DES MOINES, IA--Darl Reed was lucky to make it to the hospital during a heart attack in July, but even more fortunate to be wearing a LifeVest five days later when the protective device detected an abnormal heart rhythm and delivered a shock that saved his life.
Reed thought he’d pulled a muscle when he suffered a heart attack that began while boating at Rathbun Lake in July.
“I didn’t think I was having a heart attack at first because my impression of a heart attack was that you grab your chest and fall over. I was a little short of breath and felt a little pain in the center of the chest,” said Reed, 51, of Rhodes, Ia.
Despite the pain, he loaded his boat on a trailer and began driving to Des Moines. When the pain progressively worsened and he broke out in a cold sweat, he set the GPS to Lucas County Health Center and told his girlfriend, Flora Sasa, to drive there.
Reed was later flown to Iowa Methodist Medical Center, where physicians placed a stent in an artery that was 100 percent blocked, with a blood clot behind it. Because his heart was weakened following the heart attack, and his ejection fraction — the percent of blood that pumps out with each heartbeat — was 35 percent, Dr. Pamela Nerheim, electrophysiologist and heart failure specialist at the Iowa Clinic Cardiology Department, prescribed him a LifeVest as a precaution when he left the hospital.
Nerheim said the LifeVest, a wearable defibrillator, is for a very specific group of patients who have had some sort of event, such as heart attack or decreased ejection fraction. A normal ejection fraction is 55 percent or higher.
“Those patients are at increased risk for having a fatal heart rhythm, called sudden cardiac arrest. But that group of patients doesn’t qualify yet for an implantable defibrillator. The LifeVest is a way to provide safety during the period of time the patient’s heart is healing and remodeling the heart failure treatment we give them,” she said.
While it was difficult for Reed to believe he was at-risk for another event, she noted that every 90 seconds, someone dies from sudden cardiac arrest.
Insurance typically requires a 40- to 90-day wait to see if the ejection fraction improves before patients receive an implantable pacemaker/defibrillator, an expensive, invasive procedure. The LifeVest serves as a bridge during that period and is covered by insurance, said Jody Martin, territory manager for manufacturer Zoll. The vest must be worn at all times, except when showering, to continually monitor the heart.
“It doesn’t look appealing — there’s a big clunky box you have to wear all the time. You never know when you might have an event,” Reed said.
He felt fine until five days later, when the symptoms returned.
“I started feeling light-headed. I could feel it coming on again, real similar to what I felt before. I knew almost immediately. Within a few seconds of feeling it coming on, the vest alarmed,” he said.
Over five minutes, he pressed a button to delay the shock a dozen times. While his girlfriend called 911, he blacked out long enough that he dropped the control box. As he regained consciousness and reached for the box, the LifeVest shocked him. The vest is typically meant to shock patients while unconscious.
“Almost immediately, the lightheadedness went away, the pressure in my chest went away, the pain was gone,” Reed said.
At the emergency room, physicians delivered four more shocks and were able to review information transmitted from the vest’s electrodes to the control box. Nerheim said Reed suffered a bad rhythm, called ventricular tachycardia. Once stabilized, he received an implantable pacemaker/defibrillator, which Reed said has not gone off.
The LifeVest has been around since 2001 and slowly made its way into the health care market. Nerheim has prescribed the vests for two years and typically has five to 10 patients wearing one. Most times, they never go off — Reed is her first patient whose life was saved due to the wearing the vest.
Martin said the LifeVest saves at least one, nearly two lives every day. The first 30 days following a heart attack is the highest risk period for sudden cardiac arrest, he said, and the risk declines dramatically after 90 days. Treatment time is the critical issue and where the vest plays an important role, he said. The LifeVest has been prescribed to more than 100,000 patients.
Reed’s ejection fraction is now up to 55 percent, in part due to exercise and diet. He has since filmed a wellness piece for his employer, Kemin, and talks about the importance of screening. He didn’t think he needed a checkup last year because he didn’t have any health issues and was active. It’s hard to say if testing would have caught his problems, but it may have spotted some red flags, he said.
Nerheim echoed that message on prevention.
“We have the capabilities of telling people what their likelihood of having coronary disease or having sudden death is and do things to modify that risk. Many of the heart disease patients and arrhythmia patents we see we can actually prevent that and they never have to come to that,” she said.