Two months ago, a rare condition caused 30-year-old Christopher Snider's heart to start beating at a highly irregular rate.
One minute, he was standing in a parking lot. The next minute, he became dizzy. Then he passed out. The next thing he knew, Mr. Snider was in an ambulance headed for the hospital.
Fainting spells aren't good for anyone. But they're even worse for a cop.
"All I've ever been is a law enforcement officer," Mr. Snider said. "But as of right now, I'm pretty much done."
Responsible for the gun in his holster and the patrol car he drives as a Brown County deputy sheriff, Mr. Snider realizes that his life -- and the lives of others -- could be at risk if he passes out on duty.
So this month, Mr. Snider became the first Tristate patient to try a new medical device -- a 2-inch-long wireless cardiac monitor that can be implanted under the skin.
Doctors think Mr. Snider has hypertrophic obstructive cardiomyopathy, the type of heart disease that killed Loyola Marymount basketball star Hank Gathers in 1990.
The monitoring device is needed to help doctors confirm the diagnosis and to decide whether Mr. Snider needs a pacemaker, a defibrillator or other type of treatment.
"Diagnosing a patient with arrhythmia problems can be difficult," said Dr. John H. Wilson, a cardiologist with Cardiology Associates of Cincinnati. "When they have an event, it may only last a few minutes. By the time you see them (as a doctor), they're fine."
The device, called the Reveal Insertable Loop Recorder, is an oblong sliver of titanium and plastic that can fit in the palm of a hand. Inserted under the skin above the heart, the device continually tracks the heart's electrical activity -- just as a regular electrocardiograph (ECG) does. The recorder tracks and stores up to 42 minutes of heartbeats before it erases itself and starts over.
Once symptoms occur, the patient presses a button on a hand-held "activator" that looks like a garage-door opener. This instructs the recorder to save up to 20 minutes of past activity along with the next 20 minutes of heart activity. This feature also allows patients to activate the recorder and capture the irregular heartbeat event even after it occurs.
Since his first event, Mr. Snider has been on sick leave, living on a farm just outside Sardinia with his three children, ages 6, 8 and 12. Mr. Snider never knew he was sick until he passed out.
"I was on duty at the time," he said. "I was getting an oil change for my car. I was standing there talking to the guys, then kapow!" Since then, he hasn't passed out again. But he has felt light-headed and short of breath several times. Now, when Mr. Snider feels another "event" coming on, he hits the activator and heads for the doctor as soon as he can.
At the physician's office, doctors can retrieve and analyze the ECG data, which is downloaded via a tiny transmitter to a computer for printouts or viewing on-screen. The process is similar to retrieving data from a pacemaker.
The data will allow doctors to decide what type of treatment will work best for Mr. Snider, Dr. Wilson said.
Fainting spells from irregular heartbeats can occur in two basic ways, which require different treatments.
When the beat is too fast -- a condition called tachycardia -- doctors use medications or implantable defibrillators to control the heart.
When the beat is too slow -- a condition called bradycardia -- surgeons implant pacemakers to drive the heart at a steady pace.
The Reveal device is made by Minneapolis-based Medtronic Inc. After nearly two years of research, it won FDA approval for general marketing in February.
While heart disease is the nation's No. 1 cause of death, the Reveal recorder would be used only in rare situations.
Of the estimated 20,000 patients who visited the nine doctors at Cardiology Associates last year, Dr. Wilson said the device would have been useful in three or four cases.
Medtronic estimates that 1.5 million people a year nationwide visit their doctors with concerns about fainting episodes. About 40 percent of those cases never get a definitive diagnosis; they get treated based on educated guesses or no treatment at all.
Many of those patients would benefit from the Reveal device, said company spokeswoman Jessica Stoltenberg.
Mr. Snider doesn't care much whether his case is rare. He just hopes that this new advance in cardiac monitoring technology will be the first step in getting healthy and back to work.
