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    Hope for the Heart: Advances in Treatment

    Today two-thirds of people survive their heart attacks, thanks to medical advances. Learn how some of these medical marvels evolved.

    Clot Busters to Prevent Heart Attacks continued...

    Andreas Gruentzig, MD, of Zurich, Switzerland, performed the first angioplasty in 1977, on a patient with stenosis, a condition in which an artery is narrow and hardened. After DeWood's findings, doctors quickly picked up angioplasty as a tool for intervening in heart attacks.

    In addition to angioplasty, doctors now insert a mesh tube, called a stent that holds the artery open. Very recently, stents have been coated with a polymer that releases a drug to prevent scar tissue from forming in the artery and causing it to clog, which had been a major problem with them.

    Today, many hospitals are equipped with "cath labs" where a specialized team can immediately do angioplasty and put in a stent when a heart attack victim arrives. ERs and clinics without these facilities use clot-busting drugs.

    A Lifesaving Shock to the Heart

    As technology generally gets more sophisticated, so, too, does medical treatment. The story of the implantable cardiac defibrillator (ICD) really begins with experiments in electricity at the turn of the last century. By the early 1970s, electrical engineering was an advanced science, and doctors had begun to tap the potential of electrical devices for treating heart disease.

    Michel Mirowski, MD, had lost a dear friend to sudden cardiac death, caused by an arrhythmia, or abnormal heart rhythm. He was determined to develop an implantable device that could correct potentially fatal arrhythmias before the patient was even aware of a problem. With colleague Morton Mower, MD, he approached Stephen Heilman, MD, at a company called Medrad in Pittsburgh, to carry out the research and make a commercial product.

    "Having the idea and actually making a practical device are two different things," says Alois Langer, PhD, an electrical engineer who joined the team in 1972, with a freshly minted degree from MIT. He was charged with figuring out how to build the ICD the medical doctors envisioned.

    Pacemakers that keep a slow heart beating normally had already been in use for years. But no one had attempted to make an automatic, implantable defibrillator, which would shock the heart out of an abnormal rhythm like ventricular fibrillation. In ventricular fibrillation, the regular electrical impulses of the heartbeat get disorganized, ventricles flutter chaotically, and the heart doesn't pump blood. It is fatal in minutes or even seconds.

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