An increasing number of heart patients have the same test Vice President Dick Cheney will undergo, and many receive an implanted lifesaving device that has shrunken to the size of a small pager, local doctors said Friday. Cheney said he expected his test today will more than likely reveal the need for an implant of the device he called a ‘pacemaker plus.’ The electrophysiology study Cheney will undergo is a common procedure used to determine if the heart is prone to cardiac arrest, doctors say. An increasing number of patients undergo the test, and many receive the implantable cardioverter defibrillator, which is less than a half-inch thick. ‘These things are a quarter of the size they were eight years ago,’ said Dr. Leonard Ganz, director of cardiac electrophysiology for UPMC Health System. ‘It’s unbelievable how much they’ve been miniaturized.’ The number of the devices – first used in 1990 – has soared in the United States from 16,000 installed in 1993 to 60,000 last year, according to industry officials. Worldwide, 100,000 such devices are implanted annually. Ganz said he administers about 400 electrophysiology studies each year, some for other purposes, and that UPMC Presbyterian in Oakland implants nearly 300 of the defibrillators annually. In the Pittsburgh area, there are 17 electrophysiology specialists, said Dr. Barry Alpert, chief of the electrophysiology lab at West Penn Hospital in Bloomfield. He said that is about an average number for metropolitan areas of similar size. ‘This is a specialty that began in 1969, and it’s really burgeoned over the past five years as we’ve learned that electrophysiology testing is useful in diagnosing and treating various arythmias,’ Alpert said. For heart attack victims with weakened hearts, the benefits are simple, Ganz said. ‘They live longer once they get these devices. Remember, we’re not talking about headaches here, we’re talking about saving lives. And this is the ultimate lifesaver.’ One patient, Granville Cohenour, 74, of Hickory, Washington County, got a defibrillator after he suffered two heart attacks. Tests showed the damage from the heart attacks eventually caused Cohenour’s heart to beat nearly three times faster than normal. ‘I think anybody that’s got any common sense would say that if you need it you should get it,’ Cohenour said from his hospital bed at Presbyterian one day after having the device implanted just below his collarbone. Doctors said a better understanding of the usefulness of the implanted device, along with its small size and patient comfort, were reasons for its increased use. Doctors used to perform open chest surgery and place the device above the abdomen. The procedure now can be performed on an outpatient basis in less than one hour using a local anesthetic. ‘Once defibrillators became available when you could put a small device in the shoulder, then the defibrillator became a more useful approach,’ Alpert said. Today, the electrophysiology study also can be done in less than an hour using a local anesthetic. ‘Hopefully, now that (Cheney) is doing this, other people will undergo the screening procedure as well,’ Alpert said. Tim Puko can be reached at (412) 320-7975

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