PACE

Medtronic-Sponsored Study Indicates Bi-Ventricular Pacing Superior to Right Ventricular Pacing in Avoiding Cardiac Enlargement
Published Sunday, November 15, 2009, 21:01 (Your-Story.org)

Early Results Show Preserved Heart Size in Pacemaker Patients with Normal Left Ventricles

MINNEAPOLIS & ORLANDO, Fla.–(BUSINESS WIRE)– Pacing the two lower chambers of the heart, or bi-ventricular pacing, prevented cardiac enlargement as compared to only pacing the right ventricle in pacemaker patients with normal pumping hearts, according to results presented today from the Pacing to Avoid Cardiac Enlargement (PACE) trial, a clinical study supported by Medtronic, Inc. (NYSE: MDT). Bi-ventricular pacing is proven to reduce symptoms, extend survival and reduce heart size in symptomatic heart failure patients; however, it is not currently approved for use with pacemaker patients with normal pumping hearts. PACE data were presented today as a late-breaking clinical science session at the Scientific Sessions 2009, the annual congress of the American Heart Association in Orlando, Fla. and published online in the New England Journal of Medicine.

Meeting its primary objective, PACE results showed that after one year of pacing, patients with pacing in both right and left ventricles (bi-ventricular) had no significant changes in left ventricle size while patients paced only in the right ventricle developed enlarged left ventricles. Adverse changes in patients paced only in the right ventricle included:

“These early results show bi-ventricular pacing may be superior to pacing only in the right ventricle to preserve the heart’s normal left ventricle size and pumping ability for these pacemaker patients,” said Cheuk-Man Yu, M.D. professor of medicine at Prince of Wales Hospital, The Chinese University of Hong Kong in China and PACE lead investigator. “As the first randomized study with this patient population, these initial results suggested that ensuring synchrony of the ventricles can help maintain patient health.”

“Clinical evidence shows delivering pacing only when and where patients need it is important to improving the care of pacemaker patients,” said Marshall Stanton, M.D., vice president of clinical research for the Cardiac Rhythm Disease Management business at Medtronic. “With the Medtronic-exclusive pacing mode MVP®, Managed Ventricular Pacing, which is the only technology available that reduces unnecessary right ventricular pacing by 99 percent, and the ongoing BLOCK-HF bi-ventricular pacing study, Medtronic is dedicated to offering physicians the latest tools and clinical evidence to help physicians deliver appropriate care to their pacemaker patients.”

About PACEThe PACE study is a prospective, randomized, double-blind, parallel study enrolling 177 patients at four hospitals in Asia. Patients had a Medtronic Insync® III cardiac resynchronization therapy-pacemaker (CRT-P), or bi-ventricular pacemaker without defibrillation, and had no prior history of heart failure with normal left ventricle function and ejection fraction greater than or equal to 45 percent. Patients were evaluated at one, three, six, nine and 12 months.

About Cardiac Resynchronization TherapyCardiac resynchronization therapy (CRT), also known as bi-ventricular pacing, is a treatment for heart failure that uses an implantable device to improve the pumping efficiency of the heart. A cardiac resynchronization therapy-pacemaker (CRT-P), is a stopwatch-sized device implanted in the upper chest to resynchronize (without defibrillation) the contractions of the ventricles by sending tiny electrical pacing impulses to the heart muscle to help the heart pump blood throughout the body more efficiently and reduce symptoms. Cardiac resynchronization therapy is intended to complement standard drug treatment, and dietary and lifestyle modifications.

About MedtronicMedtronic, Inc. (www.medtronic.com), headquartered in Minneapolis, is the global leader in medical technology – alleviating pain, restoring health and extending life for millions of people around the world.

Caution: The CRT-P devices used in the PACE trial are investigational for the patient population studied; their use is limited by federal (or United States) law to investigational use for this indication.

Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic’s Annual Report on Form 10-K for the year ended April 24, 2009. Actual results may differ materially from anticipated results.

Press Release Contact Details:

Medtronic, Inc. Public Relations: Catherine Peloquin, 763-526-2494 or Investor Relations: Jeff Warren, 763-505-2696

Butchering South African Anthem...

The reggae singer the Springboks accused of butchering the anthem before the 20-13 Test match defeat to France said that he thought he had "sung beautifully".

Ras Dumisani, sporting dreadlocks tucked into a huge red, green and white Rastafarian cap, was adamant that his performance - which made large parts of the Toulouse crowd burst into laughter - had been a good one.

"No one told me they were upset with the singing," the Durban native said. "In fact, someone just came up to me and told me how beautifully I had sung."

The South African anthem was sung before France's stirring "Marseillaise" and the singer, backed by two drummers of his Afrikhaya Band, made a mess of the four-language homage to the Rainbow Nation.

At the anthem's conclusion, large parts of the crowd were left openly laughing and several Bok players looked over angrily as the singer made his muted departure from the field.

"I must convey that we are annoyed by the fact that the French disrespected our anthem," blasted South Africa coach Peter de Villiers.

"They didn't get someone who really knows the thing and show any respect for it. We expect people to show respect to the anthem of any other country."

But Dumisani was aghast that de Villiers and other Bok players were unhappy with his rendition.

"Everyone at the stadium told me I sang well, even after the match. The Nkosi Sikelel' iAfrika has been my tune since a baby," he said. "How can I not know the words?

"There are four languages: Zulu, Sesontho, Afrikaans, English. It's just four bars, always saying the same thing," said Dumisani, now based in Paris where he currently records is music and from where he is about to embark on a tour.

