A 61-year-old male presented to the emergency room with a gunshot wound to the upper left chest. He had a history of myocardial infarction, two coronary bypass graft surgeries, and intracoronary stents. The patient had chronic ischemic cardiomyopathy with a left ventricular ejection fraction of 24%. He received a Medtronic Virtuoso-DR D154AWG (Minneapolis, MN) transvenous implantable cardioverter-defibrillator (ICD) in 2007 for primary prophylaxis. Since implantation, he had never received ICD therapy but did atrial pace frequently. The ICD had been interrogated 2 weeks prior and was found to function normally. Despite the gunshot wound with an entry to the chest located just medial to the ICD generator, the patient remained alert with stable vital signs and virtually no symptoms.-Wes
Reference: Sheppard RC, Levine JC, Rovin J and van Gelder HM. "A novel way an implantable cardioverter-defibrillator prevents death: Protection from a gunshot" Heart Rhythm Volume 6, Issue 9, September 2009, Page 1390.
Wes,
ReplyDeleteAre you now advocating pacemaker placement to prevent deaths from gunshot wounds?
I do think that Medtronic should consider doing a study showing to the FDA that pacemker placement may reduce mortality from gunshot wounds. This opens up an infinite market for the use of their product!
Keith -
ReplyDeleteIf we put enough of them in, the patient could have a full metal jacket!
(Joking, of course)
Hey, as they say "Better lucky than good" when it comes to the ICD's indication for the prevention of injury from gunshot wounds.
Now regarding his EF of 24% in ischemic cardiomyopathy, that there's a FINE indication for a "boom box!"
is that covered by warranty?
ReplyDeleteGood thing that was a Medtronic device. The Boston Scientific devices being half as thick may not have stopped it!
ReplyDelete