David Y. Feigenblum, MD, PhD, director of the Cardiac Electrophysiology Laboratory at Englewood Hospital and Medical Center, is the first physician in northern New Jersey to implant innovative technology that reduces the likelihood that its recipients, heart failure sufferers, will be readmitted to the hospital for related additional procedures. The physician is among the first of his colleagues nationwide to install a new pacing system that is used to treat abnormal heart rhythms.

Dr. Feigenblum performed the 90-minute procedure soon after the procedure was approved by the FDA. His 78 year-old patient was sorely in need of an intervention due to the effects of heart failure, a condition in which the heart is weakened and does not pump blood through the body properly. "He could not walk up a flight of stairs without shortness of breath," said the physician. "Fortunately, he was a good candidate for the new pacing system. We were following the development of the product and welcomed the opportunity to use it as soon as it was available. It was a great pleasure to send this gentleman home and on his way to a good recovery the next day."

The new system, the Unify QuadraR CRT-D and QuartetR Left Ventricular Quadripolar Pacing Lead by St. Jude Medical, is the first to include a long, insulated wire with four electrodes that is a conduit between an implanted device and the heart. The lead sends electrical signals from the device to the heart to provide therapy needed to address abnormal heart rhythms and carries information from the heart back to the implanted device.

Previously, pacing systems typically have included only two electrodes, thus limiting the options for treatment and increasing the chances that complications resulting in repeat surgery will be required. The new system has four electrodes as well as ten pacing options, as opposed to the older systems that usually provide only three options, said Dr. Feigenblum. "Although only one electrode is turned on the day of the procedure, changes after that may require us to reposition a lead or activate a new electrode. Using this system means we are more likely to be able to reprogram the pacing option non-invasively, so the patient isn't required to go back to the hospital for additional surgery. For eligible patients, this is a more comprehensive, better approach from the start."

The system includes a device designed to optimize the heart's pumping function and help the heart perform in its most natural state by synchronizing the left and right ventricles of the heart through timed electrical pulses. Its companion component, a lead, features four electrodes on a single, left-ventricular lead. The combination of the two technologies provides valuable advantages.

Ultimately, having four electrodes provides more options to effectively provide resynchronization therapy. "A patient's anatomy may make some of the electrodes unusable," said Dr. Feigenblum. "Most simply put, the more pacing options we start with, the better our choices. This major advance constitutes a significant addition to the tools we use to treat our heart failure patients at Englewood Hospital, where embracing the newest technologies in cardiac care is an integral part of the hospital's highly rated medical and surgical services."

One possible example of a complication resulting from implantation of a pacing system is the unintentional stimulation of the diaphragm or the heart's phrenic nerve, which results in terribly uncomfortable hiccup-like symptoms. Dr. Feigenblum explained that in such a case, without the ability to select different pacing locations, additional surgery could be needed to reposition the pacing lead.

"Our goal and the hallmark of our care is excellence," said Dr. Feigenblum. "This new system is helping us fulfill our mission." For more Information about Electrophysiology Services at Englewood Hospital and Medical Center, visit bestheartdocs.com or call 201-894-3533.