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New Treatment for Heart Failure Being Evaluated

Roger Owen of Canton used to be so weak from congestive heart failure he had to rest every few minutes when he mowed his grass.

"Now I can go a lot longer and do more," says Owen, 54. "I have more energy. I feel a lot better."

Owen is one of eight Medical Center patients who have volunteered so far for national studies evaluating a new treatment for heart failure – using new types of pacemakers to coordinate the heart''s pumping action and improve efficiency. Until now, heart failure has primarily been treated with medications.

Congestive heart failure, the fastest growing heart disorder, affects about 5 million people in the United States. It is the leading cause of hospitalization for people for over 60. Heart failure has mortality rates similar to some cancers – 50 percent of diagnosed patients die within five years.

In most cases, heart failure is caused by coronary artery disease, the buildup of fatty deposits in the arteries that limit blood flow to the heart. When the heart doesn''t get all of the blood it needs, it cannot pump fast enough or hard enough to meet the body''s demands. Symptoms of congestive heart failure include shortness of breath, lack of stamina, fatigue, fluid retention and exercise intolerance.

The new pacemakers are suitable for patients with severe heart failure, which means they have symptoms at rest or with modest activity. Unlike regular pacemakers that control the speed of the heart, the new pacemakers are designed to correct a timing problem that develops between the two sides of the heart in many people with severe heart failure.

"It''s like the pistons in an engine; they must be timed properly for the engine to work," says John Schmedtje, M.D., a heart failure specialist at Wake Forest University Baptist Medical Center. "These new pacemakers time the two sides of the heart to help it work better as a pump."

The devices have been shown to be effective in smaller studies, says Wesley Haisty, M.D., a Medical Center cardiologist who is directing the new studies locally. He said that because the studies will include more people and are better designed scientifically, they will provide a more definitive answer. For the study period, each participant''s device is turned on for half of the time and off for the other half so doctors can use exercise testing and other methods to compare effectiveness.

"We want to see if the devices result in less illness and hospitalization and improved quality of life," said Haisty.

The studies are evaluating two types of devices. Both are pacemakers that coordinate the rhythm between the left and right sides of the heart. But one device also has a defibrillator that can shock the heart back to a normal rhythm. It is designed for heart failure patients who have a known rhythm problem that could result in sudden death. The defibrillator can reduce their risk of sudden death during the first year from 20 percent to less than 1 percent.

Owen, who doesn''t need a defibrillator, received the device that works only as a pacemaker. He has completed the two parts of the study and now has his device turned on. He said he had no problem deciding whether to enter the study and try the new treatment.

"I didn''t want to go on the way I was going," he said. "I''m thankful I got it."

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