An internal defibrillator to prevent cardiac arrest: luckily, this teenager’s sudden cardiac arrest led to the discovery of her heart arrhythmia that required an implantable cardioverter defibrillator to keep her safe – ICD

Last November, 17-year-old varsity basketball player Jessica Neace joined teammates at center court against a rival in Michigan City, Indiana. After turning to her coach for final instructions, she assumed the ready position, then without warning collapsed unconscious and lifeless to the gym floor.

Fortunately, her best friend’s mother, Jackie Eastok, who was filming the game in the nearby bleachers, witnessed the fall and rushed to the court. A registered nurse who teaches CPR and advanced cardiac lifesaving techniques, Jackie was at her side within moments.

“By the time I got to Jessica,” Jackie says, “she was already having a seizure. After that, she lost her pulse, so we began CPR.”

Little did Jackie know that the assistant coach of the Michigan City team, Holt Eddinger, also was a nurse, and he joined Jackie to resuscitate the young player.

For five minutes, the nurses administered lifesaving CPR while hundreds of silent spectators watched the event unfold from the stands. Finally, the duo succeeded in restoring Jessica’s heartbeat and breathing, even before paramedics arrived and rushed her to a nearby hospital.

Jessica’s mother, Tammy Neace, also was in the stands and talking to a friend when her daughter collapsed.

“When I looked at her, it was not your normal fall,” Tammy remembers. “Jessica was totally stiff. I immediately ran down there, and when I looked at Jess, she had already started to turn blue. Then, Jackie gave her mouth-to-mouth resuscitation. I didn’t know that Jackie and Holt didn’t know each other until later, because they worked so well as a team. I was standing above Jessica’s head. When she opened her eyes, she was confused, then smiled and asked what was going on. Everyone released a sigh of relief and started speaking to her.”

While CPR saved Jessica’s life, the medical mystery remained–why did an otherwise healthy, vital young teenager almost lose her life?

For the next six days, Jessica underwent a battery of tests that revealed no clues as to the cause of the episode. Nothing in her medical or family history suggested an underlying condition.

“We never suspected any health problem,” recalls Jessica’s mother, Tammy. “She was very active and always in three school sports each year. She was active in every club, and always an on-the-go girl. The day that she passed out was just like any other Saturday night–everything was fine.”

When local hospitals and available tests provided no answer, Jessica was referred to Dr. Eric Prystowsky, a world-renowned heart specialist in Indianapolis, for further investigation. There, Jessica underwent an electrophysiology (or EP) test to explore possible heart-related disturbances that could have resulted in the near-death episode.

“The problem was that she lost consciousness on the basketball court. People like Jessica can pass out for a variety of reasons, none of which are related to any serious heart rhythm problems,” Dr. Prystowsky explained. “As an electrophysiologist–basically, an electrician of the heart–I take care of heart rhythm problems. I see patients like Jessica all the time. It is relatively rare, in fact, for a person her age with a normal heart to have a life-threatening problem.”

A thorough examination and subsequent sophisticated diagnostic tests revealed that Jessica was suffering from a condition called long QT syndrome, a rare disorder of the heart’s electrical system. While the mechanical function of the heart may appear entirely normal, defects in the heart muscle cell structures, called ion channels, can predispose individuals to abnormal heart rhythms that result in sudden loss of consciousness–called syncope–and possibly death.

“In long QT syndrome, one can have fatal heart rhythm problems,” Dr. Prystowsky says. “She was very lucky to have had people there at that point. If Jessica had experienced one of these events unwitnessed, she could have very possibly never awakened.”

Because it is impossible to predict which patients are vulnerable to another episode of syncope and possibly death, patients with long QT syndrome are treated with beta blocker medication or an implantable cardioverter defibrillator (ICD). After discussing the therapeutic options with Dr. Prystowky, Jessica opted for the added security that an ICD seemed to offer.

“He told us our options,” Tammy Neace recalls. “He explained that with beta blockers we could never be sure if the medications would work unless Jessica had another episode.”

And that was something that Jessica did not want to experience. “If the ICD is implanted, and your heart does stop, it will shock you and bring you back to life,” says Jessica. “Because I already had an episode, I felt safer with the implanted defibrillator.”

In January, Jessica received an ICD. While an ICD is typically placed just below the collarbone and is visible, surgeons implanted her ICD on her chest so that it is cosmetically invisible.

“It hasn’t affected anything in my life, really,” reports a happy Jessica, who celebrated her 18th birthday in December. “I went back to my normal activities, other than participating in sports where I could get hit directly in the chest.”

Jessica is by all accounts a very lucky teenager, saved by the prompt response of trained CPR professionals. Her quality of life now is enhanced by the added safety of an ICD.

Her near-death experience also raised awareness of one lifesaving component sadly absent that fateful evening last November–an automated external defibrillator, or AED.

The community and school acted swiftly.

“By the next day, someone had already donated half of the money to buy an AED for the Michigan City gym, and they were going to raise the other half,” Jackie Eastok happily notes. “At our own school system in Knox, Indiana, the superintendent is buying four AED units for the school and gymnasium.”

Jessica and Jackie have spoken publicly, candidly, and frequently about the episode and the importance of AEDs and CPR in saving lives. The American Heart Association recently honored Jackie as an American Heart Saver Hero.

While the award was welcome, the satisfaction of knowing her daughter’s best friend is alive and well is reward enough.

COPYRIGHT 2003 Saturday Evening Post Society

COPYRIGHT 2003 Gale Group

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