by Amy Simmons, RN, Pediatric Cardiology and Cindy A. Abole, Public Relations

History was made at MUSC last year when an 18-year-old youth became the first pediatric patient in the United States to receive a breakthrough medical device which helped him to beat the odds in life.

The patient, who had a congenital heart defect and survived numerous surgeries since birth, received an innovative combined dual chamber pacemaker and automatic implantable cardioverter defibrillator (AICD) on July 25, 1997. The AICD is a device capable of regulating heart beat and defibrillation. Known as the Ventac AV, the device was available to the public from its manufacturer, Guidant/CPI, shortly before the implant at MUSC.

The procedure resulted from what began as a typical day at the pool to a person’s worst nightmare. The recipient, while at summer school, went for a swim at the campus pool. Following his workout, the young man’s heart began to race and he felt light-headed and faint. It wasn’t long before he was admitted to MUSC Children’s Hospital. Following an electrophysiology study, a review of the heart’s electrical system, catheterization, and a battery of other tests, it was determined that the youth suffered from a life threatening arrhythmia. The patient was implanted with the AICD making it possible for him to return to a somewhat normal lifestyle.

In recent years, studies have questioned the effectiveness of defibrillators versus anti-arrhythmic drugs for people with life-threatening heart beat irregularities. Generally, defibrillators are a costlier method to correct irregular heart beats, yet studies prove they are more beneficial. About the size of a deck of cards, the AICD is usually implanted in the chest with electrodes connected to the lower and upper heart chambers. These electrodes monitor the rhythms of both chambers, allowing the device to detect arrhythmias that are life-threatening.

The Ventac AV is designed to overdrive pace or provide a corrective shock to the heart converting the arrhythmia to a normal rhythm. Patients can often feel the corrective shock, which can be quite uncomfortable. However, episodes of detection, correction and post-event monitoring last only a few seconds and the result is a saved life. In addition, the device can record arrhythmic events and how the heart responded. The recorded events are accessed with the help of a pacemaker programmer and provides valuable diagnostic information. The device is expected to have a useful life of five to seven years.

Editor's note: The article is reprinted from The Beat Goes On, MUSC Heart Center.