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Electrophysiology: Janine's Story
An exuberant Janine Gentile has regained her health—and life—thanks to Lawrence Kanner, M.D., South Nassau's director of electrophysiology services. For over 12 years, the elementary school teacher had been suffering from fainting triggered by neurocardiogenic syncope, which is caused by a sudden failure of part of the nervous system that controls constriction of the blood vessels and heart rate to maintain blood pressure. Consequently, blood vessels dilate and heart rate slows, reducing blood flow to the brain.
Janine had no idea why she was fainting until she wound up hospitalized after a doctor's visit for 12 days. There, a cardiologist performed a series of tests and prescribed a heart medication that would help raise her blood pressure and heart rate. "He told me I had neurocardiogenic syncope and that I faint because my nervous system is unable to communicate with my heart to raise my blood pressure when I stand," she said.
This was the first time Janine knew for certain what was causing her condition, but she still did not have an answer on how to control it. Not long after, her primary care physician suggested she see Lawrence Kanner, M.D.,FACC, FHRS, director of electrophysiology at South Nassau, who discontinued some of her medications and suggested he replace her pacemaker with one that has benefited patients suffering from her condition. "The initial pacemaker she had implanted increased her heart rate after her blood pressure had already dropped and by that point, she was already blacking out," he explained.
"Most pacemakers have no way of sensing our blood pressure or autonomic state. The Biotronik Evia® pacemaker, on the other hand, senses a drop in blood pressure before it occurs and adjusts the heart rate. By restoring autonomic tone, it is able to raise blood pressure and help prevent a blackout."
Biotronik's Evia pacemaker, 20 percent smaller than traditional models, incorporates wireless monitoring and works like a cell phone. The monitoring system can immediately notify the patient's physician if the patient or the pacemaker is experiencing problems and can be used to perform a complete wireless, remote check-up.
It has been three years since Janine's new pacemaker has been implanted. She's back teaching grade school, runs eight miles a week and snow skis. In June of 2012, she even hiked a volcano in Hawai‘i with her new husband. Although she occasionally feels faint and experiences lightheadedness and sweaty palms, she doesn't black out. "I am grateful for the life that was given back to me. The thought of not being able to teach again was horrifying," she said. "Dr. Kanner's knowledge, compassion and bedside manner are amazing...My life would be very different had I not met him."
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