Tiny Pacemakers Could Be Game Changers for Heart Patients

A pacemaker is shown against the backdrop of a cardiological graph in Potsdam, Germany, Feb. 26, 2004
A pacemaker is shown against the backdrop of a cardiological graph in Potsdam, Germany, Feb. 26, 2004

 

 

Tiny, new pacemakers are making headway around the world. One type, the Micra, is keeping 15,000 people’s hearts beating in 40 countries, according to manufacturer Medtronic. One of those people is Mary Lou Trejo, a senior citizen who lives in Ohio.

 

A healthy heart has its own pacemaker that establishes its rhythm, but people like Trejo need the help of an artificial device.

 

Trejo comes from a family with a history of heart disease. Her heart skipped beats, and she could feel it going out of rhythm. Trejo wanted to do something to advance heart health, so in 2014, she volunteered to participate in a clinical trial for the Micra pacemaker. The device is 24 millimeters long implanted, one-tenth the size of traditional pacemakers.

 

Traditional pacemakers

 

Most pacemakers rely on batteries placed under the skin, usually just below the collarbone. Sometimes patients get infections after the surgery or have difficulty healing from the incision.

 

Traditional pacemakers use leads with electrodes on one end that are threaded through blood vessels to connect to the heart. There can be problems with the leads as well.

 

Dr. Ralph Augostini at Ohio State’s Wexner Medical Center says a tiny pacemaker like the Micra avoids all of these problems.

 

“The electrodes are part of the can, and therefore it eliminates the lead,” he said. There’s no incision in the chest to become infected and no chance of complications with the leads.

 

Small and self-contained

 

Augostini implanted Trejo’s pacemaker in 2014. He threaded the entire device thorough an artery in her leg up to her heart. The pacemaker has small, flexible tines that anchor it into the folds of the heart muscle. Once it’s in place, the doctor gives it a tug to make sure the pacemaker is stable before removing the catheter used to place it in the heart.

 

The Wexner Medical Center was one of the sites that participated in the Micra clinical trial. Since the Micra received FDA approval in 2016, Medtronic has been training more physicians on the procedure. A company spokesman told VOA that this device is becoming available at other centers across the U.S. and countries throughout the world.

 

Dr. John Hummell, a cardiologist at the Wexner Medical Center, has studied the effectiveness of this new generation of pacemakers.

 

“We don’t leave any wires behind and the pacemaker, the battery, the wire is all just a tiny little piece of metal sitting down in the heart,” he said. Medtronic said the results of the clinical trial showed a success rate of 99.6 percent.

 

Dr. Richard Weachter, with the University of Missouri Health Care, says the leadless pacemakers’ complication rates are about half the rate of traditional pacemakers.

 

The battery lasts for 14 years and after that, Weachter said, doctors can implant another one in the same chamber of the heart. They can repeat the procedure a third time if needed.

 

The pacemaker activates only when necessary to keep the heart beating normally. Studies show that the Micra and other leadless pacemakers are safe and effective.

 

These tiny pacemakers are not right for all patients, but as the technology develops, more people will be able to benefit from the procedure. Four years after her implant, Trejo’s doctors say she is doing fine.

Ex-Khmer Rouge Official Converts to Christianity Guided by Pastor She Once Enslaved

Im Chaem (fourth person from right) and her son Im Loeung (fifth person from right in white shirt) joins the Christian seminar in Battambang province in January 2018. Photo by Pastor Touch Chanthou. (Courtesy photo)

Im Chaem (fourth person from right) and her son Im Loeung (fifth person from right in white shirt) joins the Christian seminar in Battambang province in January 2018. Photo by Pastor Touch Chanthou. (Courtesy photo)

 

Im Chaem, a former Khmer Rouge official who was charged by a United Nations-backed tribunal with crimes against humanity including mass murder, extermination and enslavement, has converted to Christianity under the tutelage of a man who survived a forced labor camp she oversaw.

“I was redeemed,” she told VOA Khmer Friday by phone from her home in Anlong Veng, a district in northwest Cambodia known as the final Khmer Rouge stronghold.

“People have accused me of killing others. That’s wrong,” said the 75-year-old grandmother, a Buddhist by birth. “I have never used violence or threatened anyone. I did not accept the accusations of wrongdoing, as I did only the right.”

This Sunday, Im Chaem will hold worship services in her O Angre village home for the third time since her baptism Jan. 22. She plans to pray with seven church members, a congregation that includes members of her family who converted with her and friends.

There will be Bible study, perhaps from the New Testament’s Book of John, which Im Chaem told VOA she appreciates for its fairness and the verse 3:16: “For God so loved the world, that he gave his only begotten Son, that whosoever believeth in him should not perish, but have everlasting life.”

