Vol. 8 No. 1
March 1998

Insuring Quality Community Healthcare

Winthrop's Advance Directive Initiative

The Winthrop South Nassau University Health System Opens Homecare*America Superstore in Mineola

Winthrop Welcomes Three New Directors

Winthrop Opens a Second, Fully Monitored Neurosurgical Intermediate Care Unit

Winthrop's $12 Million New Life Center is on Track for July, l998

Winthrop's Long Island Regional Poison Control Center Observes Fifth Anniversary of Averting Danger, Saving Lives

Patient Unit is Dedicated to the Management of Chronic Obstructive Pulmonary Disease

Long Island's First Dual Chamber Defibrillator is Implanted in Winthrop's Electrophysiology Lab

Report from The Heart Institute at Winthrop: Third Cardiac Catheterization Lab is Authorized by State Department of Health

Winthrop's Artificial Heart Device Program: A Revolutionary Treatment for End-Stage Heart Disease Patients

Winthrop's Dialysis Centers Receive National Award for Patient Encouragement - One of Only Six Programs in the United States to be Recognized

Endoscopic Ultrasound: On The Forefront of Technology

Long Island Chapter of Impotents Anonymous Meets at Winthrop, Filling an Intimate Need ---Confidentially

Winthrop's Stem Cell Autologous Transplantation Therapy Program Saves a Life - And Can Save More!

Winthrop Adds Powerful New Radiological Intervention

Winthrop Auxilians Donate Service, Talent, and Creative Fundraising

Winthrop's Division of Reproductive Medicine Makes Parenthood Possible

Dialysis is technology...but caring is an art.

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Winthrop's COPD Management Team, awarded for its achievements in Continuing Quality Improvement on Hoag 2, include (L-R) Joan Marchiselli, RN; Michael Niederman, MD, Chief of the Division of Pulmonary Medicine; Mara Bernstein, RT; Gerald Stanick, MPA, RRT, Administrator, Respiratory Services; Jane Cordova, Placement Worker, Department of Social Work; Teresa Rodgers, RN, MSW, CSW, ACSW, Social Worker; Marisa Cassamassino, PT, Physical Therapist; and Janis Scocozzo, RNC, Hoag 2, with Martin J. Delaney, President and Chief Executive Officer of the Winthrop South Nassau University Health System.

In another "first" for the Heart Institute of Winthrop-University Hospital, a dual chamber defibrillator was successfully implanted in a 62- year-old Mineola man on July 29, l997. The new medical device had just been approved by the U.S. Food and Drug Administration during the week of July 21, 1997, and was used almost immediately to save the life of this local resident.

The patient - the father of nine children and grandfather of 12, whose wife is a Winthrop volunteer - sought medical help after several dizzy spells during which "the room started spinning."

Electrophysiology testing - a heart rhythm test similar to an angiogram - revealed that the patient had experienced a painless, though life-threatening ventricular arrhythmia. Previously, in l986, he had suffered a "silent" (painless) heart attack. This time, ventricular tachycardia - VT - almost cost him his life.

Within hours of the implantation procedure, the patient was walking, reading, feeling strong, and looking forward to playing with his grandchildren. His incision was less than three inches in length.

The dual chamber defibrillator, which incorporates a dual chamber pacemaker in a single container just slightly larger than a typical beeper, diagnoses, monitors, and treats ventricular tachycardia (VT) - rapid and irregular rhythm disturbances, which, if occurring in the lower chambers of the heart, can cause sudden death. Once the life- threatening rhythm is detected, the device emits a measured electrical impulse to defibrillate and "reset" the heart back to a normal rhythm.

Todd Cohen, MD, Director of Winthrop's EP Lab and Pacemaker-Arrhythmia Center, performed the implantation in the Hospital's EP Lab, rather than in the conventional Operating Room - a more cost-effective setting.

The new dual chamber defibrillator streamlines the treatment of patients who require two separate devices: a dual chamber pacemaker for bradycardia and a defibrillator for ventricular arrhythmias. The device is actually slightly larger than its single chamber predecessor, and its two wires necessitate a more complex implantation technique - requiring the participation of a skilled EP Team.

Upper Chamber versus Lower Chamber Tachycardia
The striking clinical advantage of the dual chamber defibrillator is its powerful, lifesaving ability to discriminate between upper and lower chamber defibrillation - facilitating a more accurate diagnosis and a more appropriate treatment.

Upper chamber defibrillation - supraventricular tachycardia (SVT) - is usually benign, while defibrillation in the heart's lower chambers - ventricular tachycardia (VT) - can be fatal. In the United States alone, 500,000 people die each year of VT. The dual chamber defibrillator also records, with greater sophistication than previous devices, a more complete analysis of the patient's arrhythmic episode for retrieval by the doctor. This helps with the identification of the origin and cause of the problem.

For many patients, the new device will eliminate the need for a second implantation in the future.

Candidates for the new, one-step device are those who have experienced a life-threatening ventricular arrhythmia, including high-risk patients with weakened heart muscles, blockages of the coronary arteries, and non-sustained, asymptomatic VT.

For further information, please contact Dr. Todd Cohen at 516/663-8530.

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