When the Heart Stops Beating

MONDAY Jan. 5, 2009 -- Deanna Babcock's heart stopped beating on July 20, 2007. Just like that.

"I was swimming in a pool at North Carolina State University, doing normal laps," recalled Babcock, who was 23 years old and in excellent health, or so she thought. "My strokes started getting sloppy, and I coasted to a stop face down."

Jim Stoltz's heart stopped on July 20, 2009. "I was sitting at my desk," said Stoltz, 66, who is an accountant who lives in Flanders, N.J. "I don't recall much. I simply went under my desk. I woke up five days later in the hospital."

Both Babcock and Stoltz were victims of sudden cardiac arrest, in which the electrical system that controls the heart's beating simply stops working the way it should. It is a condition that causes more deaths in the United States than breast cancer and lung cancer combined. An estimated 95 percent of those who experience it die before reaching a hospital.

These story endings were better, mostly because people who saw what was happening knew what to do. "They told me that co-workers standing by and two others immediately started CPR [cardiopulmonary resuscitation]," Stoltz said. "It's a combination of chest compression and breathing. They did it for about 10 minutes, until the emergency medical service arrived."

"They used a defibrillator on me," Babcock said, referring to a device available in some public places that delivers an electrical jolt to start the heart beating again. "A lifeguard did it."

Stoltz is back at work now, feeling "pretty good, almost back to the level of exercise I was doing prior to that."

Babcock's story is less happy "When I had some trouble with circulation to the outer extremities, they had to amputate my left leg above the knee." She now is an associate in the university's science department, doing research on adult education.

The two stories are illustrative of the problem of sudden cardiac arrest in several ways, said Dr. Fritz A. Ehlert, director of the electrophysiology fellowship at Columbia University.

First, sudden cardiac arrest has to be distinguished from a heart attack, in which heart muscle dies when its blood supply is cut off. "Not everyone who has a heart attack develops sudden cardiac arrest, which is a rhythm disturbance," Ehlert said.

And while the risk factors for heart attack are well-known and easily detected -- high cholesterol, high blood pressure, obesity, diabetes -- sudden cardiac arrest is not as easily predicted. The risk is higher "for anyone why has had one in the past, who has a history of heart attack, who has heart failure, who has a family history of sudden cardiac arrest," Ehlert said.

Once it happens, seconds matter. "For every minute that goes by before therapy is initiated, survival decreases by 10 percent," Ehlert said. "The issue is always getting trained medical people to respond as quickly as possible."

The availability of external defibrillators is always a help, he said. Both Babcock and Stoltz now have implanted defibrillators, which deliver shocks automatically if the heart stops beating.

"It's in there, but you can't feel it," Babcock said.

More information

Causes, prevention and treatment of sudden cardiac arrest are described by the U.S. National Heart, Lung, and Blood Institute.

Posted: January 2009


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