Confederate to Check Pacemakers by Phone

              Confederate to Check Pacemakers by Phone
By Margaret Martin
Times Medical Writer
Long distance electrocardiogram
(EKG) tests for Confederate Memorial
Medical Center pacemaker patients will
be available soon, according to Dr.
Stephen P. Glasser, cardiologist and
assistant professor of medicine at the
Louisiana State University Medical
School at Shreveport.
The new equipment means that
patients wearing pacemakers can have
their batteries tested weekly at health
facilities near their homes, and recorded
at Confederate. Their trips to the
Shreveport hospital will be much less
frequent.
Glasser discussed three types of
equipment being used in his department
during an interview this week.
Pacemaker patients are people who
have a problem with the electrical
circuitry of the heart; a problem which
causes the heart beat to slow down.
The pacemaker, implanted under the
Dr. Stephen P. Glasser, Cardiologist
. . . with ecbocardiogram, latest in heart diagnosis
skin and connected to the heart through a
vein, gives the heart a regular, steady
beat through electrical impulses. The
battery is set from 68 to 72 beats per
minute, Glasser said.
But the pacer's battery wears out after
a time, and must be replaced during a
minor surgical procedure.
Originally pacemaker batteries were
automatically replaced after two years,
but the newer ones usually last from three
to five years, Glasser said.
But now, instead of waiting until the
pacemaker has slowed down or stopped,
Glasser can monitor the pacemaker
battery every week.
"We can start seeing a trend of a
slower rate, and call the patient in," he
explained.
Equipment involved is a receiving unit
located at Confederate and a portable unit
for the patient. (The portable unit weighs
six pounds and includes electrodes to
strap under the armpits or at the wrist,
and telephone equipment.)
The patient simply plugs in the
telephone, dials a number and has his
EKG recorded. The machine records the
heart rate and beats per minute, and the
heart rate to a thousandth of a second.
Locations Told
The portable units will be set up in
area health facilities. Initially,
Confederate is purchasing three of the
portable units. They will be placed at
Coushatta, the Ruston area and in
Minden. Selection was made on the basis
of location of the 50 pacemaker patients
around the state.
The receiving unit costs $2,100 and
each portable one $395, ,but Confederate
Director Dr. Rod M. Yeager pointed out
that through Medicare reimbursement,,
the equipment will pay for itself.
The newest in diagnostic equipment at
the hospital is an echocardiogram.
It operates on ultra sound, and Glasser
likened it to the way a bat senses an
obstacle which he can't see.
And he called it the greatest boon to
diagnostic heart procedures since the
EKG, although he emphasized that it does
not take the place of the EKG or any other
equipment.
Like the EKG, the echocardiogram is
painless. It works with one piece of wire
held over the heart.
The difference in the two lies in their
functions.
The EKG records the electrical
activity of the heart; the echocardiogram
takes a picture of the specific parts of the
heart.
For instance, the echocardiogram can
depict — on a tiny television-like screen
and a tape readout — a tumor on one of
the heart's chambers, or a malfunction of
one of the heart's valves. It can measure
fluid around the heart, or show the size of
the heart. Congenital heart conditions can
also be diagnosed with it, according to
Glasser.
Because the procedure is performed on
the outside of the body, an
echocardiogram can be taken several
times without risk to the patient. The
procedure only takes a few minutes.
Another specialized diagnostic
procedure being used at Confederate and
the medical school is the Stress Test
Monitor System, a procedure which has
the capability of revealing a cardiac
abnormality while the patient is
exercising.
Probes Further
It is useful, Glasser said, because
sometimes people have chest pain, but no
abnormalities which show up on a regular
EKG test.
The person taking the test is hooked up
to an EKG machine and put on a
treadmill, which can be set for various
speeds and monitored.
The speed of the treadmill is increased
until the patient develops a rapid heart
rate.
The EKG is taken while the person is
on the machine and usually up to five to 10
minutes after exercise.
Any changes in the heart beat after
exercise will usually mean further
diagnostic tests are necessary, Glasser
explained.
And Glasser said, again, that the stress
test is not the only diagnostic tool, nor
does it take the place of any other
equipment.
"It is another test for evaluating the
heart," he said.
Testing The Stress Test Monitor System are Tommy Mook, medicine in-tern
on the treadmill, and Dr. Stephen P. Glasser, cardiologist and as-sistant
professor of medicine at the Louisiana State University School of
Medicine at Shreveport. The machine is used to test the heart beat
while the person is exercising.
Heart Beat Syncopated for Students
Teaching medical students to interpret a heart beat is
like conducting a symphony orchestra, said Dr. Stephen P.
Glasser, cardiologist and assistant professor of medicine
at the Louisiana State University School of Medicine at
Shreveport.
Punching buttons on a teaching aid called a sound
simulator at Confederate Memorial Medical Center, he
demonstrated why.
Records of a normal heart beat — amplified many
times and seen on a television-like screen in front-had a
regular rythm.
As various mumurs and other abnormalities were ad-ded,
there were extra sounds, extra beats, until the record
hit a crescendo of melody.
Then it's back to normal so students can hear the dif-ference!