Heart Attack Warnings

The chances of surviving an acute myocardial infarction continue to improve given constant technological advancements related to equipment and techniques used in prehospital and hospital environments and the promotion of bystander intervention.

But people who have suffered such an event can be nervous about the possibility of subsequent attacks. However, that anxiety may be diminished with a cardiac monitoring device that's currently being tested in clinical trials.

The experimental AngelMed Guardian cardiac monitor and alert system device, manufactured by Angel Medical Systems, has just moved into Phase III of the ALERTS clinical trial.

Ruling Out A False Alarm

It can be difficult for people to know when they really need to seek medical attention. Are the symptoms they feel indigestion, heart burn or another attack? Is it a false alarm? Do I need to get to the hospital right away?

The Guardian system is designed to remove any guesswork associated with the challenges of detecting an acute myocardial infarction. The device is about the size of a pacemaker and is implanted similarly. The AngelMed Guardian's mission is to detect changes in the heart's electrical signal that could indicate a heart attack may be imminent. If it senses a potential heart attack, it vibrates to alert the person to take action. It also stores ECG traces for later analysis.

The device works similar to an ECG machine except that is keeps track of ST elevation changes, explains Charles Koo, MD, cardiologist with Meridian CardioVascular Network and principal investigator of the ALERTS trial as well as at the Jersey Shore University Medical Center where an AngelMed Guardian device has been implanted into a 66-year-old heart attack survivor. "It looks for signs of ischemia," he says. "In essence, it's an early-warning device for patients who may develop an acute myocardial infarction.

"The key to the AngelMed Guardian system is the ability to track significant changes in the heart's electrical signal and then alert the patient to seek medical attention immediately," he continues. "If this system proves to be effective in early detection and warning of potentially life-threatening heart conditions, we may be able to shift the paradigm for early treatment at the onset of heart attacks."

How Does it Affect EMS?

According to Dr. Koos, early indications of the trial are favorable. "We're in the data collecting phase and are still finding patients," he says, noting they hope to implant about 2,000 devices into qualifying patients.

While the device has the potential to dramatically change heart attack survivors' lives, how EMS personnel cares for these patients will likely remain unchanged.

"There is not anything EMS personnel need to do differently," he says. "The standard of therapy won't change. They just need to recognize there is no pacing or defibrillating capacity. The Guardian system is just an internal telemetric device that can enhance the patient's ability to detect a heart attack."

For more information, visit www.angel-med.com and Jersey Shore University Medical Center.