UMC brings world’s smallest pacemaker to Nevada.

UMC recently became the first hospital in Nevada to provide a patient with the world’s smallest pacemaker, opening the door to an innovative new procedure designed to improve patient outcomes.

Earlier this year, Dr. Arjun Gururaj performed the minimally invasive procedure at UMC to implant the Micra Transcatheter Pacing System, which is roughly the size of a large vitamin. The wireless device is guided to the heart through the right femoral vein in the groin, requiring only a small incision.

Although traditional pacemakers have evolved in recent decades, Dr. Gururaj said every pacemaker since the 1960s has used wires, or leads, that connect a pacemaker generator to the heart. While pacemaker batteries can be swapped with relative ease, replacing the leads poses risks to the patient.

“Wires tend to crack, and they ultimately wear out after about 15 to 20 years. It is risky to take wires out that have been in place for even a few years,” he said. “The wires become solidified in the heart and the chest, and they require surgical removal, substantially increasing the risk of infection.”

Medtronic’s Micra system is completely wireless, eliminating the concerns associated with wires while representing a significant step forward for the health care community.

On average, pacemakers have a battery life of six to seven years, according to the U.S. Department of Health and Human Services. However, Dr. Gururaj said the Micra system offers a 12-year battery life.  Rather than replacing the battery, physicians can simply implant another Micra system in the heart while leaving the first pacemaker in place.

The system also serves to reduce the recovery time of patients following an implant procedure, Dr. Gururaj said.

“Theoretically, you can send the patient home the same day. It can literally become an outpatient procedure,” he said, although this is not possible in all cases.

The Micra system can be used to help a number of patients with irreversibly slow heart rates, he said.

While the Micra system is expected to have a significant impact on the medical community, Dr. Gururaj said the pacemaker is designed for patients who need one chamber of their heart paced, a relatively common condition.  The system is not designed for patients requiring pacing for both chambers of the heart, but Dr. Gururaj said he expects to see new technology within the next fewyears that will provide similar wireless pacing systems for a broader range of patients.

Dr. Gururaj said he performed the procedure at UMC as a result of the hospital’s cardiology fellowship program and its continued dedication to providing community members with the highest level of care.

“Academic medical centers like UMC are best equipped to introduce this type of technology,” he said.

Photo: Provided by UMC – Micra Transcatheter Pacing System

Valley Hospital and Southern Nevada Health District produce training video for CDC

Valley Hospital recently joined forces with the Southern Nevada Health District to produce a training video for the Centers for Disease Control and Prevention (CDC), a major operating component of the Department of Health and Human Services. This video showcases meticulous procedures for handling a blood draw for a patient under investigation of the Ebola virus or other highly infectious agents.

According to Elaine Glaser, Valley Hospital Medical Center CEO, preparation is the key to successfully responding to all potential emergencies.  “The handling and management of patients with highly infectious diseases requires precise execution of rigid protocols to circumvent the spread of diseases  to others, including medical personnel,” she said.  “We consider it an honor and a privilege to work with both the CDC and the Southern Nevada Health District to share best practices and demonstrate proven protocols for protecting against the spread of highly infectious diseases. Valley Hospital is proud to contribute to the CDC’s global initiatives to provide sound protocols and tools to other medical practitioners throughout the world.”

Course link: http://www.southernnevadahealthdistrict.org/health-care-providers/training.php.

Photo: Provided by Valley Hospital

Study is first to jointly examine Alzheimer’s and Parkinson’s diseases.

With an $11.1 million federal grant awarded in 2015, researchers at Cleveland Clinic Lou Ruvo Center for Brain Health and the University of Nevada, Las Vegas (UNLV) have embarked on collaborative efforts to further understand the progression of Parkinson’s and Alzheimer’s diseases with the goal of advancing patient care. This is the first time the two diseases have been studied together.

“The ways that Alzheimer’s and Parkinson’s diseases affect the brain can sometimes overlap,” says Aaron Ritter, MD, Director, Clinical Trials Program, at the Lou Ruvo Center for Brain Health. “Collecting data at the same time can magnify differences and similarities between the two.”

The five-year grant from the National Institutes of Health and the National Institute of General Medical Sciences established southern Nevada’s first Center of Biomedical Research Excellence (COBRE), known as the Center for Neurodegeneration and Translational Neuroscience (CNTN). Dr. Ritter is Principal Investigator of the Clinical and Translational Research Core within the CNTN. The work of Dr. Ritter and his staff focuses on improving the translation of laboratory research to humans.

This team will study findings regarding inflammation and genetic markers to be gathered from a cohort of patients over five years through functional MRIs, PET scans and blood samples. Dr. Ritter hopes to recruit about 180 patients. The group’s demographics will match those of the state of Nevada, except that participants will be 55 and older and have a diagnosis of early-stage Alzheimer’s or Parkinson’s disease. A group of participants with mild cognitive impairment and a group without symptoms will also be recruited to serve as comparisons.

Observations from this study will be tied back to observations of mice being studied in a UNLV lab in an effort to ensure that predictions seen in animal models will translate to human disease.

“Oftentimes, when we test new drugs in mice we see very promising findings, but these results have not followed in clinical trials with humans,” says Dr. Ritter.

The strength of these animal model predictions also will be tested through the use of a virtual Morris water maze developed by Sarah Banks, PhD, ABPP/CN, Head of Neuropsychology at the Lou Ruvo Center for Brain Health. The Morris water maze has been used for more than 25 years to assess spatial learning and memory in mice. The virtual version enables researchers to apply the same mouse maze challenges to humans on a computer in order to test their memory dysfunction and compare with results from the mouse model.

For a full list of research studies being conducted at the Lou Ruvo Center for Brain Health, visit clevelandclinic.org/brainhealth.

Photo:  The first annual Nevada COBRE meeting, held in October, offered a unique opportunity for the southern and northern Nevada COBRE groups to network and share scientific information. Due in part to the success of the meeting, the group plans to meet again in fall 2017.