- The Washington Times - Saturday, June 30, 2001

Vice President Richard B. Cheney will check into George Washington University Hospital today for tests he and his doctors anticipate will be followed by implantation of a pacemaker to correct abnormal heart rhythms.

"The doctors have assured me there's no reason why either the procedure or the device that's being implanted should, in any way, inhibit my capacity to function as the vice president," Mr. Cheney, 60, told reporters at a briefing yesterday morning.

In fact, he said, he plans to be back to work Monday.

This will be Mr. Cheney's third hospitalization for heart problems since the election in November. He said today's visit will be on an outpatient basis, and he will return home afterward.

"I look on this as an insurance policy," the vice president said of the expected implantation of what he described as a "pacemaker plus."

Dr. Jay A. Mazel, an electrophysiologist at the Washington Hospital Center and an associate professor of medicine at George Washington University, said the implantable cardioverter defibrillator, or ICD, is "like an insurance policy."

Mr. Cheney was smiling and looked robust at the hastily called briefing. The 30-minute news conference was conducted with little prior notice, a move that aides hoped would give Mr. Cheney a chance to deliver the news before it was leaked .

Mr. Cheney said he had discussed his situation with President Bush on Tuesday. "The president's reaction was he wanted to know the specifics and the details and strongly recommended that I go forward" with the procedure, Mr. Cheney said.

Dr. Mazel said that with a $25,000 ICD, Mr. Cheney would be "protected" from the "life-threatening" effects of sustained abnormal heartbeats of the lower chamber of the heart. He said Mr. Cheney's doctors are concerned he could be at risk for a condition known as sustained ventricular tachycardia and should be able to determine that through today's tests.

In a statement released by the White House, Dr. Jonathan Samuel Reiner, director of George Washington University Hospital's Cardiac Catherization Laboratory, said the ICD is a "small electronic device" about the size of a pager that is "placed under the skin of the upper chest and has the capacity to continuously monitor and analyze a patient's heart rhythm."

Dr. Reiner said the "main function" of the ICD is to "interrupt rapid heart rhythms" and restore normal heartbeat.

Dr. Mazel said a patient "can't recover" from sustained ventricular tachycardia without an ICD, as there is no way to stop the rapidly beating heart. With the ICD, widely available since 1994, the out-of-control arrhythmia, or irregular beating, is ended by a low-energy electrical shock.

Both Dr. Reiner and his patient, Mr. Cheney, have said the vice president has had no symptoms of irregular heartbeat.

But Dr. Reiner said the vice president was found to have "four brief asymptomatic episodes of abnormally fast heartbeats," lasting one to two seconds each, during monitoring of his heart two weeks ago. The monitoring was done using a device Mr. Cheney wore for 34 hours, which allowed him to go about his usual daily activities.

"The vice president had not experienced any symptoms before, during or after testing and continues to feel very well," the cardiologist said in his statement.

Discovery of the episodes of rapid heartbeats prompted Mr. Cheney's physicians to recommend that he undergo today's test, known as an electrophysiology study, "for the purpose of determining the vice president's risk of developing a persistent, abnormal heart rhythm," Dr. Reiner said.

The test, he said, "involves the analysis of waveforms acquired from wires passed into the heart through the veins accessible at the top of the leg."

Dr. Reiner said the test will "help assess Mr. Cheney's future risk of developing a sustained cardiac arrhythmia," or abnormal heartbeat, and "determine if an ICD should be placed during the same procedure."

Dr. Reiner said the device is implanted with the aid of local anesthesia and mild intravenous sedation and is designed to last five to eight years before needing replacement.

"It's a very common kind of procedure. The risks, I think, are minimal, although I can't say it's absolutely without risk. But … this is done about 100,000 times a year … around the country," Mr. Cheney told reporters.

The vice president has been suffering from coronary artery disease for nearly a quarter century, beginning with a heart attack in 1978 when he was a young congressman from Wyoming. He underwent quadruple-bypass surgery a decade later, after suffering two more heart attacks.

Last November, Mr. Cheney had what his doctors called a "very slight" heart attack — his fourth. They treated him by implanting a stent to open an almost completely blocked artery. In March, Mr. Cheney underwent an angioplasty to clear a clogged artery.

"It is important to note that the current testing is unrelated to the vice president's prior coronary stenting and does not indicate progression of his coronary artery disease," Dr. Reiner said.

Bush advisers believed they had mishandled the November and March hospitalizations, which raised questions about whether Mr. Cheney was fit to be vice president.

"If it were the doctors' judgment that any of these developments constituted the kind of information that indicated I would not be able to perform, I would be the first to step down," Mr. Cheney said. "I don't have any interest in continuing in the post unless I'm able to perform adequately."

In fact, Mr. Cheney said he would be "perfectly happy to serve" as vice president in a second Bush term, if the president wants him, and "if I am in shape to do it and my health permits."

He calmly took questions from reporters and demonstrated some humor. With a half-smile, he said the pacemaker is "an energy-efficient device."

"It runs for five to eight years, without having to replace the batteries," he said.

George Washington University Hospital said the combination testing and likely ICD implantation will take about three hours. Mr. Cheney is expected to be free to return home by this afternoon.

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