Kent Hospital offers new treatment for patients at risk of sudden cardiac arrest

WARWICK – For the first time, Kent Hospital recently successfully implanted a relatively new procedure – the subcutaneous defibrillator system – to treat patients at risk for sudden cardiac arrest, the hospital reported in a recent news release.

The subcutaneous defibrillator system provides protection without placing wires in the bloodstream or connecting to the heart. Sitting just below the skin, the entire system does not place thin, insulated wires – known as leads – into the heart. By leaving the heart and blood vessels untouched, this less-invasive treatment avoids potentially serious complications often associated with leads into the heart. This second-generation subcutaneous defibrillator, a smaller, thinner device, is expected to last 40 percent longer than its earlier iteration and permits remote patient management. It received regulatory approval from the U.S. Food and Drug Administration in March 2015.

Dr. Bruce A. Koplan, director of the Cardiac Arrhythmia Service for Care New England, performed the first patient implant at Kent Hospital. Koplan, with Brigham and Women’s Cardiovascular Associates at Care New England, was also the first physician in New England to implant the same device in a patient at Brigham and Women’s Hospital in Boston.

Koplan told Providence Business News in an email that some 600 of these subcutaneous defibrillator systems are implanted in patients in the United States each month; they represent less than 5 percent of the total number of cardioverter defibrillator implantations occurring in the United States. Patients generally remain one night in the hospital after the subcutaneous defibrillator procedure, which takes slightly more than one hour. Medicare and commercial insurance companies reimburse for this procedure, he said.

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During sudden cardiac arrest, a serious, life-threatening condition that happens abruptly and with no warning, the heart’s electrical system malfunctions and stops pumping blood to the rest of the body. With the lack of blood to the brain, an affected individual quickly loses consciousness and, without immediate defibrillation treatment, brain damage or death are the likely outcomes.

One treatment option for individuals at risk of sudden cardiac arrest is an implantable cardioverter defibrillator, as it may prevent sudden cardiac death. These are implanted devices that sense arrhythmias (irregular heartbeats) and deliver strong electrical shocks to the heart to restore a normal heartbeat. This form of therapy has been shown to effectively stop 95 percent or more of dangerously fast heart rhythms, and 19 of 20 people will survive sudden cardiac arrest. Kent Hospital reported that the subcutaneous defibrillator system is designed to provide the same protections against sudden cardiac arrest as do traditional implantable cardioverter defibrillators.
For patients who need an implantable cardioverter defibrillator but whose vascular limitations or infection risks foreclose that option, the subcutaneous defibrillator system could be a lifesaving route, said Koplan.

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