Roger Blanchette

Because Roger Blanchette has no memory of what happened that day in June five years ago, it's his wife Debra who tells the story. First off, she says, the story might have ended very differently if the family had spent the night before -- a Saturday night-- on their motor boat off the coast of Massachusetts as they had originally intended. But because their daughter Audrey was leaving for sleepover camp on Sunday, they decided it would be better to sleep at home.

On Sunday, after packing their van for the trip to camp, Roger was in the kitchen cooking chicken and Debra was upstairs taking a shower. After she got out of the shower, their then seven-year-old son Henry came into the bathroom to tell her that his father was lying on the floor. He also said something about their dog, which Debra didn't understand, but she assumed Roger was simply playing with the dog on the floor. When Henry mentioned that his dad's eyes were rolled back, Debra dashed downstairs.

She found her then 62-year-old husband lying flat on his back. "His face was blown up and he was purple and gurgling," says Debra. Audrey, then 14, who by now had joined her mother, felt for a pulse and was unable to find one. Debra called 911 and began administering CPR, which she had learned years before when she had taught swimming to special needs children.

A neighbor who was an emergency medical technician (EMT) responded first and began to help with the CPR. Within moments a police officer arrived, who happened to be cruising the area. And in a stroke of luck, he had with him a newly purchased portable defibrillator, a device used to restore the rhythm of a patient in cardiac arrest. The defibrillator identified Roger's irregular rhythm as ventricular fibrillation, a very rapid, uncoordinated and ineffective series of contractions throughout the lower chambers of the heart. Unless stopped, these chaotic impulses are fatal. On the second try, the defibrillator jolted Roger's heart back to life. He was rushed to his local hospital and later transferred to New England Medical Center (NEMC) in Boston.

Fortunately, the brief time during which Roger's heart had stopped beating did no damage to his brain or heart. But an extensive cardiac evaluation -- including cardiac catheterization and electrophysiologic testing -- revealed that his irregular heart rhythm could return. So at NEMC he had an implantable cardioverter-defibrillator (ICD) surgically inserted under the skin on the left side of his chest. Wires connect the device to his heart. When the ICD detects a minor arrhythmia -- or irregular heart beat -- it delivers an impreceptible electric current to the heart to restore its normal rhythm. If that doesn't work, it delivers a far greater jolt.

"I'm never aware of it," says Roger, who went on to make a rapid and thorough recovery, thanks in large part to the fact that he had been in such good shape prior to his cardiac arrest. "Maybe I think about it once a month. But it's not part of my daily life."

Except once. About a year after the ICD was implanted, he was in the check out line at a store with his son and his son's friend. He had just paid the cashier, who was counting out his change. Suddenly, he began to lose consciousness. "All of a sudden, I felt nothing…I was blacking out, so to speak," recalls Roger. "The only thing I remember thinking to myself was: 'I'm in trouble.' Then my mind shut down. Before I hit the floor, the defibrillator went off and sent the electric jolt to my heart and started it pumping again. I let out a bellow and scared everyone in line."

Roger left the store feeling OK, but a little shaky. He sat in his car with the two boys for about 10 minutes, to make sure that he was collected enough to drive. Then they drove home without mishap.

Roger says that at 68, he feels great. His defibrillator hasn't fired since, which he attributes partly to his consumption of supplements containing Omega-3 fatty acids. These compounds -- found in oily fish like salmon and bluefish -- have been shown to significantly reduce the incidence of deadly arrhythmias, which can lead to sudden cardiac death. He also visits his cardiologist every three months to have his device tested.

Before his cardiac event five years ago, Roger said that he had no idea that arrhythmias were the underlying cause of so many heart-related deaths. He now knows a lot more about the vagaries of the heart's electric currents and about the devices which save people like him. And he brought that new knowledge to a bigger audience when he testified in favor of a bill that eventually became law in Massachusetts in 1999. The so-called Good Samaritan law extends liability protections to laypersons who use automatic external defibrillators in public places like offices or planes to save the life of someone going into cardiac arrest.

This patient story may not be typical. Individual symptoms, situations and circumstances vary and response to therapy is not always the same. Please consult your physician or health care provider regarding your condition, treatment or any specific questions regarding your care.

The Automatic External Defibrillator (AED)

The Automatic External Defibrillator (AED) is a portable device that is used to restore the rhythm of the patient in cardiac arrest. It determines the patient's rhythm and delivers a shock through pads placed on the chest wall to stop a life-threatening disturbance of the cardiac rhythm. It is automated so that it may be used by non-medical personnel wherever there are people. Its portability, reliability, and accessibility have made it one of the most important technological breakthroughs of our time.

There are a number of advances in the AED design that have given AEDs widespread acceptance. AEDs have become more simplified, permitting their use by the general public. The AED has self-adhesive electrode pads that are placed on the patient after he or she has collapsed. The AED has a voice prompt that guides the user through the steps needed to defibrillate the patient. The AED has an automatic feature that interprets the rhythm to determine whether a shock should be given. Once a shock is given, the device immediately determines if the rhythm has been successfully converted.

The AED has been shown to be extremely accurate in determining whether a shock has been given. Its sophisticated computer algorithm prevents errors in classification of the rhythm. Its ability to make these determinations without human assistance has permitted its use by trained laypersons.

The AED is extremely effective in delivering a shock that successfully converts the rhythm. Important advances in optimizing the way the energy is released have results in a very high rate of conversion. In addition, the long lasting lithium batteries currently used in these devices require minimal maintenance.

As a result of the portability, ease of use, and reliability, the AED has placed in numerous locations, such as schools, offices, sports facilities, and airplanes. Numerous police and fire departments have adopted the AED for use in their emergency vehicles. Rapid access to the AED has markedly reduced the time to convert the rhythm and resuscitate the patient. Since time to intervention has been shown to be the major factor in patient survival, rapid interventions using the AED are saving lives.

The cost of the AED is now approximately $2000-$3000 and is expected to decline further as more units are placed throughout the country. Most states have adopted "Good Samaritan" laws protecting laypeople using an AED to resuscitate a patient in cardiac arrest. These important advances have led to the rapid spread of AED technology throughout our communities.