

Abstract

Cardiovascular implantable electronic devices have revolutionized the management of heart failure with reduced ejection fraction. New device generations tend to be launched every few years, with incremental improvements in performance and safety and with an expectation that these will improve patient management and outcomes while remaining cost-effective. As a result, today’s cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillator devices are quite different from the pioneering but often bulky devices of the late 20th century. This review discusses new and improved features developed to target specific needs in managing heart failure patients, some of which are especially pertinent to the current worldwide healthcare situation, with focus on the latest generation of CRTs with defibrillator (CRT-Ds) and implantable cardioverter defibrillators from Medtronic.

The Life Experience of Patients after the Implantation of Cardiovascular Implantable Electronic Devices: A Qualitative Meta-Synthesis

“…Therefore, it is necessary to reduce the physical discomfort caused by CIED to patients by reducing the size of the device, reducing the number of unnecessary electric shocks, and extending the battery life of the device. The reason is, the size of the device affects the degree of foreign body intrusion that the patient feels [ 18 ], while unnecessary electric shocks can cause anxiety and pain, and even lead to patients giving up using their CIEDs [ 31 ]. Extended battery life can reduce the number of battery replacements, the risk of infection and device damage or failure, and treatment costs [ 31 ].…”

“…The reason is, the size of the device affects the degree of foreign body intrusion that the patient feels [ 18 ], while unnecessary electric shocks can cause anxiety and pain, and even lead to patients giving up using their CIEDs [ 31 ]. Extended battery life can reduce the number of battery replacements, the risk of infection and device damage or failure, and treatment costs [ 31 ]. Regarding how to improve the patient’s acceptance of the device size, previous studies have shown that it can be achieved by optimizing the design so that the skin pressure is evenly distributed on the surface [ 32 ].…”

“…In particular, intrinsic ATP (iATP) can provide adaptive ATP therapy that responds to the tachycardias of individual patients, terminating 87.8% of ventricular tachycardial episodes [ 34 ]. Regarding how to prolong battery life, studies have shown that using high-density integrated circuits and low-energy Bluetooth transmission can reduce quiescent current consumption by 9% [ 31 ]. Using chemical techniques can increase the battery capacity by 14% without a concomitant increase in battery size [ 31 ].…”

“…Regarding how to prolong battery life, studies have shown that using high-density integrated circuits and low-energy Bluetooth transmission can reduce quiescent current consumption by 9% [ 31 ]. Using chemical techniques can increase the battery capacity by 14% without a concomitant increase in battery size [ 31 ]. However, whether these achievements can play a role in the clinic and be widely applied still needs to be determined through continuous and comprehensive equipment monitoring and multi-center clinical trials.…”

Batteries in Service of Human Health

“…[2][3][4] The implantable cardiac pacemaker, defibrillator, and resynchronization devices enabled by new battery technologies revolutionized cardiac health care for patients, providing a treatment for heart disease and sudden cardiac death due to ventricular fibrillation. 5,6 Small, implantable battery-powered pumps are used for controlled delivery of pain medication directly to the spinal cord through intrathecal drug delivery devices (pain pumps) for patients with chronic pain conditions. 7 The impact of battery-powered implantable devices on human health is invaluable.While the power demands, size, capacity, and configuration of the batteries vary based on the type of device and the therapy, there are common requirements for implantable batteries that aid human health.…”