Friday, April 4, 2003

Study: Combo heart device is lifesaver



By Tim Bonfield
The Cincinnati Enquirer

If it weren't for the three wires connecting his heart to a palm-sized metal box in his chest, a Casper the Friendly Ghost cartoon would have been the last television show that 57-year-old Robert Plunkett ever saw.

Instead, the Richmond, Ky., resident is living proof of a national medical study reporting that many people with advanced heart failure can live longer if fitted with combination pacemaker-defibrillators. The findings of the "companion" heart failure trial were announced Monday in Chicago at a scientific meeting of the American College of Cardiology.

The study of more than 1,600 patients at 128 medical centers - including 34 at the University of Cincinnati Medical Center - reported 43 percent reduction in "sudden cardiac death" among heart failure patients using the device.

Wider use of the combination devices offer a chance to sharply reduce deaths from heart failure, said Dr. Arthur Feldman, a researcher at Thomas Jefferson University Medical College in Philadelphia who co-authored the study.

"Despite the fact that over the past two decades we've developed new drugs for treating heart failure, we still have a million hospitalizations (a year) and we still have a one-year mortality rate of 15 to 30 percent from this disease," Feldman said.

Congestive heart failure is a common form of heart disease that occurs when heart muscle is weakened so much - by previous heart attacks or other disease - that the heart cannot pump blood through the body strongly enough.

In Cincinnati, the new findings won high praise from experts at the University of Cincinnati.

"This is the first study to show that the device makes people live longer. And a 40 percent reduction in mortality is pretty dramatic," said Dr. Lynne Wagoner, director of cardiac services at University Hospital.

For Plunkett, Feb. 9 was winding down to a quiet evening with his grandchildren. He had just flipped over to the Disney Channel to see if there was a show the kids might like to see.

"I was just sitting here watching TV when everything started going dark, just like turning down the brightness on the TV," he said.

But the device - the Contak CD resynchronization defibrillator made by Guidant Corp. - sensed Plunkett's heart slipping into a dangerously irregular rhythm. It fired three times.

Plunkett's wife, Pat, said her husband's eyes rolled back and his arms flailed in the air as an electric pulse from the device shocked his heart back to a normal beat.

"I didn't feel a thing," Plunkett said. "Thank God the kids were still outside."

Upon looking at data collected from the device, Wagoner said Plunkett would have died that day. Yet the device was installed two years ago only because Plunkett was part of the clinical trial.

Plunkett has had heart failure since childhood, and survived the first of four heart attacks at age 24. But like many other heart failure patients, Plunkett had not shown symptoms that would have prompted most doctors to install the combination pacemaker-defibrillator, Wagoner said.

E-mail tbonfield@enquirer.com




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