Returning Ultimate Control of Care to the Patient

The Incrementalist Graphic Rob Kowal

This week I am talking to Rob Kowal, MD, PhD Chief Medical Officer, of Medtronic (@Medtronic/@MDT_Cardiac) and a cardiac electrophysiologist who has been part of the incredible progress and innovation that have taken place in implantable cardiac devices. He talks about the progress from the early days of external pacing devices, to early implantable pacemakers that had to be adjusted manually with special needles:

Programmability of permanent pacemakers was introduced in the 1960s with the installation of 2 insulated potentiometers at the lateral edge of the pulse generator that were accessed using special needles inserted percutaneously to adjust rate and output

You can read more of this historical review 50th Anniversary of the First Successful Permanent Pacemaker Implantation in the United States and see how the early devices consisted mostly of batteries.

Moving to the Patient Home Early Pacemaker gr4

Implantable devices now come with 1, 2, and even 3 wires for additional functionality, remote programming capabilities, and even as “MRI-conditionalpacemakers – ones that can now be implanted but still allow for MRI’s to be carried out, and even headless devices

Moving to the Patient Home Leadless pacemaker Micra heart

We discuss how the incremental basis for some of this innovation that centered on answering a core question of the unmet needs of the patient

  • The Power of the Team
  • Working with Physicians

and perhaps most importantly

Not stopping innovation as solutions are developed but continuing to seek the next incremental improvement

As with so many other areas COVID19 has accelerated some of the innovation and in the case of remote monitoring as Rob puts it “things are better at home” and they have focused on how to bring remote monitoring with devices that not only gather data but communicate this automatically to the clinical team offering earlier interventions before problems arise and even start to predict when problems might arise so they can be prevented from occurring.

Listen in to hear the details around the built-in security in implantable devices and the review by a patent of his who was also a security expert and what they had to say

 


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