LifeVest gives peace of mind in days after heart attack
By Elizabeth Cooney
Telegram & Gazette
Copyright 2007 Worcester Telegram & Gazette, Inc.
All Rights Reserved
Athol, Mass. — When Robert Hurley says wearing his LifeVest was like being wrapped in an EMT, that’s high praise.
After all, Athol fire and rescue workers, on- and off-duty, were part of the team that saved his life on Valentine’s Day. When the 41-year-old father had a major heart attack, EMTs shocked his heart back into action and other first responders cleared a Nor’easter’s worth of snow burying the stairs up the hill to his house so they could bring him to Athol Memorial Hospital. After being stabilized there, he was shipped to UMass Memorial Medical Center - University Campus for treatment to open his blocked arteries.
“Those are all the people who saved me,” he said. “I was really very lucky and I’m very appreciative.”
Now he’s grateful for a device that gave him and his family peace of mind after he came home from the hospital, carrying two stents to prop open blocked arteries, multiple new medications to take and fears about ever feeling anything but weakness and worry.
The external defibrillator that he wore was originally approved by the Food and Drug Administration in 2002 to cover people whose implanted cardiac defibrillators were removed, either because of infection or malfunction, and who needed to wait for a replacement. In 2005 Medicare expanded its coverage of the LifeVest to include heart attack survivors, with other insurers following suit. It costs $3,200 per month to rent a LifeVest. An implantable defibrillator comes to about $30,000.
Heart attacks damage heart muscle, and a scarred heart can more easily fall into the chaos of an abnormal rhythm, needing to be jolted back into the proper rhythm in minutes. The purpose of the LifeVest is to protect patients who may later need defibrillators implanted in their chests or even a heart transplant. Sometimes patients’ hearts heal, but first they have to live through the vulnerable time after they have left the hospital and before their course is clear.
Current research says that the first month after a heart attack is too soon to implant a defibrillator. But those first 30 days after a heart attack are also when people are at the highest risk for sudden death. One choice is to have an automatic external defibrillator, or AED, on hand. AEDs have become more common in public places like airports or schools as well as private homes, but they require another person to operate them. Another choice is the LifeVest, made by Zoll LifeCor Corp.
“It was like my lifeline,” Mr. Hurley said. “I didn’t want to move, but the LifeVest gave me the confidence to go get in my car on my own or walk the kids to school, to do just about anything.”
The vest, which is worn next to the skin, contains sensors to continuously monitor the person’s heart rate and also produces an electrocardiogram that can be sent to doctors via the Internet. There are two patches, one in the front and one in the back, that form an electrical field between which a shock is delivered to the heart if an abnormal rhythm is detected. The monitor and battery fit in what feels like a lightweight tool belt, Mr. Hurley said.
If the monitor senses an unusual heart rate, an alarm sounds, giving the person a chance to override the coming shock in case the reading is false. If it’s a real problem, the person has probably already fainted and the shock is given within a minute.
“It acts before you can call 911,” explained Dr. Dionyssios A. Robotis, Mr. Hurley’s cardiologist and a specialist in electrophysiology at UMass Memorial, adding that someone should still call 911 if the defibrillator is activated.
The LifeVest is not meant to be a permanent solution, Dr. Robotis said. About half of the 12 patients seen by UMass Memorial cardiologists who have used the device have gone on to have defibrillators implanted.
“This is a bridge. It gives the heart a chance to recover and protects it at the same time,” he said. “Sudden cardiac death is a major issue. Anything we can do to protect patients with risk is good.”
Two small studies published in 2004 showed that the wearable defibrillators are beneficial to people waiting for implantable ones and to those who are not clear candidates for them. Some people found the wearable versions uncomfortable and stopped wearing them.
Mr. Hurley said his three children, two stepchildren and wife, Karrie, were all shocked by his heart attack and thankful for the LifeVest, which never did need to deliver a shock but was a comfort to all of them, just in case.
When he began cardiac rehab exercise classes, he felt much more comfortable wearing the LifeVest. But he has steadily gained strength and confidence as his heart’s function has improved.
After 90 days with the LifeVest, his final echocardiogram showed his heart had regained its normal function. So he never needed the implanted defibrillator or heart transplant doctors had broached with him when he was still in the cardiac intensive care unit.
And he no longer needed the LifeVest.
While he was still wearing it, his daughter Jessica, 10 years old and fascinated by science, wanted him to come to her school to give a presentation on it. He said no.
“If I was a fireman and saved somebody’s life, then you could ask me,” he said. “I’m a guy who had a heart attack who was just wearing this LifeVest.”
The highlight of his recovery was attending his step-daughter Vikki’s high school graduation.
“I thought that was the epitome of everything,” he said. “I might not have been able to see her graduate.”