Marysville man pioneers use of new heart defibrillator

MARYSVILLE — Just one day after a surgical team spent 90 minutes implanting a new defibrillator in his chest, Merle Yoney was having lunch with his wife at Shawn O’Donnell’s restaurant in Everett.

Yoney, 78, walked out the doors of the University of Washington Medical Center early Friday afternoon. He was the first patient on the West Coast to receive the “> since the federal government gave final approval for its use on Sept. 28.

Dorothy Yoney provided a quick update on her husband’s condition as they wrapped up lunch. She was elated at her husband’s ability to bounce back so quickly from his surgery. “He did really well,” she said.

They were eager to start the drive back to their Marysville home. “We’re happy,” she said. “We’ll just put our feet up and relax.”

The fact Yoney could be discharged from the hospital just a day after his surgery is credited in part to way the defibrillator is wired up with his heart.

The device was designed to detect an out-of-sync heartbeat and trigger an electrical shock that sends the heart back into its normal lub-dub rhythm.

The generator, encased in a container about the size of a business card, is similar but far smaller than the lunchbox-sized external defibrillator units now widely found in offices and schools.

The thin electrical wire, or lead, from the defibrillator’s generator doesn’t go into the heart, as other defibrillators do. Instead, the wires from the unit are implanted along the bottom of the rib cage and breast bone.

“It stays outside the chest wall and is just under the skin,” said Dr. Jordan Prutkin, a cardiologist at the UW Medical Center who performed Yoney’s surgery. “Fewer wires mean less chance of infection.”

• • •

That was just the type of problem that had led Yoney to contact the UW. Earlier this year, he noticed an unusual swelling in his upper chest. It was later diagnosed as an infection caused by a wire in his defibrillator. He went to Prutkin to get it checked.

Defibrillator wires are much easier to put in than to remove, Prutkin said. Once they’ve been in about a year, they become encased in scar tissue that grows out from the blood vessels. “You can’t just pull it out,” he said.

In August, Prutkin removed as much of the electrical wire from Yoney’s chest as he could.

Until surgery for the new defibrillator could take place Yoney was given a LifeVest, a portable defibrillator unit with a battery he could wear on his belt. “This has kinda put a cramp in my style; I don’t have any energy any more,” Yoney said before his surgery. “I can’t walk like I used to walk.”

Yoney was a Boeing machinist for 31 years, working on the 747, 767 and 777 lines. He retired in 1999.

For the past three months, he just hasn’t felt up to the weekly ballroom dancing dates with his wife at a local VFW hall.

His schedule includes morning coffee meet-ups with “the boys,” a long-tenured group of friends. “We solve all the world’s problems,” Yoney said.

And as a volunteer with the Marysville Police Department, he and a fellow volunteer cruise the city in a Chevy pickup, checking on people’s homes while they’re out of town and assisting with street fairs.

Two days before his surgery, Yoney talked about the upcoming procedure with a calm, outward stoicism bred from his upbringing on a wheat farm near the North Dakota community of Petersburg.

“Modern medicine, they can do anything,” he said. “The guys I met down there are young guys. I think they have a steady hand.”

• • •

Yoney’s history of heart problems dates back to 1979, when he had a heart attack. A decade later, he had bypass surgery.

For the past 13 years, he’s lived with a condition that causes both rapid heartbeats and a cycle of irregular heart rhythms that put him at increased risk of sudden death.

It’s the same condition that has caused young athletes to unexpectedly collapse and die at sporting events.

Yoney’s first defibrillator was implanted in 2000. Since then, he has had two surgeries to replace defibrillator batteries, the most recent of which occurred in April 2010.

“When we do a battery change we have to change the whole unit out,” Prutkin said. The batteries typically last five to eight years. In most cases, the wires are left in.

• • •

Nationally, more than 100,000 patients have surgeries to implant defibrillators each year.

The University of Washington participated in an initial test of the new defibrillator last year.

It currently is one of seven medical centers in the country approved to implant the devices. For the next several months, it will be the only site in Western Washington where the new devices can be implanted, Prutkin said.

Two types of patients will benefit most from the new defibrillators: Those who like Yoney have had infections from a defibrillator wire, and young people, especially athletes, he said.

The wires in traditional defibrillators can’t be as strong and stiff as those in the newer device. “If they were, they would poke a hole through the heart,” Prutkin said.

Younger people are more active and the electrical wires, or leads, don’t tend to last as long because of their activity, he said.

Because the wires are placed in a different spot in the chest, the leads in the new type of defibrillator, made by Massachusetts-based Boston Scientific, can last longer and would be a good choice for athletes, Prutkin said.

One of the final steps in Yoney’s surgery was to test the defibrillator the surgical team had so meticulously stitched into place.

The first time it was programmed to send a shock to Yoney’s heart, his heartbeat didn’t regain its normal rhythm.

The second shock was programmed in a different way. It worked exactly as expected.

But Prutkin wanted to be sure. The surgical team tested it one more time, with Yoney’s body tensing and his chest jumping as the shock was sent to his heart.

Yoney was sent home with a relatively short list of restrictions. No raking leaves or vacuuming around the house and no driving outside the city limits for a few weeks.

On Sunday, Yoney and his wife attended a concert in Everett to hear singer Terry Baker.

Late Monday morning, Yoney had left the house on his own.

“Yes coffee with the boys,” his wife said, chuckling as she imagined the how the gathering would play out. “You don’t want to sit around them. They don’t tell the truth. They do a lot of kidding around.”

Before the surgery, Yoney said that once he recovered, he hoped he and his wife could go camping.

“Next spring, we’ll be back at it,” he said. “I’d like to go back to Yellowstone.”

It’s been a few years since they’ve been able to visit, and the drive only takes about a day and a half, he said.

“We drove into the park and here’s all these elk and buffalo — the buffalo standing over there eating some grass,” he said. “So peaceful.”

Prutkin said there are no medical issues to prevent him from making a return trip. “I would love to see that,” he said. “I see no reason he can’t go.”

Sharon Salyer: 425-339-3486; salyer@heraldnet.com.

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