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Home > Archive > Jul 26, 2007

The Heart of the Matter
By Cami Cox
Staff Writer
New, cutting-edge technology being tested at Dixie Regional Medical Center may be the answer to problems for heart-failure patients.
As part of a national clinical study, DRMC is in the midst of testing LATITUDE devices, part of a technologically advanced patient-monitoring system for individuals with pacemakers and defibrillators. Utilizing the latest in wireless Internet technology, LATITUDE devices enable doctors to keep tabs on their patients' conditions anytime, anywhere.
“It is an Internet-based process that allows us to receive data from both pacemakers and from defibrillators over the Internet on a weekly and/or daily basis if we need to,” Dr. Greg Price, a 12-year DRMC cardiologist, said. “Our goal was to see if we can prevent hospitalizations and improve patient outcomes. Heart failure is one of the most common causes for acute hospitalizations.”
Price is one of only two doctors in the St. George area qualified to implant the LATITUDE heart-monitoring devices. The other is Dr. John Jentzer, an electrophysiologist at Dixie Regional. Together, the two are collaborating on the local study of these devices, known as RAPID-RF, to determine the effectiveness of the devices, their benefit and whether they can help prevent hospitalization in heart-failure patients. The results seen so far have been encouraging.
“It's made such a difference in some of our patients that it's unbelievable,” Price said.
Formerly, when patients had pacemakers or defibrillators implanted, they had to return to their doctors every six months to have the devices checked. Some remote tracking of the devices was possible through simpler software, but there were limitations on the types of data that could be accessed. With the new LATITUDE technology, doctors can get information such as patient blood pressure, weight changes and other factors indicative of heart-health risks without having to see the patient in person. Doctors can also ensure that the pacemakers and defibrillators themselves are working properly. Should there be a problem with a device, hospital staff are notified immediately and can then alert the patient to make sure that person gets to a hospital and receives the care they need.
“It provides us warnings or red flags that in the old days we would not have known about for three or four months, until we brought the patient back and retested the device,” Price said.
LATITUDE systems operate collaboratively between the implanted devices, in-home monitoring units, a secure Web site to which patient data is sent and wireless weight scales and blood pressure cuffs to monitor the patients' conditions and any danger signs, such as sudden weight gain or changes in blood pressure. Utilizing Bluetooth-type technology, LATITUDE devices make this information available to physicians, and the doctors can access the data from any location where there is an Internet connection.
“I could even be on vacation,” Price said. “If there's a big issue, I could have my office pull the data up and fax it to me somewhere, and then I can look at it, even if I don't have access to the Internet.”
Not only a help for doctors, the LATITUDE systems provide relief for patients, who rest easier knowing that their health is being constantly monitored, Sara Palmer, RN BSN and RAPID-RF research coordinator at DRMC, said.
“The consensus from the patients participating in the RAPID-RF study is that the LATITUDE equipment and software provide them with a great sense of comfort, knowing that a physician is aware of their blood pressure, aware of their body weight and aware of their heart rhythms, and that if there is going to be a problem, the doctor is going to be aware of it and initiate appropriate treatment,” Palmer said.
One participant in the RAPID-RF study, 83-year-old Julianne Cottrell, of St. George, was hesitant to have a pacemaker-defibrillator implanted. A heart patient since age 65 when she suffered a heart attack, Cottrell has experienced related health problems ever since but didn't want to go the pacemaker route. Price, her doctor, finally convinced her to give the new LATITUDE technology a try.
“I've taken care of this lady and her husband for years, and they're two of my favorite patients. I just absolutely love them,” Price said. “She was bedridden and could hardly get up. She could not make it from her bed to the bathroom, which was 12 feet. After multiple prolonged conversations in the hospital, she agreed to have the device implant, but she was so tired and so fatigued, she just thought, 'It's not worth it. I'm just so tired. I don't want to do this anymore.' Remarkably enough, after the device, she's going shopping, she's getting out with her husband. She feels a lot better. It has substantially improved her quality of life.”
The dual pacemaker and defibrillator device regulates the pumping of the heart and also automatically administers a shock in the case of cardiac arrest. Paired with the LATITUDE technology, the device has made a drastic difference in Cottrell's life.
“It's given me a lot more energy. I was just so tired all the time. I couldn't stand up for more than five minutes at a time,” she said.
“It's a big relief. She's got so much more energy now, able to do things that she hasn't been able to do for a long time.” Cottrell's husband, Bill Cottrell, said. “I've got a helper now. She really couldn't do anything. Her heart just wasn't functioning.”
In addition to improvements in energy and health, an unanticipated benefit of the LATITUDE technology, Price said, has been the effect it has had on patients' diligence in following medical advice.
“One of the biggest things that I'm seeing, that's sort of indirect, is improved compliance for patients,” he said. “They're taking their medicines. ... You know if you don't take it, your doctor's going to be calling you in three or four days and giving you a hard time about not taking it!”
Not only a good motivator, the new technology is also a great help for heart-failure patients who live far away from the hospital, Jentzer said.
“Living a hundred miles away is no longer an issue for a lot of our patients. Patients in nursing homes no longer have the inconvenience of having to bundle down to St. George from Cedar City. Instead, they have their care done wirelessly, accurately and conveniently for them,” he said. “This is the wave of the future.”

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