Miniature electronics that power smartphones and gaming consoles are sparking new innovations in cardiology. Wireless devices monitor the heart 24/7 to save lives in specialized hospital units. Now, the sophisticated gizmos are standing watch over heart patients after they go home.

Today’s tiny implants monitor blood flow or heart rhythm, among other key measures. Then, when something goes wrong, the device signals a medical professional and alerts the patient to seek help immediately. Research proves that implanted heart failure monitors reduce hospitalizations and improve outcomes. Pacemaker and defibrillator monitors with wireless communication features routinely perform checkups without a trip to the doctor’s office.

On the horizon: an early warning system to detect heart attacks before symptoms occur, ensuring the best, most timely treatment possible. Clinical trials of the AngelMed Guardian device (the ALERTS study) are recruiting patients at nearly 80 study locations nationwide.

Innovations in Heart Health The Saturday Evening Post

Bypass surgery for clogged arteries can increase SCA risk, but the danger often drops significantly as the heart heals. As a result, doctors who specialize in heart rhythms (electrophysiologists) wait three months to treat patients with an implantable cardioverter defibrillator (ICD).

“With the current treatment guidelines, there is a window of time during which someone at risk may not be protected—and that’s when we recommend the Zoll LifeVest,” explains electrophysiologist Krishna Malineni. “When the vest activated, it proved what we had suspected—Mr. Dalrymple had a permanent need for an ICD and we promptly provided him one.”

Heart patients waiting for transplants or being treated for infection-related heart problems are also potential candidates for LifeVest, which is covered by most health insurance plans.

Unlike Mr. Dalrymple and other heart patients, however, most of the 400,000 Americans stricken by SCA every year have no idea they are at risk for the tragic event. Click here to read more about sudden cardiac arrest and ongoing research to better identify those at risk, as well as what to do when SCA strikes.

A Life Vest for the Heart The Saturday Evening Post

Here are 5 facts from the ongoing HRS Apples and Oranges campaign to help you understand the difference between the two heart emergencies—and why it matters:

1. SCA is a malfunction of the heart’s “wiring” or electrical system that controls your heartbeat. Heart attacks result from bad “plumbing”, or problems within the blood vessels that carry oxygen to the heart muscle.

2. SCA immediately and completely halts blood flow throughout the body, starving the entire body of oxygen. Heart attacks (also called myocardial infarctions or MIs) reduce or block circulation to a particular area of the heart muscle.

3. SCA occurs without warning and is often the first indication of unsuspected heart rhythm problems. Loss of consciousness occurs within 20 seconds. Heart attacks are usually (but not always) preceded by chest discomfort or trouble breathing and happen to people with high cholesterol, high blood pressure, or a personal or family history of heart disease. Heart attacks can trigger the deadly heart rhythm called ventricular fibrillation that causes SCA.

4. SCA has a cure. It is to “shock” the heart back to normal rhythm with a machine called a defibrillator. But the window of opportunity is short—chances of survival decrease about 10 percent for each minute spent waiting for a defibrillator. Fortunately, many therapies exist for heart attacks and getting prompt emergency treatment can avoid or reduce heart muscle damage when symptoms are recognized early.

5. SCA occurs almost 1,200 times per day in the U.S. Heart attacks claim the lives of about 600 Americans daily, including 300 who die before reaching the hospital. Most of those deaths are from SCA.

Click here for more on SCA from The Heart Rhythm Society.

Watch for more about preventing SCA and saving lives in future weeks.

Understanding Sudden Cardiac Arrest The Saturday Evening Post

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.

Questions (and Answers) About Blood Thinners and Defibrillators The Saturday Evening Post

Months later, a doctor called to find out if Frank was still alive. He is, and he does not have brain damage. The doctor said the first shock was given 2½ minutes after Frank’s heart stopped and that the paramedics arrived in 5½ minutes. There are no words to express our appreciation to the people who helped a perfect stranger. Even a customs supervisor came over to help. I hope everyone who was so kind to us will read this letter, especially the two young ladies!

Virginia

California

We hope they do, too! Your letter is a good reminder that sudden cardiac arrest can happen anywhere and anytime. We’ve been advocating for years that automated external defibrillators (AEDs) should be as common as fire extinguishers. Fortunately, the lifesaving devices are now in visible locations at airports, stadiums, and some schools and churches. But most heart emergencies happen in the home. As the adage goes: Plan for the worst and hope for the best. When determining your response to a heart emergency at home, consider: Are you or a family member trained in CPR? Where is the nearest AED? How long will it take for the AED to arrive? Is it feasible to have a home defibrillator or one in a neighborhood clubhouse or lockbox? Today’s AEDs are so simple that almost anyone can use them without prior training. If you are in a position to help save a life by using an AED, remember three things: 1) recognize a heart emergency; 2) open the AED box; and 3) follow the prompts.

Husband’s Life Saved by Defibrillator The Saturday Evening Post