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Susan Daly of Spotsylvania County wears an external defibrillator under her clothing to monitor her heart. Daly is the first patient in Virginia to wear the device. |
O FAR, SUSAN DALY'S new defibrillator has not knocked her to the floor at Wal-Mart, as her old one once did.
Daly was shopping at the Fredericksburg store with her husband, Frank, last December when the heart device inside her chest misfired. The defibrillator was meant to monitor her heart and protect her from sudden cardiac arrest. Instead, without warning, it sent three jolts of electricity through her body.
"It was just like my whole chest exploded," Daly said. "I just landed on the floor screaming."
Store employees called an ambulance, and Daly was hospitalized after the incident. Technicians recalibrated the device to prevent it from misfiring again.
But five months later, the 51-year-old Spotsylvania County resident had other problems with her defibrillator--its site within her chest became infected.
Daly's doctors at the Medical College of Virginia Campus of Virginia Commonwealth University in Richmond removed the device but decided to wait before implanting a new one. They wanted to treat her infection first.
So, while awaiting a new defibrillator, Daly became the first person in Virginia to receive an external, wearable one.
"We didn't think it would be safe for her to go home without protection," said Dr. Richard K. Shepard, one of Daly's heart doctors at MCV.
The federal Food and Drug Administration approved use of the external defibrillator last October. Called a LifeVest, it is now worn by 75 people nationwide, according to a spokeswoman for Lifecor, the manufacturer.
Daly wears the vest 24 hours a day, beneath her clothing and next to her skin. She removes it only to shower. The device monitors her heart rhythms and will shock her back into a normal rhythm if an abnormal rhythm develops.
The vest consists of a set of white canvas belts worn around the chest and a holster at the waist. It weighs 1.8 pounds and is almost invisible beneath Daly's clothing.
The belts are reminiscent of the safety belts once worn by school-crossing guards. The holster holds a small black box that serves as defibrillator, monitor and battery pack.
The holster, Daly said, is the LifeVest's main drawback.
"It's not exactly attractive," she said.
The belts contain four electrodes, which continuously monitor her heart, and three pads that can deliver an electrical shock.
The device warns the wearer if it is about to administer a shock. The wearer can prevent a shock that seems unnecessary by pressing an "OK" button.
About 350,000 people die each year from the faulty rhythms that cause cardiac arrest. Unconsciousness results when the electrical signals become erratic and the heart does not pump sufficient blood. Patients like Daly with heart disease are at increased risk of this happening.
Defibrillators have been used for more than 40 years to shock the heart back into normal rhythm. At first they were used only in hospitals. In recent years, however, smaller, portable versions were developed and can now be found in shopping malls and airports, or carried by rescue squads, police and fire fighters.
About 20 years ago, a tiny internal version, now about the size of a thick business card, was developed. This type is implanted just below the skin in the upper chest near the heart.
Defibrillators have saved countless lives, yet, as Daly learned, the internal variety has its downsides.
Since it is placed inside the body, an internal defibrillator can cause an infection. In addition, its battery must be changed periodically, which means additional surgery.
And, the device can misread the heart's rhythms, as Daly's did, and produce an unneeded shock. The Journal of Cardiovascular Nursing reported last year that up to 20 percent of shocks delivered by internal defibrillators are inappropriate, though other heart experts say that number is too high.
Daly received her internal defibrillator in New York City almost three years ago. She and her husband were living in Chester, N.Y., at the time. Because of heart disease, she was in need of a defibrillator's constant monitoring.
Daly said she was able to lead a normal life with the device inside her. Though now retired on disability, she worked then as a computer operator for a grocery chain.
The couple moved to Spotsylvania last year and was living in the Lancaster Gate subdivision when the misfiring occurred in Wal-Mart. The device was removed last month.
"I didn't want it to come out," she said.
Daly will be a candidate for another internal defibrillator next month. In the meantime, the vest has allowed her to receive antibiotics at home, rather than in the hospital. The vest also would be appropriate for patients who are awaiting heart transplants, Shepard said.
"I'm sure I'll be using it quite a bit more in the future," he said.
To reach JIM HALL 540/374-5433 jhall@freelancestar.com
