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CHANNUKAH
MIRACLE:
INFANT'S HEARTBEAT REVIVED
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Schneider
Children's Medical Center of Israel: The
life of an infant with cardiac disease was saved thanks to an internal
resuscitation device that was implanted in a rare operation for the
first time in Israel in such a small child
The
child's mother: "We had a Channukah Miracle; from our perspective,
my daughter has been born anew"
For
the first time in Israel and one of the few cases in the
world: a rare operation to implant an internal defibrillator in a
10-month-old infant who suffered cardiac arrest due to diseased heart
muscle. The operation took place at Schneider Children's, a member of
Clalit Health Services. The internal resuscitation device (defibrillator
implant) was adjusted and programmed by Meditronic, manufacturers of the
device, to the age and body size of the infant.
Until
the implant, the infant's life had been saved on two
occasions: thanks to the resourcefulness of the parents who, following
cardiac arrest events, resuscitated the child at home through electric
shocks to the heart using a Lifepak Kit (external defibrillator) which
they had at home for emergency use.
Dr.
George Frankel,
a cardiac surgeon in the Cardiothoracic Surgery Department at Schneider
Children's headed by Prof. Bernardo
Vidne, performed the operation with the assistance of Dr.
Rami Fogelman, Director of the Electrophysiology Unit in the
Cardiac Institute at Schneider Children's. Dr. Fogelman: "The
infant first arrived at the hospital at the age of two months following
cardiac arrest, and was diagnosed with diseased heart muscle. Because of
this event, we recommended the use of an external resuscitation device
(defibrillator)."
The
child's mother underwent special training in the use of the
external resuscitation device - manufactured by Meditronic - in times of
emergency. The device works like an ECG, identifying irregular heart
rhythm and automatically sending vocal instructions to the defibrillator
how to react to emit an electric shock in order to return the heart beat
to normal.
The
2-month-old infant was connected to the device and discharged
from hospital. She suffered two cardiac arrests at home both of which
endangered her life. Her parents conducted immediate life-saving
resuscitation using the external defibrillator which automatically
responded with the appropriate electric shocks to the heart. "The
timing in these events is critical," noted Dr. Fogelman, "and
without the parents' resourcefulness, it is doubtful that the child
would have arrived alive at the hospital."
After
two near-fatal heart attacks at home and despite her low
weight – 8 kgs – the medical team at the Institute of Cardiology at
Schneider Children's headed by Dr.
Einat Birk, decided to implant an internal resuscitation
device. Only a few cases are known in the world where implants of this
kind were performed on infants and children weighing less than 20 kgs.
The
operation ensued about an hour and a half during which the
device – adjusted to the size of the infant - was successfully
implanted. The defibrillator was implanted in the wall of the stomach
together with three electrodes inserted into the outer layers of the
heart and close to the lung membrane, as opposed to standard procedure
in adults where the electrodes are implanted within the heart. This is a
special technique utilized for the first time in Israel in such a young
child weighing under 20 kg.
About
cardiac arrest and
treatment with the resuscitation device:
Cardiac arrest is known in the western world and affects all ages.
Cardiac arrest is expressed electrically by a very rapid heart beat,
which affects function and prevents the proper flow of blood to the
organs of the body. If allowed to continue for more than a few minutes,
the brain can be affected and death can even occur. Timing is an
important element where every minute that passes without the
administering of electric shocks reduces the chances of survival by 10%.
About 8,000 people in Israel die every year from cardiac arrest.
The
key to survival from cardiac arrest is swift resuscitation.
The external resuscitation device (such as the Lifepak
made by Meditronic that the parents of the infant received) is capable
of identifying life-threatening rapid heart beats and of emitting
electric shocks to the heart. This means immediate and simplified
medical treatment without the presence of a doctor. This activity
regulates the heart's activity thus saving the life of the patient. The
defibrillator available to the public functions as an automatic
defibrillator. In order to operate it, a 4-hour training course in
resuscitation is required.
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