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"CHANNUKAH MIRACLE: INFANT'S HEARTBEAT REVIVED"

Schneider Children's Medical lCenter of Israel: The life of an infant with cardiac disease was saved thanks to an internal resuscitation device that was implanted in a rare operation for the first time in Israel in such a small child

The child's mother: "We had a Channukah Miracle; from our perspective, my daughter has been born anew"

For the first time in Israel and one of the few cases in the world: a rare operation to implant an internal defibrillator in a 10-month-old infant who suffered cardiac arrest due to diseased heart muscle. The operation took place at Schneider Children's, a member of Clalit Health Services. The internal resuscitation device (defibrillator implant) was adjusted and programmed by Meditronic, manufacturers of the device, to the age and body size of the infant.

Until the implant, the infant's life had been saved on two occasions: thanks to the resourcefulness of the parents who, following cardiac arrest events, resuscitated the child at home through electric shocks to the heart using a Lifepak Kit (external defibrillator) which they had at home for emergency use.  

Dr. George Frankel, a cardiac surgeon in the Cardiothoracic Surgery Department at Schneider Children's headed by Prof. Bernardo Vidne, performed the operation with the assistance of Dr. Rami Fogelman, Director of the Electrophysiology Unit in the Cardiac Institute at Schneider Children's. Dr. Fogelman: "The infant first arrived at the hospital at the age of two months following cardiac arrest, and was diagnosed with diseased heart muscle. Because of this event, we recommended the use of an external resuscitation device (defibrillator)."

The child's mother underwent special training in the use of the external resuscitation device - manufactured by Meditronic - in times of emergency. The device works like an ECG, identifying irregular heart rhythm and automatically sending vocal instructions to the defibrillator how to react to emit an electric shock in order to return the heart beat to normal.    

The 2-month-old infant was connected to the device and discharged from the hospital. She suffered two cardiac arrests at home both of which endangered her life. Her parents conducted immediate life-saving resuscitation using the external defibrillator which automatically responded with the appropriate electric shocks to the heart. "The timing in these events is critical," noted Dr. Fogelman, "and without the parents' resourcefulness, it is doubtful that the child would have arrived alive at the hospital."

After two near-fatal heart attacks at home and despite her low weight 8 kgs the medical team at the Institute of Cardiology at Schneider Children's headed by Dr. Einat Birk, decided to implant an internal resuscitation device. Only a few cases are known in the world where implants of this kind were performed on infants and children weighing less than 20 kgs.

The operation ensued about an hour and a half during which the device adjusted to the size of the infant - was successfully implanted. The defibrillator was implanted in the wall of the stomach together with three electrodes inserted into the outer layers of the heart and close to the lung membrane, as opposed to standard procedure in adults where the electrodes are implanted within the heart. This is a special technique utilized for the first time in Israel in such a young child weighing under 20 kg.

About cardiac arrest and treatment with the resuscitation device: Cardiac arrest is known in the western world and affects all ages. Cardiac arrest is expressed electrically by a very rapid heart beat, which affects function and prevents the proper flow of blood to the organs of the body. If allowed to continue for more than a few minutes, the brain can be affected and death can even occur. Timing is an important element where every minute that passes without the administering of electric shocks reduces the chances of survival by 10%. About 8,000 people in Israel die every year from cardiac arrest.

The key to survival from cardiac arrest is swift resuscitation. The external resuscitation device (such as the Lifepak made by Meditronic that the parents of the infant received) is capable of identifying life-threatening rapid heart beats and of emitting electric shocks to the heart. This means immediate and simplified medical treatment without the presence of a doctor. This activity regulates the heart's activity thus saving the life of the patient. The defibrillator available to the public functions as an automatic defibrillator. In order to operate it, a 4-hour training course in resuscitation is required.

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