Defibrillators at heart of breakthrough

National research study draws heavily on KU Medical Center patients

Terry Glenn calls it his little insurance policy.

Embedded in his chest, just below the skin, is a pager-sized defibrillator ready to shock his heart back into action if it stops beating, as it did in 1994.

Terry Glenn, Baldwin, is part of a successful research study testing new defibrillator and pacemaker devices for heart patients. Glenn cruised his yard Tuesday on his garden tractor with his granddaughter Brittani Glenn, 7.

“When you read all the information about defibrillators at airports, it’s reassuring to know I’m carrying one with me,” said Glenn, who lives in Baldwin. “It only takes one heart attack to know you want to take these things seriously.”

A new worldwide study involving Glenn and more than 1,200 others may pave the way for many more heart patients to receive the implanted devices.

The study’s results, released Tuesday at a meeting of the American College of Cardiology in Atlanta, suggest the devices could reduce heart attack survivors’ chance of dying by a surprising one-third and could benefit millions of Americans.

The study also indicates the devices should be considered for those with a history of heart attack and evidence of resulting heart weakness.

“We are talking about preventing the sudden death of people who are active and functioning,” said Dr. Arthur Moss of the University of Rochester, who led the study. “The opportunity here is quite profound.”

KU Med involvement

Doctors at Kansas University Medical Center provided 56 patients for the study, more than any other hospital. Altogether, 1,232 patients from the United States, Europe and Israel were included.

Loren Berenbom, a cardiologist at the Med Center, said he expected the results to convince the FDA to broaden the uses for the internal defibrillators, which have mainly been reserved for those who survive cardiac arrest or are found to be at high risk through testing.

The devices, tiny implanted versions of the chest-shocking paddles seen on TV hospital shows, have been available for 25 years and first gained U.S. Food and Drug Administration approval for limited use in 1986.

Such defibrillators, similar to one given last summer to Vice President Dick Cheney, serve as a pacemaker and monitor heart activity. If the heart stops, the device sends electrical impulses to restart it.

The devices are implanted in a minor procedure that usually allows patients to return home the next day. Cost for the implant and the procedure is about $30,000.

Study participants’ average age was 64, and many had suffered multiple heart attacks. All received similar medical treatment, but 742 were randomly assigned to have the defibrillators implanted in their chests; 490 of the patients were not given the devices.

The mortality rate over 20 months for participants with the device was 14.2 percent, compared with 19.8 percent among those without them.

Millions may benefit

Moss said at least 2 million Americans and perhaps more could benefit from the devices. Another 300,000 patients each year become at risk for heart disease. Berenbom estimated as many as 1,000 patients served by the Med Center could qualify for the implants under the proposed guidelines.

For Glenn, who had the device implanted in 1998, joining the study didn’t require much deliberation. He had a history of heart problems, including a heart attack, congestive heart failure, bypass surgeries and angioplasties. Now 63, he went on disability from his job as director of KU’s Career and Employment Services in 1997.

William Poole of Kansas City, Mo., has seen first-hand what the defibrillator can do. He had the device implanted in 1999, four years after quadruple bypass surgery.

Poole, 46, was at work in a Kansas City warehouse in October 2000 when he had a heart attack and blacked out. The device kicked in, restarting Poole’s heart.

“I would’ve died, depending on how long it took for the paramedics to get there,” he said.

It was the second time the device shocked Poole’s heart. The first time, eight months earlier, it malfunctioned while he was at his house watching television. He said it felt as if a lightning bolt shot through his upper body.

Doctors later adjusted the device’s software to prevent another glitch. Berenbom said the manufacturers of the devices Guidant Corp., St. Jude Medical and Medtronic continue to make the devices smaller and more effective.

“It’s not common, but it certainly happens,” Berenbom said of the glitches. “They’re reliable technology, but they’re not foolproof.”


The Associated Press contributed to this report.