Replacing defibrillators leads for the long-term patient

  • Updated: September 14, 2013 - 7:05 PM

For a guy like Scott Belasco of Long Grove, Ill., a defibrillator with wires running into his heart wasn’t a good option.

The 57-year-old suffers from a disease that is deteriorating the right ventricle of his heart, converting muscle into fatty tissue. That not only weakens his heart, but the fatty tissue blocks the conduction of electricity. A defibrillator wire connected to his heart might not deliver a lifesaving jolt when needed.

Belasco has had two traditional defibrillators with wires implanted previously, the most recent in 2008. But he began to have problems last year.

“Things had been happening. There were misfires,” he said. “In the fall, I got a shock out of the blue for no reason.”

Doctors decided to remove the old wires. When they did, they found one was badly calcified and the other was not even attached to his heart anymore.

Leads, the wires that run from a device to the heart, are the weak link in the device chain. Subjected to 100,000 heartbeats a day, leads have fractured, separated from their insulation and disconnected over time. What Belasco experienced was not unique.

So, in October, he agreed to receive Boston Scientific’s S-ICD, a defibrillator that does not snake wires into the heart. Instead, it runs a wire just under the skin to a spot above the breast bone. When the heart needs a shock to regain a healthy rhythm, the jolt is much like that from an external defibrillator with paddles.

For younger patients who will need defibrillators for more years than lead wires may last, Boston Scientific thinks its device might be an option that makes sense. So does Belasco — even if the device is a bit bigger and bulkier than he would like.

Belasco, a regional sales manager who is on the road a lot for his job, said the new device has given him the confidence to travel without fear that his device won’t work or that it will deliver an accidental jolt.

“It gives me the freedom to keep going,” he said, adding: “You start looking at younger and younger patients, how are they going to handle leads in their heart that long? This, for longer terms, is probably the way.”

James Walsh

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