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Car Enthusiast Restored to Good Health with Life-Saving Biventricular Device Implantation


February 2005 — Paul had just returned from a trip to Little Rock, Arkansas, after purchasing his dream car, a 1940 Lincoln Continental convertible. He was awaiting delivery of the car to his home in the Florida Keys when he came down with what he thought was a cold.

"No fever, no chills, just an ordinary cold, we thought," recalls his wife, Barbara. "But he was not himself, and the cold wasn't going away."

Then one evening as the couple was preparing for bed, Paul turned to his wife and said, "I don't want to scare you, but look at my feet." When she saw the extreme swelling, Barbara replied, "I think this is serious."

Signs of Congestive Heart Failure

Paul was diagnosed with congestive heart failure, a condition which results from ineffective pumping of the heart due to a weakened heart muscle. As the heart fails — gradually losing its ability to pump blood — the body can't get enough blood to meet its needs. Shortness of breath, fatigue and leg swelling often result. When fluid accumulates in the lungs, the condition is called "congestive heart failure."

Dr. Mitrani

Approximately 5 million Americans are living with cardiac dysfunction, and each year as many as 700,000 more are diagnosed with this serious and potentially life-threatening condition. In Paul's case, he had retained 30 pounds of water and was experiencing swelling in his abdomen, legs, ankles and feet. Terrible leg cramps would awaken him from sleep – if he could sleep at all. Paul also experienced fatigue, weakness, nausea, lack of appetite and shortness of breath when lying down.

Paul was immediately placed in a local hospital's Intensive Care Unit, where he remained for a week. "They ran all the tests," says Barbara. "He was very tired, very lethargic and did not even want to live, let alone restore his dream car." Following cardiac catheterization, Paul was put on medications. He and Barbara were told nothing else could be done.

"They told me my husband probably wouldn't live much longer," says Barbara. "But I simply wouldn't accept that death sentence."

Wheels in Motion

Soon afterward, Paul and Barbara were referred to Raul Mitrani, MD, Director of Cardiac Electrophysiology at Memorial Regional Hospital. "Dr. Mitrani said my husband was a candidate for a biventricular implantable cardioverter defibrillator (biventricular ICD)," says Barbara. On March 3, 2004, Paul underwent surgery to have the device implanted under the skin in his chest.


"ICDs are recommended for patients with congestive heart failure and weak heart muscles," says Dr. Mitrani. "Standard ICDs are used to continually monitor heartbeats and to 'shock' the heart when rhythms become irregular. In addition, a pacemaker may be incorporated for patients whose heart rates are too low."

"Paul received a biventricular ICD," he continues. "This means that he has a wire running to each lower heart chamber – the ventricles – instead of the standard single wire to just the right ventricle. With these two wires in place and a third wire running to the atrium, the biventricular ICD can help synchronize the heartbeat and improve the symptoms of congestive heart failure."

Dr. Mitrani says that only about one-third of congestive heart failure patients are candidates for the biventricular device; an electrocardiogram (ECG) test must first detect the presence of certain abnormalities. Even without these abnormalities, a patient still might be a candidate for a standard ICD.

On the Road Again

In Paul's case, his wife proclaims the biventricular device "a miracle." "This is the man I married — full of vim, vigor and vitality. He is so enthusiastic, so energetic. He is doing everything he did 10 years ago. And he is restoring his gorgeous 1940 Lincoln Continental," Barbara says.

"He is doing to the car what Dr. Mitrani and his staff did to him – a total restoration. We are overjoyed."

If you are concerned about your risk for heart disease and would like a referral to one of our highly qualified physicians, call Memorial Physician Referral Service toll-free at (800) 944-DOCS.