Defibrillator implanted under the skin works without wires
Devices mean doctors no longer have to go through patients’ veins
Doctors at St. Paul’s Hospital in Vancouver stopped Mike McLellan’s heart last year then restarted it with an electric shock from a device they’d implanted under his skin.
“I’m still working on a good story about that,” says the 45- year- old sporting goods sales rep from Squamish. “Maybe white light?”
Even without a near- death memory, McLellan is marvelling at the advancement in an invention designed to save him from sudden cardiac arrest due to his irregular heartbeat. He’s the first person in B.C. to receive a subcutaneous implantable cardioverter defibrillator ( S- ICD). Implanted defibrillators work by monitoring a patient’s heart and then administering an electric shock to reset a racing or irregular heartbeat. Until recently, all such devices had to be implanted, along with wires threaded through veins near the heart. Now there’s the option at St. Paul’s of having a defibrillator placed just under the skin on the side of the chest without surgery on blood vessels.
“You don’t have any wires in veins near your heart, which is the really great advancement of this device,” McLellan said Friday in Vancouver. “It’s amazing technology.”
Since McLellan’s operation a year-and-a-half ago, 19 more devices have been implanted at St. Paul’s by a team led by heart surgeon Dr. Jamil Bashir.
“One of the biggest challenges we face with implantable defibrillators is the invasiveness of the procedure,” Bashir said in a news release. “This new device is a paradigm shift that allows us to shock the heart without having to place a wire in the blood vessels. Because the heart and blood vessels are untouched, the potential for blood vessel injury is eliminated, the potential for system infection is reduced and the patient’s vein access is preserved for the future.”
Those wires — also called intracardiac leads — also fail in 1 out of 200 patients every year, requiring another complex operation, according to St. Paul’s.
Nearly 1,000 conventional defibrillators are implanted in B.C. patients each year for heart arrhythmias. Some also need pacemakers, which are not available in the subcutaneous — or under- the- skin — model.
McLellan was shocked when he first learned he had heart arrhythmia because he didn’t think he’d had any symptoms. He’s a sports-loving guy who skis and bikes and the only clues were a few instances of fainting over the years. Yet heart monitoring tests recommended by his doctor revealed not only an irregular heartbeat, but also an enlarged ventricle wall in his heart, which can also lead to cardiac arrest.
With the extra insurance of what he calls a life- jacket for his heart, he’s resumed his outdoor pursuits — even riding 650 km over four days in Colorado and Utah four months after the operation.
As for how it feels, McLellan lobs a few sports comparisons.
“It feels like something the size of a hockey puck under your arm, but otherwise I don’t notice,” he says. “If I’m sleeping on my left side, I feel like I’m sleeping on a mouth guard.”
It feels like something the size of a hockey puck under your arm, but otherwise I don’t notice.
MIKE MCLELLAN SPEAKING OF HIS IMPLANTED DEFIBRILLATOR