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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.

    A Lifesaving Shock to the Heart continued...

    Many doctors were skeptical, even hostile, to the idea, so Mirowski's team experimented and tinkered with their device for nearly a decade before attempting a human test. "We weren't getting a lot of support from the medical community," Langer says, somewhat understating the opposition.

    "At the time, this was a very radical approach," Resar says. Most doctors thought that drugs then available were adequate for controlling arrhythmias, and that an implantable defibrillator was not only improbable but also unnecessary.

    In 1980, at Johns Hopkins University Hospital, the prototype ICD was implanted in a patient. It was roughly the size and weight of an iPod or pager, placed in the abdomen with wires running up to the heart.

    Langer says two prototypes were made, just in case someone dropped one on the floor. "The first one really did get dropped," he says.

    After the device was in, the researchers had to test it, which meant purposely inducing ventricular fibrillation in the patient. Having done so, they waited for the device to switch on and shock the heart back into a normal rhythm. "That seemed like an eternity," Langer says, as the seconds ticked by. But it worked.

    "The first indications for use were fairly strict," Langer says. To qualify for an ICD, you had to have experienced sudden cardiac death and been resuscitated. Today, the devices are used much more broadly, and they're a lot smaller. People with heart failure routinely get them. Vice president Dick Cheney has one.

    Langer moved on from ICDs to found Cardiac Telecom Corporation, where he developed a telemetry system that keeps track of a heart patient's vitals at home, and alerts doctors or calls an ambulance if something goes wrong.

    An Ounce of Prevention Still Best for Heart

    Although medicine has come a long way from what James calls "the bad old days" of the late 50s and early 60s, he says it's still a fact that, "the vast majority of the heart disease that we're treating is unnecessary."

    For those with access to top-notch cardiac care, it's too easy to think that when we have our inevitable heart attacks, the docs will be able to fix us up and send us home. But prevention -- by diet, exercise, quitting smoking, and taking cholesterol-lowering drugs if needed -- is still most important.

    James recalls hospital wards full of people stricken by polio who breathed with the help of huge ventilators known as iron lungs. Most heart disease, like polio, is now preventable, he says. Focusing exclusively on treating end-stage heart disease is like "working on the technology so you could walk around with your ventilator instead of developing the vaccine."

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