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Questions (and Answers) About Blood Thinners and Defibrillators

Q: What can you tell me about dabigatran, a new blood thinner that is in the news?

A: Unlike warfarin, a blood thinner used for decades that is regulated by blood tests, the experimental drug dabigatran prevents blood clots with a fixed dose that is taken twice daily. The FDA approval of dabigatran, the first of a new class of drugs called direct thrombin inhibitors, is expected sometime this year.

Q: A doctors says our neighbor died in his sleep of a massive heart attack. Could a defibrillator have saved him?

A: While it is possible your neighbor did have a heart attack, the event that likely killed him was an abnormal heart rhythm called ventricular fibrillation. You do not give your neighbor’s age, but assuming he/she was an adult, a heart attack could have triggered the VF. The usual heart rate at rest is around 70 beats/min. During VF, the ventricular rate surges to 400-600/min, preventing effective contraction of the major pumping chambers that deliver unoxygenated blood to the lungs (right ventricle) and oxygenated blood to the rest of the body (left ventricle). The ventricles during VF look like a bag of squiggly worms, a belly dancer gone berserk. With no blood flow to the brain, loss of consciousness occurs in 10 to 20 seconds and death in five to eight minutes. Sudden cardiac arrest occurs almost 1,000 times per day in the U.S., claiming the lives of half of those who have heart attacks before they reach the hospital. It is likely that prompt use of a defibrillator to shock the heart rhythm back to normal could have saved his life.

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