Name: 【TED】Robert Fischell: TED Prize wish: Finding new cures for migraine, depression, malpractice
Uploaded: 2015-10-22T22:37:00.000Z
Duration: 27 min 36 s
Description: Thousands of YouTube videos with English-Chinese subtitles! Now you can learn to understand native speakers, expand your vocabulary, and improve your pronunciation...

I'm going to discuss with you three of my inventions

that can have an effect on 10 to a 100 million people,

We discussed, in the prior film, some of the old things that we did,

like stents and insulin pumps for the diabetic.

And I'd like to talk very briefly about three new inventions

that will change the lives of many people.

At the present time, it takes an average of three hours

after the first symptoms of a heart attack are recognized by the patient,

before that patient arrives at an emergency room.

which, translated into English, means they don't have any symptoms --

it takes even longer for them to get to the hospital.

which is a doctor's big word so they can charge you more money --

-- means a heart attack. Annual incidence: 1.2 million Americans.

Mortality: 300,000 people dying each year.

About half of them, 600,000, have permanent damage to their heart

that will cause them to have very bad problems later on.

or have significant damage to their heart muscle.

Symptoms are often denied by the patient, particularly us men,

because we are very brave. We are very brave,

and we don't want to admit that I'm having a hell of a chest pain.

Then, approximately 25 percent of all patients never have any symptoms.

What are we going to do about them? How can we save their lives?

It's particularly true of diabetics and elderly women.

Well, what is needed for the earliest possible warning of a heart attack?

A means to determine if there's a complete blockage of a coronary artery.

That, ladies and gentlemen, is a heart attack.

The means consist of noting something a little technical,

ST segment elevation of the electrogram --

if there's an electrical signal in the heart, and one part of the ECG --

which we call the ST segment -- elevates,

And if we had a computer put into the body of a person who's at risk,

we could know, before they even have symptoms,

that they're having a heart attack, to save their life.

Well, the doctor can program a level of this ST elevation voltage

vibration like your cell phone, but right by your clavicle bone.

And when it goes beep, beep, beep, you better do something about it,

because if you want to live you have to get to some medical treatment.

because the FDA won't just let us use them on people

and the best model for this happens to be pigs.

And what we tried with the pig was external electrodes on the skin,

and I'm going to show you why they don't work very well.

And then we put a lead, which is a wire, in the right ventricle inside the heart,

which does the electrogram, which is the signal voltage from inside the heart.

before we blocked the pig's artery to simulate a heart attack, that was the signal.

After 43 seconds, even an expert couldn't tell the difference,

if you really studied it, you'd see a difference.

But what happened when we looked inside the pig's heart, to the electrogram?

There was the baseline -- first of all, a much bigger and more reliable signal.

Second of all, I'll bet even you people who are untrained can see the difference,

and we see here an ST segment elevation right after this sharp line.

Look at the difference there. It doesn't take much --

every layperson could see that difference,

and computers can be programmed to easily detect it.

We see that the signal that's actually in the heart,

we can use it to tell people that they're having a heart attack

even before they have symptoms so we can save their life.

Then we tried it with my son, Dr. Tim Fischell,

we tried it on some human patients who had to have a stent put in.

Well, he kept the balloon filled to block the artery,

to simulate a blockage, which is what a heart attack is.

And it's not hard to see that -- the baseline

Next to it, at 30 seconds, you see this rise here,

then this rise -- that's the ST elevation.

And if we had a computer that could detect it,

we could tell you you're having a heart attack so early

it could save your life and prevent congestive heart failure.

And then he did it again. We filled the balloon again a few minutes later

and here you see, even after 10 seconds, a great rise in this piece,

which we can have computers inside, under your chest like a pacemaker,

with a wire into your heart like a pacemaker.

We have a little battery and on this little battery

that computer will run for five years without needing replacement.

Well, on the left is the IMD, which is Implantable Medical Device,

and tonight in the tent you can see it -- they've exhibited it.

It's about this big, the size of a pacemaker.

It's implanted with very conventional techniques.

And the EXD is an External Device that you can have on your night table.

It'll wake you up and tell you to get your tail to the emergency room

when the thing goes off because, if you don't, you're in deep doo-doo.

And then, finally, a programmer that will set the level of the stimulation,

which is the level which says you are having a heart attack.

The FDA says, OK, test this final device after it's built in some animal,

which we said is a pig, so we had to get this pig to have a heart attack.