In an operating room, dressed in scrubs and holding a scalpel, Dr. Mani Nallasivan is trying to save a life.
The patient lying on the operating table has had a heart attack, and bypass surgery to try to fix his heart. Now that patient is in danger of dying from another type of heart problem, and Nallasivan holds the key in his hand to keeping his patient alive.
The little metal object Nallasivan is preparing to implant into this man's body will hopefully save him from dying of sudden cardiac arrest -- an event a lot of people don't realize exists.
The month of October is Sudden Cardiac Arrest Awareness Month, and Nallasivan wants people to know how deadly the event can be. "Sudden cardiac arrest kills more people than cancer," Nallasivan, a Merced cardiologist, said. "It's something that people have to realize can kill them."
A lot of people think sudden cardiac arrest and a heart attack are the same thing.
Not so, Nallasivan said.
"A heart attack is a plumbing problem, sudden cardiac arrest is an electrical problem," he said.
A heart attack happens when an artery or vein in the heart is clogged. The heart is deprived of blood, and that part of the heart dies.
Sudden cardiac arrest is when the heart suddenly stops beating, or beats too fast or too slow, because the electrical signal to it malfunctions.
People's whose hearts stop can be revived by using a defibrillator, which uses electricity to restart the heart.
Unfortunately, most people whose heart suddenly stops aren't near a defibrillator. But if there is damage to the heart and a cardiologist knows it, an implantable cardiac defibrillator can be surgically inserted into the patient's chest.
"Once the patient has the defibrillator implanted, if they have an arrest at home, the device can help revive them by shocking the heart back to a good rhythm," Nallasivan said.
On Thursday afternoon, Nallasivan was putting one of the devices into a patient, with help from Patrick Massetti, a sales representative for Medtronic, a maker of defibrillators.
During the surgery, the device was surgically implanted into the chest muscles of the patient. Nallasivan then threaded two wires into the heart muscle. "Once the wires are in, we have to check to make sure they are in the right place and that they work," Massetti said.
A computer screen showed Massetti exactly what the patient's heart was doing. When Nallasivan was ready, Massetti pushed computer keys that caused the patient's heart to go into fibrillation, or rapid, irregular, and unsynchronized contraction of muscle fibers. When a heart is in fibrillation, no blood is being pumped, and the patient can die from it.
Watching the screen, Massetti pushed some buttons and the patient's heart went from about 90 beats a minute to about 250 beats. "This is what happens when you die," Nallasivan said.
The defibrillator waited a few seconds, and then shocked the patient. Almost immediately, the heart returned to its normal rate of beating, and Nallasivan finished the surgery by stitching up the small incision.
"Almost 1,000 people a day die from sudden cardiac arrest," Nallasivan said. "People who are at risk need to be tested to see if they are at risk, because this device can save them."
Reporter Carol Reiter can be reached at (209) 385-2486 or firstname.lastname@example.org.