Defibrillator unable to save patient

Press, 6 March 1984, Page 1

Defibrillator unable to save patient

A rare heart operation last month failed to save the life of Mr Patrick Gilmour, the first New Zealander to be given an electronic heart defibrillator. The diseased heart of the Christchurch man, aged 65, which had already stopped about 35 times in the last six months, finally gave out unexpectedly yesterday while he was recovering at The Princess Margaret Hospital in Christchurch. Ten days before, Mr Gilmour, a retired hotel manager, became one of the first two people to be fitted with the $13,000 device in Australia.

Surgeons who had operated on Mr Gilmour at the Royal North Shore Hospital had estimated the device would improve his chances of long-term survival by 50 per cent. The American-designed automatic implantable cardioverter defibrillator had been used in only eight cases outside the United States. More sophisticated than a pacemaker, it responds to irregular heart

beats by sending an electrical current through two wires to restore the'heart’s rhythm. The chief cardiologist of the Canterbury Hospital Board, Dr Hamid Ikram, said Mr Gilmour had died from heart failure rather than heart arrest. The defibrillator appeared to have been working well but the rare combination of problems that had made him a candidate for the surgery had already damaged the heart. Dr Ikram said the patient had been weak and tired after the Tasman flight on Sunday but otherwise in a satisfactory condition. The heart flutters, which had activated the defibrillator several times after the surgery, had not recurred in Christchurch.

His heart rhythm had even improved by yesterday morning. “About 11 a.m. he developed more problems very suddenly,” Dr Ikram said. The heart became unable to pump enough blood through the body.

His wife and two sons were called and Mr Gilmour died about lVz hours later.

“It was an intense disappointment,” Dr Ikram said. “But all of us who had been looking after him expected that this might well have happened any time in the last six months.” Dr Ikram said the surgery might have aggravated Mr Gilmour’s condition. “But when someone has got a heart like that almost anything can bring it on.” It was unusual that Mr Gilmour, who suffered Jrom ischaemic heart disease and coronary heart disease, had survived as long as he did. Another New Zealand hospital had previously rejected him for heart by-pass surgery because of the heart damage. A post-mortem examination would be made to confirm that the defibrillator had been working properly. However, Dr Ikram said no decision had been made about the device itself. It might be returned to Australia or the United States,

or kept in New Zealand to be used again. The Canterbury Hospital Board saw only about one patient every two years who fitted the criteria for the surgery but other boards might have suitable recipients.

A spokeswoman at Sydney’s Royal North Shore Hospital said neither the surgery or the defibrillator had been at fault. Mr Gilmour’s death was believed to have been caused by the mechanical state of his heart.

“There was absolutely nothing wrong with the electrical state of the heart,” she said. Sydney surgeons had only hoped to delay the “predictable and inevitable end” by righting the electrical beating of his heart. It was the first such surgery done at the Royal North Shore Hospital. The other of two defibrillators brought to Australia by its manufacturers had been implanted in a Melbourne woman patient two days before Mr Gilmour’s-