"I am the biggest reggae man in South Africa and the Springboks are my team. "Everyone has their own tastes and you can't always account for that but most people find my music so beautiful."

Speaking after the match on Friday, Bok vice-captain Victor Matfield said Dumisani's rendition of the anthem had taken some of the wind out of the Springbok sails just moments before a kick-off.

"It's almost like receiving a jersey - every week's a special moment," Matfield said of lining up to sing the anthem.

"Every time you go out on the field and sing the national anthem, it's very important for us and that's something that fires you up because it really fires you up because you know you're playing for your country.

"It was a joke out there. The guys couldn't sing along to it and

even the crowd were starting to laugh. It was very disappointing." (source UK Telegraph)

SO HERE IS MY NATIONAL ANTHEM AGAIN ESPECIALLY FOR RAS DUMISANI...

NKOSI SIKELEL'I FOR AFRICANS/AFRIKANERS AND ENGLISH SPEAKERS

Thu 12 Nov 2009, 02:55 (2) 37 Comment(s)

Angiogram at Umhlanga Hospital

I was admitted at 9 (last Monday )

In the ward they immediately did an ECG ; Blood glucose, High Blood Pressure and completed the pages and pages of personal health questions…

When it comes to my Porphyria, it always causes a stir, because belief it or not it is not as common as I thought.
My cardiologist got sick and his excellent partner took over. My baby sister who has been the private PA of a well-known Oncologist in Durban for nearly 25 years put in a good word with the kind and professional cardiologist.

My baby sister and I could have been twins, so close is the resemblance; and he jokingly remarked on the fact. He was great and did a complete check-up. The ECG did show a TL wave V1 and V3 irregularity and therefore the angiogram. I have been cancelling my appointments with the Cardiologist for the last 4 months; I just didn’t have the courage to go…

It was a very long morning and I only went into the Cath Lab at 15:45

I have been through some big operations before but this one really scared me…

It is very intimidating in the Catheterization Laboratory with all the big computers, scanners and radiation equipment/shields all over and around the special examination table. The cardiologist and sisters wore full protective clothing and worked behind a protective shield/screen during the full procedure. I had to be injected with a hydrocortisone due to my sensitivity to Iodine, etc (porphyria and allergic reaction to the x-ray dye); which regulates carbohydrate metabolism and maintains my blood pressure. After local anesthesia was given, a catheter was inserted into a main blood vessel in my groin by means of a needle-stick. The catheter was advanced through the blood vessel to my heart. It hurt in the beginning and caused a sort of ‘hot flush’ up in my head and down to my toes, a very weird and odd sensation.

By injecting the dye through the catheter a series of rapid x-ray images were recorded, some kind of x-ray movie was made of the blood flowing through the cardiac chambers; and/or through the blood vessels surrounding my heart – this is what is known as angiography/angiogram/arteriography.

The procedure took about 30 minutes. The catheter was removed and bleeding was controlled by placing pressure (a 2kg sandbag) on the catheterization site for 6 hours +. I was restricted from bending/moving my leg or getting up …

Cardiac catheterization and angiography are relatively safe, but because they are invasive procedures involving the heart, several complications are possible…

I had minor bleeding at the site of the catheter insertion and temporary heart rhythm disturbances caused by the catheter irritating my heart muscle as well as temporary changes in my blood pressure. I was put on blood thinners to keep a blood clot forming (just a precautionary measure; thrombosis etc.) . I battled with a terrible migraine, nausea and my eyes were sore, and my vision was blurring for more than an hour after the procedure. I will not mention the more significant complications, because they are life threatening…

They then moved me directly into ICU 1 for the night. I shared the ward with three triple bypass patients (males) as well as one serious case, a man who had a ‘5 bypass – a quintuplet?’
Yes, ladies in ICU; I shared the room with males. Very uncomfortable!
I had an Indian male at my feet (no pun intended); who was better off than the rest of the patients in ICU. We could 'face' each others every move; not the ideal position when I was restricted to my bed and had to make use of a bedpan and he a bottle... (He could move into a sitting position the next day and was having meals after his triple bypass. I couldn't believe my eyes when he opened a packet of Simba chips...)

That same evening at 20h00, we had a code blue; which caused some serious activity happening in the ward! He didn’t make it and it was very upsetting, because although they closed the curtains, the sounds caused some vivid images… It happened during visiting hours and the visitors had to leave in a hurry. The family was so upset and the removal of the body was so ‘everyday’; when the staff arrived with the trolley to remove him to the morgue; the guy asked loudly for everyone to hear where the body is?? They enclosed ‘him’ in the body bag and I still cannot get the awful zipping of the bag out of my head as well as the sound of the trolley wheels as they moved out of ICU. With the sound disappearing in the passage, another precious life has departed from this sad world!

The next morning the Indian man with ‘quintuplet’ bypass had a code blue as well, and they nearly lost him… They did revive him, but his whole life was by then controlled by machines…

I take my hat off to the staff in ICU1; they do brilliant work! I don't know how they cope with the 'stress factor' however... Or is it just a normal everyday at work for them? Do they get immune to these situations?

What cheered me up was a surprise visit by Anil… It wasn’t visiting hours; so don’t ask me how she got into ICU! I don’t care, I was so thankful for her visit; it made my day!

I was so relieved when I was eventually discharged just before 14h00 …


I am still suffering from alexithymia …