“I got a big fright today” said Brian, a fit-looking tradesman. “I had one of those dizzy spells, except this time I blacked right out. Problem was just minutes before I’d been working on a roofing job three stories above the ground!”
His doctor did not need to be reminded that Brian’s family had a history of SCD or Sudden Cardiac Death. Tragically, two years ago, his triathlon-contesting, younger brother died in his sleep with no cause ever found.
One in a thousand Australians of all ages die of SCD annually. SCD is caused by an entirely unpredictable “malignant” change in the heart rate known as Ventricular Tachycardia or VT, which rapidly induces unconsciousness. Unless some electrical defibrillator is available, death is the usual outcome. It is the legacy of a famous close call for the late Kerry Packer that the “Packer Zapper” is, today, standard equipment in all emergency services and most public places in NSW.
Today, such deaths are potentially avoidable, with the advent of the Implantable Defibrillator. Inserted under the skin, the device registers early changes in the heart’s rhythm and delivers a timely electrical jolt. Very often, the person is not aware that he’s had a Packer-like experience.
There is a challenge in tracking down the causes of “faints and funny turns” caused by abnormal heart rhythm. The standard test, the “Holter Monitor”, collects a full 24 hours of heart rate. Even so, the so-called “benign” culprits of too rapid or too slow a heart rate tend to be elusive in fit and healthy adults.
Returning to Brian’s story: “We will put you on the heart monitor again,” said the doctor “ but I think the experts will be wanting to do something even if the test is negative yet again.
Next day the Holter showed just a few brief runs of VT. However it was enough to convince the experts . “Send him in for a Defibrillator Implant today, and don’t let him drive.”