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Cardiologist Says Vice President Cheney Would Benefit From Defibrillator

WASHINGTON – Vice President Dick Cheney’s announcement Friday that he suffers from an irregular heartbeat did not surprise cardiac experts who have followed his condition from afar.

Such arrhythmia or abnormal heart rhythms occur when disease, aging and the long-term effects of medication damage the muscles of the heart. Left untreated, they said, the condition could be life-threatening.

“We already know that Mr. Cheney has coronary artery disease involving several blood vessels,” said Dr. Jay Mason, a cardiologist and chief of medicine at the University of Kentucky at Lexington. “And it’s common knowledge he had heart attacks and heart muscle damage. This is a common setting for this kind of rhythm disturbance.”

Dr. Richard Page, a cardiac specialist in Dallas, said it made sense to act quickly to determine whether Mr. Cheney is a candidate for a device called an implantable cardioverter defibrillator, which passes an electric current through the heart in order to maintain a steady heart beat.

“There’s no question he will benefit from a defibrillator,” offered Dr. Page, who is an associate professor of medicine at the University of Texas Southwestern Medical Center at Dallas. “I think we can rest more comfortably if Mr. Cheney has a defibrillator in place.”

Typically, the defibrillator, which is smaller than a deck of cards, is implanted below the left collarbone with two wires fed into the upper and lower chambers of the heart, said Dr. Christopher Wyndham, who specializes in heart arrhythmia at the North Texas Heart Center in Dallas.

When the heartbeat goes below 60 to 70 beats per minute, it acts as a pacemaker and increases the rate, and when it beats too fast, small electrical impulses restore a natural rhythm, Dr. Wyndham said.

The test that Mr. Cheney will undergo Saturday, called an electrophysiology study, will determine whether his irregular heart rhythm interferes with the pumping of blood, Dr. Mason said. “The purpose of the study would be to determine if he is vulnerable to having sustained ventricular tachycardia.”

Studies have shown that people who experience tachycardia can benefit from having a small internal defibrillator. One study, published in the New England Journal of Medicine in 1999, concluded that among people who tested positive for the condition, the mortality rate was 30 to 50 percent higher for those who did not get the implant, compared with those who did.

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