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Cheney's Heart Restored to Normal Rhythm

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[November 27, 2007]  WASHINGTON (AP) -- Doctors administered an electrical shock to Vice President Dick Cheney's heart and restored it to a normal rhythm during a 2 1/2 hour hospital visit Monday. The procedure was described as a low-risk, standard practice. Cheney, 66, went home from George Washington University Hospital and was expected back at work on Tuesday.

Cheney, who has a history of heart problems, was discovered to have an irregular heartbeat around 7 a.m. when he was seen by doctors at the White House for a lingering cough from a cold. He remained at work throughout the day, joining President Bush in meetings with Mideast leaders.

The irregular heartbeat was determined to be atrial fibrillation, an abnormal rhythm involving the upper chambers of the heart, said spokeswoman Megan Mitchell. He went to the hospital about 5 p.m. and was discharged about 7:30 p.m.

"Atrial fibrillation is extremely common," said Dr. Zayd Eldadah, an electrophysiologist and director of cardiac arrhythmia research at Washington Hospital Center. "The way to get rid of it right away is to do what he did today. This is standard practice, low-risk, easy to do."

He said Cheney's underlying heart problems were probably a factor in his atrial fibrillation. Aging is a common factor, too.

"He'll probably have other episodes," said Eldadah, who is not involved in Cheney's care. "Atrial fibrillation in and of itself is not threatening. The problem is that it has long-term consequences. It increases the risk of stroke." He said Cheney probably would be put on the most potent blood thinner.

About 2.8 million Americans have atrial fibrillation, the most common type of irregular heartbeat, and cases are increasing as the population ages.

The condition occurs when the heart's top chambers, called the atria, get out of sync with the bottom chambers' pumping action. It is not immediately life-threatening, and the heart sometimes gets back into rhythm on its own. Many times, patients aren't aware of an episode of atrial fibrillation.

But if the irregular heartbeat continues, it eventually can cause a life-threatening complication -- the formation of blood clots that can shoot to the brain and cause a stroke.

The main treatment is to try an electrical shock to restore normal heartbeat. If that doesn't work, patients may need to take the blood thinner warfarin to reduce stroke risk.

"An electrical impulse was used to restore the upper chambers to normal rhythm," Mitchell said. "The procedure went smoothly and without complication. The vice president has returned home and will resume his normal schedule tomorrow at the White House."

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Cheney has had four heart attacks, quadruple bypass surgery, two artery-clearing angioplasties and an operation to implant a defibrillator six years ago. In July he had surgery to replace the defibrillator which monitors his heartbeat.

The type of defibrillator Cheney has is used to prevent sudden death from a very different type of irregular heartbeat that starts in the bottom of the heart. The atrial fibrillation, in contrast, requires a different type of treatment.

In 2005, Cheney had six hours of surgery on his legs to repair a kind of aneurysm, a ballooning weak spot in an artery that can burst if left untreated. In March, doctors discovered that he had a deep venous thrombosis in his left lower leg. After an ultrasound in late April, doctors said the clot was slowly getting smaller.

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On the Net:

National Institutes of Health on atrial fibrillation:
http://www.nhlbi.nih.gov/health/
dci/Diseases/af/af-what.html

[Associated Press; By TERENCE HUNT]

AP Medical Writer Lauran Neergaard contributed to this report.

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