Upgraded Pacemakers Give Patients Better Results

April 5, 2023

Read More: Mercy Springfield Patient Gets New Pacemaker

ST. LOUIS – Anne Silvestri recognized something was off when she suddenly became winded going up the stairs. An avid walker at age 59, she was health conscious, stayed active and had a good family history, yet she nearly passed out walking up steps.

Even with a history of high blood pressure and an at-home monitoring device, Silvestri did what many women do and powered through the rest of her day; she even flew to Kansas City for work the next day.

Mercy doctor's coat Anne Silvestri (right), with her husband and friends, likes to stay active.

“Upon my return, I couldn’t even walk up the ramp from the airplane and told my husband there was a problem. When I finally took my blood pressure, my pulse rate was in the 30s,” Silvestri said. “I called my doctor’s office after hours, and the nurse wanted to send an ambulance immediately.”

Instead, her husband drove her to Mercy Hospital St. Louis, where it was “all hands-on deck” in the ER when she arrived due to her low heart rate.

Dr. Lalit Wadhwani, electrophysiologist with Mercy Clinic Electrophysiology, joined Silvestri’s care team, running countless tests to make sure there were no other issues causing her problems. Turns out, the electrical system of her heart had stopped working.

With her heart beating so slowly, oxygen wasn’t circulating through Silvestri’s body efficiently, leading to her fatigue. That’s typically when surgeons implant a pacemaker, a device that became commonplace in the 1970s. It contains a battery and electrical circuitry connected to the heart through wires, or leads. The pacemaker sends impulses to the heart when the natural “wiring” isn’t telling the heart to beat fast enough.

“Given my age and heart rate, Dr. Wadhwani told my husband and I about a newer pacemaker option,” Silvestri said. “We were supportive of the decision.”

Mercy doctors are now able to implant the tried-and-true technology in an entirely new, more natural way.

“For patients like Anne, the device does 100% of the heart’s electrical work,” Dr. Wadhwani said. “With traditional pacemakers, there is a 10-15% chance the heart muscle function could decline with such a high pacing burden. The new lead and system are implanted in such a way that the pacemaker mimics the heart’s natural electrical conduction, leading to physiologic pacing and minimizing chances of heart muscle dysfunction.”

Mercy doctor's coat Silvestri celebrated her 60th birthday shortly after her hospital stay.

The new type of pacing helps patients avoid complications that can be associated with traditional pacing methods, including cardiomyopathy, when the heart muscle weakens and can no longer pump efficiently.

Silvestri knows she was lucky. “Fortunately, nothing bad happened due to me delaying care, and I have learned not to ignore the signs when something doesn’t seem right.”

It’s unknown why her heart’s electrical system stopped working, but she’s thankful to Dr. Wadhwani for the solution.

“It took several weeks to get my stamina back, but I feel like my old self now,” Silvestri said. “I can take my daily walks, rain or shine, and don’t feel winded at all.”