Implanted Defibrillator Malfunctions And Still Saves A Life - Or, Somebody's Looking Out For This Dude/Dudette

He/she had just finished a long shower & gotten dressed when the first shock hit him/her and dropped him/her to his knees.  Shaking it off, he/she made it to his/her feet just as the second shock took him/her back to the floor without warning.

He/she had the implanted defibrillator installed just over a year ago after his/her heart attack.   He/she is only in his 40's, but looks 10 to 20 years older, mostly because of the booze.

That's the story we got once we arrived on scene.  He/she's sitting in the lazee boy, clearly worried. 

He/She's sweating, too.  No particular reason, but there it is.

Oh, and his/her heart rate is 130.   Hmmm.

The 12-Lead is unremarkable.  I can see the evidence of the first heart attack, but nothing acute.  I assume that his/her heart rate was even higher at some point, and that's why the defibrillator went off.  Or it just malfunctioned.  No matter, because the treatment is the same - transport & punt to the cardiologists.

So we bundle him/her off to the hospital.  No changes enroute.  I ask him/her a bunch of questions - palpitations, dizziness, length of shower, etc., trying to perhaps determine just what happened.  No joy.  At the end of the ride, it's just some guy/lady with a fast heart rate, sweating, whose defibrillator slapped him/her around a few times.  I did elicit that his/her first MI was a silent one.  The only way he/she knew was after he/she woke up in pulmonary edema.

A quick handoff, and now it's the doctor asking him/her the same questions.  I hand over my 12-Lead, gather my signatures and depart, headed for other calls.

Oh, and try to determine - do I chart this as an 'electrocution' or as 'heart problems'?

Several hours later, I happen to see the physician again and ask him about the patient.

Turns out he/she was having The Big One.  Another Big One.  Their 12-Lead (taken some time after mine) showed just a millimeter elevation in V5 & V6. 

So what about the ICD, I ask.

'Oh, well, we interrogated it (waterboarding or other technique, I'm not quite sure), and it discharged on Normal Sinus Rhythm.'

We both agreed that it was rather unusual, and that with his/her history of silent MI, even though the ICD malfunctioned, it still saved his/her life.  Amazing.  One for the books.

I believe that the fast heart rate & diaphoresis was due to the catecholamine release secondary to the heart attack - the only signs to be found.

And it was charted as 'heart problems'.