Sunday, November 20, 2005

Dead Meat Can Beat

Okay, you've had your heart attack and been told your heart muscle is weak. Your doctor tells you you need an internal cardiac defibrillator (ICD). "A what?", you say. "But I feel fine. I haven't collapsed, fainted, lost conciousness. Why do I need one of THOSE? What the heck ARE they, anyway?"

No doubt there are tons of you out in the blog-o-sphere that have an "ICD." Yet there remains an unmet need for folks with weak heart muscles to receive them. Doctors use an echocardiogram or nuclear medicine test to determine the "ejection fraction" of your heart (that is, the fraction of blood pumped out of the main pumping chamber of your heart with each heart beat - normal is greater than or equal to 50%). If you have an ejection fraction of 35% or less, you might need an ICD. You should DEFINITELY ask your doctor if you qualify and YOU SHOULD LEARN YOUR EJECTION FRACTION NUMBER! This single value correlates with mortality better than any indicator in cardiology studies.

Now you have to be careful.... turns out the estimation of ejection fraction is not quite as good in people who have irregular heart rhythms (like atrial fibrillation), but certainly folks in normal rhythm can be fairly accurately estimated and this number helps doctors recommend which therapy is best for you. Folks with EF's less than 30% can have an estimated 23% reduction in mortality if an ICD is installed over conventional medical therapy. Granted ICD's are not for everybody, but the word needs to get out. You can learn about ICDs and see what they look like after they are installed (yes real pictures!) here.

Yes, dead heart muscle can beat too fast, causing inadequate time for the main pumping chamber of the heart to FILL with blood, thereby limiting the amount of blood that can be pumped out. So dead meat CAN beat, and occassionally be fatal. ICD's can save lives. Learn your "EF" number and advocate for yourself.

--Wes

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