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Last Updated: Tuesday, 8 January 2008, 12:47 GMT
Pacemaker to stop faints fitted
Professor Richard Sutton
Professor Sutton fitted the device
A London hospital has become the first in the world to implant a new generation of pacemaker to stop people regularly fainting.

A 65-year-old man from west London was fitted with the device under local anaesthetic at St Mary's Hospital.

The Biotronik Cylos 990 pacemaker detects subtle, early changes in the body ahead of a fainting episode and then works to prevent it.

Fainting currently accounts for around 3% of admissions to hospital.

Around a third of people are thought to experience fainting at some point, but some have frequent episodes that seriously disrupt their lives.

This regular episodes can be caused by a number of factors, including neurological and cardiovascular diseases.

In a small group of patients the heart rate drops dramatically before the fainting episode.

In these patients, pacemakers - which can detect this fall in heart rate and treat it by stimulating the heart to beat faster - are well established as a good form of therapy.

No clear signs

But a larger group of patients do not experience any clear fall in heart rate ahead of a fainting episode, and pacemakers have traditionally not been of any benefit to these patients because they could not act in time to prevent the episode.

Biotronik Cylos 990 pacemaker
The pacemaker detects subtle changes in the body

The new pacemaker could potentially help this group, who account for about one in 20 people over the age of 40 who have problems with regular faints.

The pacemaker monitors performance of a chamber of the heart called the right ventricle, into which blood returns after it has passed round the body.

When the pacemaker detects that the right ventricle is unusually small - a sign that a fainting episode may be imminent - it is spurred into action.

The pacemaker also contains a chip linking it to a monitoring system, allowing doctors to keep tabs on patients at home.

Once every 24 hours, data from the pacemaker is sent to a transmitter in the patient's home and on to a secure information centre.

Any potential problems with the patient, the pacemaker or its electrodes will be emailed or sent by SMS text message to the patient's care team so they can respond appropriately.

The patient's cardiologist can also use the daily report in their follow-up care.

Professor Richard Sutton, a consultant cardiologist at St Mary's, said: "This new device is an exciting development which should be very helpful to this patient.

"It also has other new features such as the ability to monitor the device, and how it is interacting with the patient, at home.

"This way of supporting pacemaker patients in their everyday lives is the future of cardiac device care."

It will be between six months and one year before clinicians can be sure it has been fully successful in preventing future fainting episodes.

Ellen Mason, of at the British Heart Foundation, said can regular fainting could be debilitating.

"This is the first pacemaker like this implanted in the UK and follow-up results will be important for knowing whether this has a wider use for other patients."

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