Wearable Defibrillator Prevents Post Heart Attack Death
Ochsner Cardiologists Offer Patients World¹s First Wearable Defibrillator
February is National Heart Month and Ochsner Medical Center is offering local heart patients a cost- and life-saving alternative to traditional surgery. Called the LIFECOR LifeVest, its the worlds first wearable defibrillator for the prevention of sudden cardiac death following heart attack. With heart disease being
 Louisiana¹s number one killer, all preventive and therapeutic resources should be used for best overall patient outcomes.

The LifeVest is the first ³wearable defibrillator² and is worn outside the body under normal clothing rather than implanted in the chest.  The non-invasive device weighs three pounds, monitors the heart to detect abnormal rhythms, and delivers an electric shock, if needed, to restart the heart.

³Sudden cardiac death is a real risk for patients who have heart disease, have suffered a previous heart attack, or have a condition called NICM where the heart muscle becomes weak,² explains Dr.Freddy Abi-Samra, Cardiac Electrophysiologist at Ochsner. The most common treatment for at-risk patients is surgical implantation of an Internal Cardiac Defibrillator (ICD), ICDs are designed for use over a long period and require surgery at considerable expense. Due to a variety of medical reasons, some patients who may eventually qualify for ICD implantation, should not be immediately subjected to the implantation procedure.  Such patients include those who have just suffered a heart attack, patients who have potentially reversible conditions (such as recent-onset non-ischemic dilated cardiomyopathy), patients with infections, etc.

In contrast to ICDs, wearable defibrillators are for temporary use, may be rented on a monthly basis, and are only needed for 30 to 90 days, says Abi-Samra. He cites the 2005 VALIANT study in the New England Journal of Medicine, which shows that heart attack patients Are  most vulnerable to sudden death in the first 30 days following a Cardiac event, and after three months, the risk is greatly reduced. Thisdata provides rationale for considering early interventional strategies,  including short-term therapies, such as wearable defibrillators, in  select patients.

Furthermore, for such patients, early post-heart attack, ICD implantation is not covered by most health insurance companies, including Medicare.  The rationale for lack of insurance coverage includes the fact that the heart may recover following a previou heart  attack as well as the fact that surgery so early post heart attack may negatively affect patients¹ long-term survival.  Currently, the only Medicare-covered devices are wearable defibrillators. ³Wearable defibrillators, such as the LifeVest, highlight the importance of helping patients in the short-term, preventing more dire medical outcomes, and saving the patient from financial stress,² says Abi-Samra. ³The LifeVest is a great bridge to ICD implantation or reassessment of a patient¹s condition.² Around the country, patients have readily accepted the device and the reassurance it offers.

³Not all cardiac patients are candidates for wearable defibrillators,² warns Dr. Hector Ventura, Section Head of Heart Transplant and Cardiomyopathy.   ³Only those who would otherwise qualify for implantable defibrillators but cannot or should not be implanted in the short term are candidates for the LifeVest.²  The LifeVest is also being utilized by Ochsner Cardiologists Drs. Tim Donahue, Sammy Khatib, Daniel Morin, Onajefe Nelson-Twakor, Hamang Patel, and Hector Ventura at Ochsner Medical Center, 1514 Jefferson Highway.

When the RTA Paratransit van stops in front of the LSU Health Sciences Center New Orleans School of Allied Health Professions on February 10, 2009 at 2:00 p.m., it won’t be picking up or dropping off passengers. Instead, it will serve as a classroom for 34 LSUHSC  Masters of Occupational Therapy (OT) students. The LSUHSC OT students will participate in a collaborative service-learning community mobility project with the Regional Transit Authority beginning at 1900 Gravier Street at 2:00 p.m. where they will learn the ins and outs of a new RTA Paratransit van. At 2:30 p.m., the lesson will continue as the faculty and students walk up to the bus stop at South Roman Street and Tulane Avenue where they will get an overview of the accessibility features of a new RTA biodiesel full size bus with a new mobility ramp. The project highlights the importance of accessible public transportation for people with disabilities and the elderly in the recovery of New Orleans as well as the advances RTA is making in going green and meeting accessibility requirements under the Americans with Disabilities Act.

The collaboration will provide the students with direct access to learn all about these modes of transportation which will increase their understanding of the ease of use of public transportation with a mobility device like a wheelchair or for those with sensory impairment. The students will also get firsthand knowledge about bus driver expectations related to accessibility. They will learn about the policies and procedures of the bus ramp and securement before they go out during the following weeks to ride the buses for their assignment to evaluate the use of public transportation for those with disabilities, including environmental barriers like uneven sidewalks, lack of curb cuts and overhead shelters, late buses, etc.

Accessible public transportation for people with disabilities and the elderly is key to their ability to gain and maintain employment, access education, take part in social/leisure activities, and keep important appointments like for therapy or medical care.

 “Community mobility enables full societal participation and integration of individuals,” notes Kerrie Ramsdell, LOTR, Assistant Professor of Occupational Therapy at LSU Health Sciences Center New Orleans. “Understanding the obstacles to community mobility, and advocating for accessible transportation enhances the perspective of the occupational therapist and occupational therapy student when considering all areas of occupation for clients.”        

“We are proud to partner with LSUHSC and the Advocacy Center as this community mobility project highlights the importance of accessible public transportation for people with disabilities in New Orleans,” said Cesar Burgos, Chairman of the RTA Board of Commissioners. “Enhancing service for all our customers is one of the RTA’s top priorities. Partnerships like this ensure the RTA reach our goal of improving system accessibility.”