Guest guest Posted May 4, 2001 Report Share Posted May 4, 2001 Wearable Device Delivers Heart-Saving Shock Vest an Option After Heart Attack or Before Heart Transplant By Neil Osterweil WebMD Medical News May 2, 2001 (Boston) -- Some people wear their hearts on their sleeves, but for patients with failing hearts, playing it close to the vest has its advantages, too. Their lives could be saved with a wearable defibrillator vest -- a battery-powered device that automatically detects a dangerously unstable heart rhythm and delivers a shock to put the heartbeat back in sync. German researchers described their experience with the wearable cardioverter defibrillator at the annual meeting of the North American Society of Pacing and Electrophysiology (NASPE) held here. They report that the device can be a lifesaving option for patients who may not be candidates for permanently implanted defibrillators. In patients who have had their hearts stop, " it's not difficult to decide if one needs an implantable defibrillator, " Helmut Klein, MD, professor of medicine and chief of cardiology at University Hospital Magdeburg in Germany, tells WebMD. But he explains that in some people who have had a heart attack, it is difficult to say what the risk is for having heart rhythm problems. " Before you implant the device you need to be sure that you don't ... implant a device that costs $25,000 and then after a few months you don't need it any more because the risk is quite low. " ---------------------------------------------------------------------------- ---- If you have comments about an implanted device, or about this new device, join WebMD's Heart Disease: Living With an Implanted Cardiac Device chat board. ---------------------------------------------------------------------------- ---- " The highest risk for sudden cardiac death for someone who has had a heart attack if they have substantially weakened heart muscle is in the first six months, " L. Winters, MD, tells WebMD. After that some people have an improvement in their heart muscle function, which lessens their risk, he says, so that they do not need an implantable device. Winters is director of cardiac electrophysiology at town (N.J.) Memorial Hospital and an investigator in U.S. trials of the device. According to NASPE, about 350,000 people in the U.S. die from sudden cardiac death each year; about half of the cases are caused by ventricular fibrillation, in which the heart goes into a chaotic rhythm and loses its ability to efficiently pump blood to the rest of the body. Ventricular fibrillation can be caused by a variety of conditions, including heart attack, coronary artery disease, congenital problems or genetic disorders. Left untreated, serious arrhythmias may lead to heart attack, stroke, and death. No TV medical drama would be complete without a scene in which a patient in 'V-fib' is shocked back to life with electrically charged paddles placed on the chest. The device that does the shocking is called a cardioverter defibrillator, because it converts a chaotic or dangerously unstable heart rhythm -- or arrhythmia -- back into a stable, regular rhythm. For several years, patients at risk for sudden cardiac death due to serious arrhythmias have had the option of receiving an implantable cardioverter defibrillator. The device is placed in the chest cavity with electrical leads connected to the heart. When it senses an arrhythmia occurring, it automatically delivers a shock to put the heart back into a stable rhythm. More recently, computerized automatic defibrillators have begun showing up in emergency response vehicles and in public places such as shopping malls, commercial airliners, and golf courses. The devices allow even untrained bystanders to step in and possibly save a life during a cardiac emergency. The wearable device is designed to bridge the gap between hospital-based heart monitoring and implantable defibrillators. " The device is ideal for certain patients who have a need for [implantable cardioverter defibrillator] protection, but either need it only for the short term or require the protection long term, but are not candidates for [implantable cardioverter defibrillators], " says investigator J. Tchou, MD, head of electrophysiology and pacing at The Cleveland Clinic, in a written statement. ' Tchou says that the device is " as comfortable as wearing a T-shirt, " but perhaps he's accustomed to wearing T-shirts that weigh 2.5 pounds. The wearable defibrillator consists of a vest made of a synthetic material containing embedded electrodes that sense the heart rhythm and deliver an electrical shock through special embedded paddles when necessary. The device has a patient-operated cutoff switch that can be used to prevent an inappropriate shock when the patient is awake and alert. The device runs for about 24 hours on a rechargeable battery pack worn on a belt. The German study involved 58 patients, 40 of whom had suffered heart attacks, 10 of whom had undergone bypass surgery, and eight of whom were waiting for new hearts. During a four-month period, two surgery patients and one heart attack patient had appropriate shocks. One patient, a woman who had recently had hip surgery, received an inappropriate shock because her use of crutches prevented her from reaching the cutoff button in time. Six of the patients went on to receive implanted devices. Two patients with abnormally enlarged hearts who were at risk for ventricular fibrillation died because they failed to wear their vests, so following your doctors instructions is very important, says Ult Meltendorf, MD, attending physician at University Hospital Magdeburg. He tells WebMD that patients who at times do not wear their vests -- during bathing, for example -- should do so only when another adult is present to give help if needed. The wearable cardioverter defibrillator is currently approved for use in Europe and is being evaluated in U.S. clinical trials. If it receives FDA approval, it could be available as early as the next few years, according to Symkiewicz, MD, from the vest's manufacturer, Lifecor Inc in Pittsburgh. © 2001 WebMD Corporation. All rights reserved. Quote Link to comment Share on other sites More sharing options...
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