Wired for Living

Things looked bad for Michael Fairman, 78, when he entered Georgia's Glynn-Brunswick Memorial Hospital little more than a month ago. Within a few days he had a succession of heart seizures, and his condition got so bad that drugs helped only briefly. Last week Retired Businessman Fairman was at his son's home for New Year's, his heartbeat regular as clockwork. The remedy: Fairman's heart muscle had been wired directly to a tiny electric pacemaker, which he wore clipped to his belt.

Fairman is one of a small but growing group of U.S. heart patients who have been wired for living with a variety of pacemakers that are alike in principle but differ in detail. When a diseased heart stops or goes into fibrillation (a useless twitching and fluttering), it can often be restored to normal beat by a single electric shock. In more stubborn cases, small electrical impulses must be transmitted to the heart at a near normal pulse rate (60 to 72 per minute).

This has been done in many hospitals with cabinet-type pacemakers weighing up to 50 Ibs. At first the current was applied externally, to the chest skin. Then Dr. C. Walton Lillehei, famed open-heart surgeon of the University of Minnesota Hospitals, got the idea of implanting the electrode directly in the muscle of the heart wall.

Needle to the Heart. The Minneapolis team has done this with many patients whose hearts were exposed during surgery, and has fitted some with featherweight, transistorized pacemakers, which they carry around. Other surgeons have used different approaches to the heart: at Montefiore Hospital in The Bronx, surgeons wired a 67-year-old man by slipping a thin electrical cable into an incision in his neck and working it through a vein into the heart. In some cases, surgeons have plunged a hollow needle through the chest wall and into the heart itself; when a fine wire, passed through the needle, is in place, they withdraw the needle.

In Fairman's case, the doctors did not dare open the chest to sew the electrode into the heart muscle because they doubted that the patient would survive surgery.

So they decided on the direct-puncture method. With only a local anesthetic, the job took ten minutes. Surgeon Erwin Jennings, 38, put the king-sized needle between Fairman's fourth and fifth ribs, aimed for the right ventricle. Jennings knew when he had hit it, because electrical impulses from Fairman's heart were transmitted through the wire. A fishhook type of barb on the end of the wire set it in the heart muscle.

Fairman's pacemaker, about the size of a pocket transistor radio, weighed only 12 oz., was powered by a 9.4-volt battery.

He kept it going continuously until last week, when doctors shut it off because his heart no longer needed the pacemaker's added push.

Built-in for Permanence? Even Fairman's compact and ingenious device is not the ultimate, say medical researchers.

At the Veterans Administration Hospital in Buffalo, a team of doctors and electronics experts has constructed a pacemaker to be implanted permanently in the body. The device is 2 1/2 in. in diameter, 5/8 in. thick--about the size of a railroader's pocket watch. Powered by mercury batteries with a five-year life, the built-in pacemaker has been tried in dogs, and has kept one alive for four months.

It is about ready for trial in man.

This file is automatically generated by a robot program, so reader's discretion is required.