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Doernbecher Patient One of the Youngest Ever to Receive Heart Defibrillator

   Portland, Ore.

A 4-month-old boy is the recipient of groundbreaking surgery

After two near-death experiences, 4-month-old Erik Brooks received a heart defibrillator, which makes him one of the youngest patients ever to get the device. The surgery was conducted at Oregon Health & Science University's Doernbecher Children's Hospital on Tuesday, Dec. 4. The defibrillator was implanted in Erik as a last-resort, life-saving measure following episodes of rapid, erratic heartbeats, also known as ventricular tachycardia. "Now he's back to his normal self," said Erika Brooks, Erik's mom. Erik was a perfectly healthy child. But on October 26, 2001, without warning, a frighteningly fast heartbeat sent him into cardiac arrest; he almost died while being rushed to a hospital in Tacoma, Wash. At the hospital, he was given medications, stabilized and sent home. But on Thanksgiving morning, Erik's heart began to beat wildly as he fought to survive. "They (Tacoma doctors) recommended the specialists down here. They preferred that we come down here because of the expertise (of the heart team at Doernbecher)," said Erika.

Carl and Erika Brooks decided to place the welfare of Erik into the hands of Seshadri Balaji, M.D., cardiologist at Doernbecher and associate professor of pediatrics (pediatric cardiology) in OHSU School of Medicine; and Irving Shen, M.D., cardiothoracic surgeon at Doernbecher and assistant professor of surgery (cardiothoracic surgery) and pediatrics, OHSU School of Medicine. Balaji and Shen agreed, Erik's history showed symptoms of erratic, irregular heartbeats, but they couldn't determine the cause. To ensure Erik's safety, they chose to insert a defibrillator that would jump-start his heart into a normal rhythm if another episode should occur. "There is no test or any procedure that we can do right now to assure ourselves that just putting him on medicines and sending him home is going to prevent a third episode," said Balaji. The defibrillator is used as a safeguard in case his medications don't work.

But inserting the defibrillator was a complex procedure. Balaji and Shen had never implanted one into someone so young, because defibrillators are usually put in adults. Balaji said placing one in Erik's little body created enormous challenges. The defibrillator, which is the size of a cigarette box, was placed in Erik's abdomen, so his fatty tissue would prevent the device from wearing through his abdomen wall or outer skin. Adults normally have them inserted in their upper chest. Erik's tiny blood vessels were also too small to accommodate the electrical shock wires, used in adults, that are inserted into blood vessels and run to the heart. Instead, Erik had a tentacle-like array of electrodes inserted beneath the skin that would help to jump-start his heart -- much like paddles used to shock patients on the outside of their chests.

The four-hour surgery proved to be very successful. "I have to say the surgery was brilliant. It just went so well. I think it was very exciting because it was an extremely challenging surgery. It's groundbreaking as far as I'm concerned," Balaji said. Highlighting the difficulty of placing the defibrillator inside Erik, Shen stated, "As far as the surgery itself, it was a success in that we were able to get this device into him." Erik's parents feel the same. "They wheeled him into surgery, and he came out fine."

For now Erik is being closely monitored by his doctors until he is released to go home. But his future looks bright. Now that Erik has the defibrillator, the doctors are assured that if another episode occurs he will not die, before he can seek medical attention. His parents couldn't be happier. "It feels good knowing he has a better chance of surviving," said Carl and Erika.


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