Giving Heart Patients an Extra Layer of Protection
Sudden cardiac arrest [SCA]—a very serious condition-occurs when the heart stops pumping, shutting off blood flow to the rest of the body. But doctors at MedStar Good Samaritan Hospital are using new technology—a wearable vest—to decrease the risk for patients with SCA.
 "One of the most common causes of SCA is an abnormal heart rhythm, or arrhythmia," says Jerald Insel, MD, chief of the division of cardiology at MedStar Good Samaritan Hospital. An arrhythmia can occur because of many different conditions, including high blood pressure, coronary heart disease or heart failure.
To prevent a life-threatening arrhythmia, surgeons insert a device called an implantable cardioverter defibrillator [ICD]. The surgeon places the tiny device under the skin and connects special sensors, called electrodes, to the heart. The ICD monitors the heartbeat and sends an electric impulse through the electrodes if it picks up a dangerous rhythm. This impulse restores the heart to its natural pace.
"When a patient comes in with an arrhythmia, we may not know how long it has been there or whether it will get better on its own," Dr. Insel says. For instance, some patients may develop an arrhythmia after a heart attack, but the arrhythmia may go away once the heart muscle has time to heal. So doctors monitor patients for 60 to 90 days before considering a permanent defibrillator.
During this time, SCA can be a real threat and, until now, there was no safeguard to prevent it. As soon as wearable defibrillators proved effective, doctors at MedStar Good Samaritan Hospital started using them for patients diagnosed with arrhythmia as an advanced precaution before beginning treatment, according to Dr. Insel.
What is a wearable defibrillator?
The wearable defibrillator fits under clothing. It consists of two main parts: the first is an elastic belt that wraps around your chest. The belt contains tiny electrodes that sit on top of your chest. The second part is a small monitor that you wear on a shoulder strap or attached to your belt. If the monitor detects an abnormal beat, it sends an impulse through the electrodes to restore rhythm.
Patients can wear the small device at all times, except when showering or bathing.
Preserves Patients' Freedom
The wearable defibrillator helps ease patients' fears, knowing it will save their lives if they experience SCA. "I recently had a 50-year-old patient with a weak heart who was terrified to go about his daily activities because he was at risk for SCA," Dr. Insel says. "As soon as I gave him the device, he felt a tremendous amount of freedom and was no longer paralyzed by fear."
After a patient uses the wearable defibrillator, doctors can determine the best course of action. That could mean treating the underlying problem with medication, such as using beta-blockers to control high blood pressure. If necessary, doctors can implant a permanent defibrillator.
"Doctors at Good Samaritan stay up-to-date with cutting-edge technologies that can benefit patients, and the wearable defibrillator is an important way in which we have done this," Dr. Insel says. "It is a very safe device that saves patients' lives."
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