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Daniel Trussell, left, nurse coordinator in cardioelectric physiology at UMC, uses a wand to help the Zoom programmer communicate with the CRT device implanted in Shirley Fletcher's chest.

Thanks to a new implantable device, cardiologists at the University of Mississippi Medical Center can now keep a constant eye on their heart-failure patients — even those who live many miles from the Jackson campus.

Introduced recently at UMC, the cardiac resynchronization therapy device (CRT) connects the patient to physicians via radio frequency technology. It gives physicians instant information about their patients' heart status as well as vital signs from many miles away.

Dr. John P. Payne, UMC associate professor of medicine and director of the Medical Center's adult heart rhythm service, said the device was introduced as a way to help stem the already high cost of healthcare. For patients, it can mean spending less time and money on clinic visits as well as on travel there and back.

"For a rural state like Mississippi, home monitoring of heart failure patients can reduce the need for frequent long distance travel," Payne said. "This is a way of extending the care delivered at the office to the patients on a real-time basis as they really need it."

The challenge of keeping congestive heart failure patients feeling well and physically active is a major one, considering the condition affects more areas of the body than just the cardiovascular system.

It's the patients with moderate-to-severe heart failure who maintain symptoms despite proper drug therapy that are suited for CRTs.

The integrated system includes four main parts: the wireless-enabled implantable device, an in-home monitoring unit that automatically reads and transmits information from the implanted device upon physician request; a secure Web site that provides around-the-clock access to patient data collected by the communicator; and a wireless programmer. A weight scale and blood pressure monitor are optional.

At UMC, cardiologists implanted more than 40 CRTs in 2006. Information relayed by the devices includes heart rhythm changes, device malfunction and fluid retention in the lungs.

For patients like Shirley Fletcher of Kosciusko, the system both collects her vital signs and also asks the kinds of questions she'd answer while giving an in-clinic history.

"Every Monday morning when the machine blinks on, it asks me questions such as how many pillows I slept on last night, or how many times I woke up breathless," Fletcher said. "I can hook the blood pressure machine to it and it reads my blood pressure automatically. When I have to weigh myself, it automatically records my weight, too."

Payne said patient response to the device has been "uniformly positive."
"For some patients, it has been an opportunity to take a more active role in managing their heart condition because they have access to the information that the healthcare provider has," he said. "For all, it has given them additional peace of mind that they are being cared for closely and with state-of-the-art medical technology."

Also at UMC, a recent expansion of the cardiology fellowship program offers fellows on-site training in diagnosis and treatment through partnerships with Baptist Medical Center and Cardiovascular Associates PA.

The one-year Interventional Cardiology Fellowship Program was launched in July 2005 by doctors Anderson Mehrle and Walter Woody.

UMC's Cardiology Fellowship Training Program is a three-year training term. Approval from the Accreditation Council for Graduate Medical Education provides for 12 fellows — four per year in the three-year program — as well as two fellows per year in the interventional cardiology program.

As the only cardiology fellowship program in the state, it is the referral center for many of the most complex cardiac cases in Mississippi. Fellows' clinical experience includes everything from coronary artery disease, complex arrhythmias and heart failure to cardiac transplant, valvular and adult congenital heart disease.


June 2007

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