Case dismissed

Last year, on Feb. 22, the Extraordinary Chambers in the Courts of Cambodia, the tribunal tasked with trying those accused of the most horrific crimes of the Khmer Rouge rule from 1975 to 1979 dismissed the case against Im Chaem. The court found that she “was neither a senior leader nor otherwise one of the most responsible officials” of the regime.

Weeks earlier, in December, U.N. prosecutor Nicholas Koumjian said in a statement that Im Chaem “played a key role in the commission of crimes which led to many thousands of deaths.” International prosecutors said in a statement that Im Chaem had had been selected by the Khmer Rouge to lead a cleansing campaign in northwest Cambodia.

Im Chaem had refused to cooperate with the court.

The charges, which she had denied in the past, stemmed from her tenure as deputy secretary of the Koh Andet District in her native Takeo province and her role as district chief of the Preah Net Preah district in Banteay Meancheay province. With a colleague, she may have been responsible for as many as 560,000 deaths, according to The New York Times.

When the charges against Im Chaem were dismissed, Neth Pheaktra, tribunal spokesman, said there had been no pressure from the government to drop the case.

FILE - Cambodia's Prime Minister Hun Sen attends a ceremony at the Angkor Wat temple to pray for peace and stability in Cambodia, Dec. 3, 2017.
FILE - Cambodia's Prime Minister Hun Sen attends a ceremony at the Angkor Wat temple to pray for peace and stability in Cambodia, Dec. 3, 2017.

Prime Minister Hun Sen, as with many in Cambodia’s government and military, is a former Khmer Rouge functionary. He has cautioned the tribunal that prosecutions could lead to civil war, and international critics have accused the government of not cooperating with the tribunal.

Since its inception in 2006, the tribunal has convicted three people: two senior leaders and Kaing Guek Eav, commonly known as Duch and the commandant of Tuol Sleng, the notorious Khmer Rouge prison. He converted to Christianity in 1996 and was convicted of war crimes in 2010 in the torture and killing of more than 14,000 prisoners.

Im Chaem with students during donation of books, pen and study tools with a US Christian missionary team led by Pastor Christopher LaPel in November 2017 near her home in O'Angre village, Anlong Veng District, Oddar Meanchey province. Photo by Pastor Touc
Im Chaem with students during donation of books, pen and study tools with a US Christian missionary team led by Pastor Christopher LaPel in November 2017 near her home in O'Angre village, Anlong Veng District, Oddar Meanchey province. Photo by Pastor Touc

Khmer Rouge converts

Christopher LaPel, a Cambodian pastor for the Golden West Christian Church in Los Angeles and a founding leader of the Cambodian Christian Church in northwest Cambodia, converted to Christianity in 1979 while in a Thai refugee camp, where he’d fled as the Khmer Rouge fell to the invading Vietnamese.

LaPel converted Duch, who joined about 2 percent of the population in an overwhelmingly Buddhist nation.

LaPel also converted Im Chaem, who oversaw construction in Trapeang Thma, where enslaved Cambodians, including LaPel, built a dam by hand.

On Thursday evening, LaPel told VOA, “While many people may hate her, I love her.” He was determined to help her find peace after living through the tumult of Cambodia’s Khmer Rouge era, he told VOA.

In November, while visiting Cambodia, LaPel was listening to VOA and heard about developments in Im Chaem’s case before the tribunal. He decided to find her and traced his onetime nemesis to Oddar Meanchey province and then to her village.

“It’s true that Mrs. Im Chaem received Jesus Christ as her savior God on November 6, 2017,” he told VOA, adding that her husband and children also converted.

“She accepted Christ because she heard testimonies and gospels from her Khmer Rouge comrades,” LaPel said. “They give their testimony about their life to her, that God changed them, that before they had never known what’s peace and what’s love.

“And she has been through all these kinds of issues, that her life had no direction and was empty,” LaPel said. “When she decided, she knows that only Jesus can give her harmony, peace, love, hope in her life and her family and God can forgive her sins.”

Im Chaem hands out gifts like books, pens and study tools to students during a donation events with US Christian missionary team in November 2017 near her home in O'Angre village, Anlong Veng district, Oddar Meanchey province. Photo by Pastor Touch Chanthou.
Im Chaem hands out gifts like books, pens and study tools to students during a donation events with US Christian missionary team in November 2017 near her home in O'Angre village, Anlong Veng district, Oddar Meanchey province. Photo by Pastor Touch Chanthou.

When asked if those sins were those set forth in the charges the tribunal dropped, LaPel said, “The sins or issues relating to Khmer Rouge era, we did not know if she was involved or not. It is the personal relationship between her and God only.”

Im Chaem told VOA she has felt relieved since she converted, in part because a mysterious illness afflicting her son Loeung, who also converted, is abating.

She insisted that her Christian faith is steadfast. “I will never change,” she said. “God has come into my heart and helps me to spiritually grow.”

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