- The Washington Times - Sunday, July 1, 2001

Doctors yesterday implanted a device in the chest of Vice President Richard B. Cheney to control episodes of rapid heartbeat and said afterward he could go back to work Monday.
"Everything went exceedingly well, exactly as planned," Dr. Alan Wasserman, chairman of the department of medicine at George Washington University Hospital, said at a nationally televised news conference that followed the out-patient procedure.
Mr. Cheney's cardiologist, Dr. Jonathan Samuel Reiner, director of GWU's Cardiac Catherization Laboratory, informed reporters he "explicitly told" Mr. Cheney that "this procedure and this device would not in any way interfere with his ability to perform as vice president" or carry out his "full schedule."
Mr. Cheney, 60, who has a 23-year history of coronary-artery disease, was released from the hospital about seven hours after his 8 a.m. arrival.
"I feel good. Sore shoulder, good shape," the vice president said, as he smiled and waved to well-wishers on his way out the door.
"He'll be back to work in an unrestricted fashion Monday," Dr. Reiner said.
Mr. Cheney was mildly sedated during insertion of the $25,000 pager-sized device known as an implantable cardioverter defibrillator, or ICD.
He describes the tool as a "pacemaker-plus" because it both speeds up an abnormally slow heart rate and slows down an out-of-control rapid heartbeat, which is life-threatening if untreated.
"He felt great after it was over," Dr. Reiner said at the news conference, which began at about noon.
Shortly beforehand, Mr. Cheney received a call from President Bush, who was at Camp David with Japanese Prime Minister Junichiro Koizumi. After talking with Mr. Bush, the vice president had a lunch of shrimp salad.
Mr. Bush, not the GWU physicians, first told the media and the public that Mr. Cheney successfully had the ICD implanted. He was asked about the operation by a reporter at Camp David.
"They did put it in. … I'm told the operation went well," the president said.
Mr. Cheney plays a major role in the Bush administration, and the president said he does not think his second-in-command needs to cut back because of health problems, which include four heart attacks since 1978.
"No, I don't think he ought to slow down. I think he ought to listen to his body, which he has been doing. I think he ought to work at a pace he's comfortable with," Mr. Bush said.
The president added: "If I told him to slow down, he'd say, 'Forget it.'"
Dr. Reiner had only glowing news about the vice president's medical condition. "His blood pressure is normal. His blood flow is terrific. … His cholesterol has really improved," the cardiologist said.
Dr. Reiner acknowledged that Mr. Cheney's heart suffered "a moderate amount of damage" over the years. But "his prognosis is terrific" and his life expectancy is "excellent," the cardiologist said.
"For the next several days — maybe the next couple of weeks — we'd discourage vigorous upper-body exercise," Dr. Reiner said.
The ICD, which weighs less than 3 ounces, was surgically placed under the skin on the upper left side of Mr. Cheney's chest in an operation that took about an hour.
The implantation came after doctors conducted a 35-minute test called an "electrophysiology" study. The test involved threading wires into the vice president's heart from the groin and using them to stimulate the heart with a mild shock to determine whether they could induce an abnormal heartbeat.
That goal accomplished, Mr. Cheney's doctors concluded he was at risk of developing a sustained rapid heartbeat, which is potentially dangerous. They made the decision to implant the ICD, a sophisticated instrument for monitoring heart rhythms and restoring abnormal heart rates to normal within seconds.
Physicians anticipated Mr. Cheney would need the ICD, given the results of 34 hours of monitoring he underwent two weeks ago. The vice president alerted the White House press corps to his condition and treatment plans during an unexpected news conference Friday morning.
The earlier testing turned up four separate asymptomatic episodes of abnormally fast heartbeats, lasting one to two seconds each. Dr. Reiner yesterday said those episodes were so mild that they would not have sent the ICD into action.
But Dr. Sung Lee, the GWU electrophysicist who performed the procedure, stressed that if the vice president does experience prolonged incidents of heartbeats fast enough to be life-threatening or to cause him to lose consciousness, the ICD would respond within 10 seconds by delivering an electrical shock.

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