Heart failure is a scary diagnosis for most people, but it's not a death knell. There's a new technology that can help people with heart failure live longer, more comfortable lives.
Frederick Memorial Hospital in Frederick, Md., has a new system called Aquapheresis therapy that helps patients get rid of the fluid buildup caused by heart failure. It makes patients more comfortable and eases one of the most dangerous side effects of heart failure.
Heart failure was once known as congestive heart failure. While it is still called that in many circles, cardiologists prefer to use the phrase heart failure.
Five million to 6 million Americans have heart failure, and it affects one in 100 Americans over 65.
"The number is growing for three reasons," said Dr. Catherine Fallick, a cardiologist who practices with Cardiovascular Specialists of Frederick .
"People are being saved from heart attacks, they are not dying from cancers the way they used to and the aging of the population," she said.
Survivors of heart attacks may have a weakened heart, said Dr. William Haynos, another member of the practice. The practice is led by Dr. John Vitarello, FMH chief of cardiovascular services, who was instrumental in getting the technology approved and budgeted for at the hospital.
Haynos and Fallick completed fellowships in the field of heart failure, and each specialized in heart failure while working in teaching hospitals. Heart failure occurs when the heart doesn't pump the amount of blood your body needs. "When the heart loses its ability to function effectively with a pump, the pressures inside the heart build up, and blood backs up into the lungs," Haynos said. Heart failure is usually treated with a standard triple drug therapy, using ace inhibitors, beta blockers and diuretics. "When those don't work, we resort to hospital admissions," Fallick said. Jeff Pearsall, of Frederick , was one of those patients. He had been admitted to the hospital repeatedly to have fluid drained. Pearsall, 48, didn't have classic heart failure symptoms. He had shortness of breath, and cardiologists learned he had cardiomyopathy. The volume of blood being pumped out of his heart was much lower than it should have been. Pearsall works at Cardiovascular Specialists as a technician, giving him a unique perspective. Seven weeks ago, he entered FMH to try Aqua therapy, as it is known. Blood is removed, similar to dialysis. Fluid is then removed from the blood, and the blood is replaced in the body. This therapy removed 71u2 liters of fluid from Pearsall's system.
Patients with heart failure often retain large amounts of fluid, which stresses their hearts even more. Their bodies hold onto fluid because their abnormal hearts are causing their hormones to malfunction. Even small amounts of sodium can cause their bodies to retain fluid. Blood pressure rises, and the volume of blood that should be pumped out of the heart drops. Pearsall was hospitalized for 48 hours to have the fluid removed using Aqua therapy. He has not had to return since, which his doctors consider a success. That's the key to the success of Aqua therapy. Patients seem to need to make many fewer hospital visits. "Heart failure is a huge drain on the health care system," Haynos said. Billions of dollars a year are spent treating heart failure, often with multiple hospital visits. Aqua therapy cuts down on those visits because it prevents the need for repeated flushing. The medical practitioner controls the rate at which fluid is removed. The device has safety monitors to detect air or blood inside the blood circuit. Nurses love the new procedure, said Ronna Dixon, a registered nurse and the Intensive Care Unit manager at FMH. "Patients we used to know the first names of we see much less often," she said. "We're excited to see the patients go home. We see how much it changes their lives."
So far, nine patients have used Aqua therapy, and of those, only one has returned needing to be admitted to the hospital for follow-up. The hospital is working toward accreditation for treating heart failure, said Rachel Mooney. Systems such as Aqua therapy will help the hospital get that certification, she said. FMH is one of six community hospitals in Maryland with Aqua therapy. It is usually found in teaching hospitals. Cardiologists are limited as to what they can prescribe to help heart failure patients, and most of that is drug therapy. Aqua therapy gives them another tool, one that can be more effective. "In our patient therapy, we can minimize doses of medicine, but the most important way to determine the outcome is to have a patient who feels well," Fallick said.