The 700-Volt Lifesaver

When T.D. Stallings went to church on a warm Sunday morning last July, he didn’t expect to drop dead and live to tell about it. But after being resuscitated, Stallings, seventy-three, underwent a series of tests and received some startling news. His heart problem was electrical, a short circuit that was probably the result of scar tissue from a 1970 heart attack. He had a 30 percent chance of another attack within a year.

“After I left the hospital, my wife, my son, and a neighbor took CPR. and someone was with me at all times in case it happened again. It was awkward, demanding, and there was some anxiety,” says Stallings, a retired accountant.

When his cardiologist suggested that he undergo a new procedure to reduce the risks of sudden cardiac death (SCD), Stallings said no. But in October, after living for several months under the cloud of SCD, he agreed to become one of the first people in Dallas to have an automatic defibrillator implant.

The device detects an irregular heart beat rhythm, or arrhythmia, A battery pack is implanted just above the waist near the rib cage; guide wires lead to sensing patches attached to the heart. If a patient’s heart begins to race abnormally-a warning sign of SCD-the defibrillator discharges after a few seconds and delivers 700 volts of electricity, or about seven times the jolt of a household wall socket.

Last summer, Baylor and Parkland Memorial Hospital began implanting defibrillators in SCD patients. Since then, each hospital has performed about a half dozen implants. Nationally, about one thousand implants have been performed. With February designated as American Heart Month, doctors boast about the newest technology for the patient who lives with high risk.

“This is a lifesaver for these people,” says Dr. Kevin Wheelan, Baylor cardiologist and director of Pacing & Elec-trophysiology. “It is not like a heart attack, where heart and muscle actually die. It’s like blowing a fuse.”

An estimated 400,000 people in the United States suffer an episode of SCD each year. Many of them die because no one performs CPR, or because resuscitation starts three minutes or longer after the onset of the attack, when brain death can occur.

The average SCD patient is a male, about sixty years old, who has suffered a previous heart attack but recovered and leads an active life. One day, he suddenly collapses and is revived through CPR or external defibrillation. Cholesterol buildup is the most common reason for the heart attack and damage. New clot-buster drugs help some patients. But most resuscitated SCD victims don’t respond to drug treatment, or the drug’s side effects prove too risky.

For these victims, implanted defibrillation is the best-if not the cheapest-solution. The implant device costs $17,000. Tests, surgical fees, and other costs create a total expense of approximately $35,000. But Medicare and many private insurance companies cover the operation.

Ted Stallings does not live in terror, waiting for the jolt from his defibrillator. “I look at it as insurance,” he says. “Before, it was just a miracle someone was there to do the right thing.”