[geeks] Well, crap ...

[Phil Stracchino]

Patrick Giagnocavo wrote:
> 2.  Technology increasing purchasing power - computers getting cheaper, 
> yes; but also things like being able to pay $500 for an MRI and it 
> taking only 1 hour instead of a $5000, invasive surgery to figure out 
> what is going on.

Real-world example here:  Heart arrhythmias.  Atrial fibrillation is
debilitating.  Ventricular tachycardia can kill you.  Until a few years
ago, there were two ways of mapping an arrhythmia.

The first way was to put catheters in through the femoral arteries.  You
could get about two catheters into each side of the hears that way, each
with two electrodes on them.  So you map, and move; map, and move; map,
and move; map, and move; build up a huge stack of EKG charts, and
compare them by hand to figure out where you think the arrhythmia is.
The second way was to crack the chest open and put what amounted to an
electrode-studded sock around the heart.  Either way could take up to
eighteen hours to map an arrhythmia.  Then once you had it, the options
for treatment were poor.  You could go with drugs, which were about 50%
effective, and typically have to be changed about every six months
because they become ineffective over time.  For AF, there was an option
known as the "Maze procedure", which basically means you open the chest
and cut the top of the heart into about three separate pieces, then sew
them all back together again, to create a network of scar lesions that
breaks up the chaotic undesired electrical signals that cause sinus AF.

Then Cardima came up with a new way of building heart catheters, that
enabled putting 16 electrodes onto a catheter only .020" in diameter.
We called it the Pathfinder 020.  We could fit four catheters into an
8-guage guiding catheter, and that meant we could get 128 electrodes
into the heart *simultaneously* via the femoral arteries.  That made it
possible to map an arrhythmia in an hour to 90 minutes.  Then we could
*fix* the arrhythmia via RF ablation using the mapping catheters,
positioning an electrode right on top of the defect and injecting RF
energy straight down the line.  The actual treatment takes about thirty
seconds for VT, a few minutes for AF, it's a *curative* treatment
instead of palliative, and the patient usually goes home the same day.


Yeah, technology can be fucking wonderful.  If I say so myself.




Of course, then you come across things like the ballerina who dropped
dead on stage in New York about 8 years ago from VT, and you think to
yourself, "DAMMIT, if we could have just gotten her into one of our
clinical programs, we could have saved her ...."

But we didn't know about her, and her doctors didn't know about our
Pathfinder and Tracer technology.  So she died.


-- 
 It's not the years, it's the mileage.
 Phil Stracchino              phil.stracchino at speakeasy.net
 Renaissance Man, Unix generalist, Perl hacker, Free Stater
 Landline: 603-429-0220                Mobile: 603-320-5438