After Emily Coles suddenly collapsed at home, she had to put her life on hold while doctors investigated the cause.
Emily now knows that her heart had stopped beating for ten seconds, but at the time she had no idea that her life was at risk.
Emily, 24, was having coffee with her older sister Lauren in September last year in their kitchen when she fell to the floor.
“One moment we were catching up and the next I was on the floor,” says Emily, a nurse who lives with her mother Karen, 56, and father Nigel, 58, in Rotherham, South Yorkshire.
“The only thing I remember is feeling a little dizzy.” Lauren, 28, who is training to be a doctor, was so worried she took Emily to A&E where she was treated by a specialist cardiac physiologist.
Emily underwent tests, including an electrocardiogram and a tilt test, in which the patient lies face up on a motorized table, which tilts to a nearly upright position for 45 minutes.
Heart rate and blood pressure are monitored at all times to see how different positions affect the patient’s heart.
After half an hour of standing on the tilted table, Emily suddenly fainted. As he did so, monitors showed that his heart had stopped beating.
After Emily Coles (pictured) suddenly collapsed at home, she had to put her life on hold while doctors investigated the cause.
He was diagnosed with reflex syncope, in which the heart slows so much that it causes a temporary loss of consciousness (syncope is the medical term for fainting). Emily was one of the first to have a new high-tech pacemaker, which comes with a battery that should last 25 years.
He was diagnosed with reflex syncope, in which the heart slows so much that it causes a temporary loss of consciousness (syncope is the medical term for fainting).
The worrying thing is that Emily’s heart would stop for ten seconds or more at a time.
She was told she needed a pacemaker, becoming one of more than 500,000 people in the UK each year to have one implanted.
But Emily was one of the first to get a new high-tech pacemaker, which comes with a battery that should last 25 years (more than double that of previous models) and has a lower risk of complications.
While doctors don’t know what caused Emily’s condition, looking back now, she remembers that in the two years before this she had sometimes felt dizzy: “I would have to hold on to something to stabilize myself,” she says. But tests performed at the time, including an echocardiogram (an ultrasound to inspect the heart), found nothing.
Following her collapse and diagnosis last year, Emily was banned from driving.
This made it harder for her to get to work (and her 12-hour shifts at a busy hospital), as well as taking away from her social life and making her nervous about going out.
She was also told to drink more water and eat more salt, which helps keep her blood pressure up and prevents falls that can cause fainting.
The implant has a battery and electronic chips housed within its compartment. The most important thing is that its battery has a much longer life than conventional pacemakers: up to 25 years.
But to keep her condition under control long-term, cardiac specialists at Sheffield Teaching Hospitals NHS Foundation Trust, where Emily (pictured) was being treated, said she needed a pacemaker fitted to prevent future life-threatening collapses.
A pacemaker is usually implanted through a small 5cm incision on the left side of the chest. The wires connecting the pacemaker to the heart are passed through a vein to the heart, before the pacemaker is inserted just below the collarbone.
The device senses through the wires what the heart is doing, and if it slows down or misses a beat, the pacemaker fires an electrical impulse to restore it to its normal rhythm.
Disadvantages of conventional pacemakers include that the leads can malfunction. Additionally, they only last about ten years before needing to be replaced.
For Emily, this could mean multiple replacements over the course of her life, leaving her vulnerable to the risks of surgery, such as infection and sepsis.
A 2019 study by the University of Manchester NHS Foundation Trust, published in the journal PLOS One, found that over a two-year period, the Trust tackled 84 cases of pacemaker-related infections, with half of those patients requiring surgery emergency.
Not only were patients’ lives at risk, tackling the problem cost the trust almost £25,000 per patient.
Dr Nigel Lewis, a consultant cardiologist who treated Emily, says: “We try to avoid putting pacemakers in young people as they have to be replaced.”
A pacemaker is usually implanted through a small 5cm incision on the left side of the chest. The device detects through the wires what the heart is doing and, if it slows or misses a beat, the pacemaker fires an electrical impulse to restore it to its normal rhythm.
However, Emily’s pacemaker, which is about the size of a AAA battery, requires less invasive surgery and has fewer risks associated.
The implant has a battery and electronic chips housed within its compartment. The most important thing is that its battery has a much longer life than conventional pacemakers: up to 25 years.
It also has no cables, avoiding the type of malfunction that would require changing the pacemaker.
In January, Emily became one of the first patients in the UK to have the leadless pacemaker fitted during an hour-long procedure under local anaesthetic.
A thin tube (catheter) was inserted into a vein in his leg and taken to the right ventricle, one of the two lower chambers of the heart.
Doctors then inserted the small pacemaker through the tube and attached it with small hooks to the septum, the wall of tissue that divides the right and left ventricles.
In a two-year trial, the leadless pacemaker, developed in the United States, proved to be as effective as traditional devices.
Dr Lewis says: “It can be a game-changer for younger patients and for those on kidney dialysis who have long-lasting lines on their bodies.”
“If infected, a traditional pacemaker can easily infect these lines as well.
‘In some breast and lung cancer patients receiving radiotherapy, the treatment can cause blockages in the veins, making it difficult to fit a traditional pacemaker.
“So this new pacemaker could benefit hundreds of patients at first, and then in the long term it will be thousands.”
For Emily, it has been life-changing. “I found it difficult to accept the fact that I needed a pacemaker at 24 years old,” he says.
‘Sometimes I can feel it pacing my heart, which feels like a strange flutter at the base of my neck.
‘But I feel like I’ve got my life back on track. I’m driving again and have reinstated my gym membership. “I took it all for granted before my diagnosis, but I am very excited to be active again.”