ICD stories can be shocking…

Though ancient for social media, I thought this week-old but bizarre defibrillator story might be worth a mention.

From the South Florida news feeds, Implanted defibrillator killed Gateway man after wife’s heart stopped.

Here’s the skinny: In October, an 80 year-old woman—with an internal defibrillator– and her 85 year-old husband of 60 years were enjoying themselves in a South Florida hot tub. Something dramatic happened, as they were both found dead the same day.

It took nearly four months for the medical examiner to release the outrageous findings that the woman’s defibrillator electrocuted her husband. Shockingly, the ME released this misleading statement: (remember the rule—no information is better than bad information.)

“Although (implanted defibrillators) are life-saving devices, the public should be made aware of the hazards associated with these devices so proper safety measures can be taken by those in contact with affected patients,” Wheaton said in the statement.

Oh, the many ways to spin this story.

First, it’s well-known and accepted that ICDs confer risk to the patient who has the device. But let’s debunk the myth that an internal defibrillator could harm anyone else. ICD shocks are delivered internally and any person in contact with a patient getting shocked would merely feel muscle contractions, even if they were in water.

Second, in this case, the husband did not have an ICD, so there would be no record of his rhythm at the time of death.

Third, although I am no forensic expert, an external electrical event that would have affected both seems far more likely.

Finally, another way one could look back at this event is with a very wide-angle, big picture life camera. In this lens, the tragedy might look slightly less tragic. (Caveat first: no one advocates for accidental deaths and we all hope to live forever.)

But…How about this view? An elderly couple married for sixty years die together, suddenly, under a Florida sky and after a full life. Their final inning did not involve chemo, nursing homes, dementia, diapers and time away from each other.

Ooh, Death is hard to write about.


7 replies on “ICD stories can be shocking…”

Yes, it was a good way to go. As is sudden cardiac death, which doctors often attempt to prevent by installing ICDs in octogenarians despite the fact that the minority who get a lifesaving shock may thereby be condemned to chemo, dementia, nursing homes, etc. Doesn’t your final comment also imply that a person of that age ought to give serious consideration to having the device preemptively deactivated?

Deactivation is an important and very complicated topic to discuss. Yes, I believe end-of-life discussions should be considered ‘normal’, not extraordinary. It would help if deactivation was part of the initial discussion of the ICD. In real life, I will testify that mentioning death to a patient and spouse who seek you out for a fix is…you guessed it…very hard.

A long time ago, I told my EP that SCA beat the holy hell out of cancer. He didn’t argue with me. He knows that I know more about that aspect of it than he does. Seriously, how many times have you heard about a person dying shortly after their spouse? It happens.

Thanks for the column. I can testify that docs do not generally, before an implant, include the hard stuff, let alone lead with it — this is the choice you’ll be stuck with lifetime, inappropriate shocks happen almost as often as appropriate ones, and there’s a heck of a psychological component, but I won’t be helping you with that part, etc. . . . . Mostly, they run fast lists of the physical potential complications of the procedure, and we’re all so accustomed to those lists (risks include infection, hematoma, puncture, & oh, who knows, an erection lasting more than 36 hours, etc etc) that we’re immune to them. Let alone end of life discussions. I do understand that docs have to triage, and time is short, and liability fears mean it’s hard to discourage an ICD! The system that doesn’t give either side time to ponder is the problem. So, discussions like this one really help, thanks.

I take comfort that my uncle (who never knew he needed an ICD), though he was far too young, died very quickly doing the thing he loved, on a sunny day on the 60th km of a bicycle ride.

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