San Antonio (Feb. 3, 2005) – Generally it’s a good thing to have a big heart, but in 9-year-old Bradley Price’s case, he literally had too big a heart.
Bradley was born with congenital heart disease and underwent a number of surgeries by age 2, including placement of a pacemaker. Although his activity level seemed normal for a growing toddler, scans showed progressive enlargement of his heart muscle to a dangerous condition called dilated cardiomyopathy. He was in need of something dramatic, something new, and physicians from The University of Texas Health Science Center at San Antonio, Wilford Hall Medical Center and CHRISTUS Santa Rosa Children’s Hospital provided it.
In July 2004, they performed South Texas’ first known implant of a cardiac “resynchronization” device to save Bradley. He was one of the first 100 children in the country to receive the new pacemaker system, which consists of electrodes placed on both the left and right ventricles that fire synchronously to improve heart function.
The results have been exciting. Follow-up exams show the device is working well, and the size of his heart has returned to normal (a 20 percent reduction). He has normal heart rhythms, and his ejection fraction (a measurement of the amount of blood pumped by the heart during each beat) is in the acceptable range. “His parents say he has more energy,” said Bradley’s physician, Maj. David M. Bush, M.D., Ph.D., staff pediatric cardiologist and associate pediatric residency program director at Wilford Hall Medical Center.
John Calhoon, M.D., the President’s Council Chair of Thoracic Surgery at the Health Science Center, and Daniel Martinez, M.D., performed the surgery with Dr. Bush’s guidance at CHRISTUS Santa Rosa Children’s Hospital. Dr. Calhoon is professor of surgery and head of the division of thoracic surgery in the Health Science Center’s School of Medicine and Dr. Martinez is assistant professor of surgery.
“Resynchronization pacemaker therapy is relatively new and quite a hot topic in heart circles,” Dr. Calhoon said.
“These devices work to change the flow of electricity in the heart so that the heart muscle can contract more normally,” Dr. Bush commented.
The pacemaker implant can be done with a smaller incision than open-heart surgery and is expected to last for five years without being changed. “It has the potential to really change how we approach the patient who needs a pacemaker and has developed signs of heart failure,” Dr. Martinez said.
Cardiomyopathy is rare among children. U.S.1 and Australian2 studies published last year in The New England Journal of Medicine showed an estimated incidence of about 1 in 100,000 children, and the U.S. study showed slightly higher incidence in boys than girls.
Symptoms vary among individuals and may include shortness of breath, chest pressure, dizziness, palpitations, fainting, stroke and congestive heart failure. Some individuals have no symptoms and are diagnosed during a routine physical or screening. In very rare cases, the first sign of the disease is sudden death precipitated by acute arrhythmia. Anyone with symptoms and/or a family history of cardiomyopathy should be checked regularly by a physician.
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For more information on the resynchronization pacemaker, click on the link below: