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Laura Seitz, Deseret News

New implantable device saves Utah man's heart, life

By Wendy Leonard | Posted - Jan 24th, 2014 @ 6:33pm

5 photos

MURRAY — Brandon England doesn't have to worry so much about his faulty heart muscle anymore.

"It's kind of like having his own paramedic squad in his chest," said Dr. Jeff Osborn, a cardiologist at the Intermountain Medical Center Heart Institute.

England, of South Jordan, is the first Utah recipient of a newfangled device that is supposed to protect him from sudden cardiac arrest.

"It felt like I could start living again," the 20-year-old said Thursday, following successful surgery to implant the device on Tuesday.

England, who received a crushing diagnosis of dilated cardiomyopathy in April, hopes other Utahns will benefit from the same subcutaneous implantable cardiac defibrillator that is now keeping him — and about 1,400 others around the world — alive.

Medications just weren't doing the trick, he said, adding that they provided little hope of survival.

"When I heard about this defibrillator, it lifted so much weight off my shoulders," England said.

England's case marks the first time the technology has been used in Utah.

Dr. Jeff Osborn, cardiologist with the Intermountain Medical Center Heart Institute, talks about the subcutaneous implantable cardiac defibrillator at the Intermountain Medical Center in Murray on Thursday, Jan. 23, 2014. (Photo: LAURA SEITZ, Deseret News)

The S-ICD system, offered by Boston Scientific and approved by the Food and Drug Administration more than a year ago, differs from traditional defibrillators because it doesn't require implanting wires directly into the heart to deliver a shock when it is necessary to get the heart pumping again. No wires, Osborn said, can be a good thing, especially for younger patients.

"There are some downsides to having leads or wires directly touching the heart," the doctor said, adding that wires have a "finite life" and may need to be replaced, which is an even higher risk procedure and involves another open-heart surgery.

Wires in the heart can also become infected, causing even more risk for the patient.

"This new device offers less risk with the same life-saving benefit," Osborn said.

Rather than placing the wires into the heart, the new S-ICD is placed under the skin and across the ribcage. It has two main components: the pulse generator, which powers the system, monitors heart activity and delivers a shock, if needed; and the electrode, which enables the device to sense the cardiac rhythm and serves as a pathway for shock delivery, when necessary.

The device is housed in a pocket in the skin below the left armpit, and a durable electrode then is tunneled along the rib cage to the center of the chest, across the sternum and toward the neck.

Osborn said the system's action would be similar to having the two paddles of the automated external defibrillator placed on the chest at all times, "but buried under the skin."

"In a young patient like Brandon, this new procedure will allow him to have a lifesaving system close at hand, without the risks associated with wires running into his heart," he said.

Cardiac arrest
More than 359,000 Americans suffered an out-of- hospital cardiac arrest in 2013, with a 9.5 percent survival rate, according to the American Heart Association.

Most episodes of cardiac arrest, Osborn said, are caused by the rapid and/or chaotic activity of the heart, known as ventricular tachycardia or ventricular fibrillation.

Recent estimates reveal that approximately 850,000 people in the United States are at risk of sudden cardiac arrest and would benefit from an implantable cardioverter defibrillator device, which has been used to monitor and assist hearts since the early '80s but remain unprotected.

Osborn said the devices are known life savers, and new technology is upping the game.


Wendy Leonard

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