Dr. Shaival J. Kapadia (left) checks out the LifeVest on Michael V. Edwards before he leaves CJW Medical Center (Chippenham). The back of the LifeVest holds the therapy pads and tactile vibrator that alerts the patient before a shock is delivered. LINDY KEAST RODMAN (TIMES-DISPATCH)

Sometime in the past, he doesn't know when, 41-year-old Michael V. Edwards had a heart attack.

Edwards found out about the heart attack a month ago - when he had a minor stroke.

In late September, still without electricity from Hurricane Isabel, Edwards was cooking on the grill.

"I just felt a strange feeling come over me," he said. "It felt like I had been drinking."

When the feeling did not go away, he went inside, where he tripped over a coffee table. His girlfriend, Sharon Greenplate, immediately noticed something was terribly wrong - one side of his face was drooping. She dialed 911.

Edwards was rushed to the hospital, where doctors diagnosed a stroke and began treating him. Over the course of that treatment, they discovered the heart damage.

"Apparently, the heart attack was sometime ago," Edwards said. "I never knew I had it. It had done damage to my heart, and now I have heart failure from it."

Heart-failure patients are at increased risk of sudden death from irregular heart rhythms. To treat Edwards, his doctors plan to surgically implant a cardioverter defibrillator, a device that continuously monitors the heart and is able to deliver a shock if there is a life-threatening irregular rhythm.

But they cannot do the surgery immediately because of the blood-thinning drugs Edwards is taking for the stroke.

One possible interim solution was to have him stay in the hospital until he could have the defibrillator implanted. That could be a month or longer.

Another option was to send him home with a portable automated external defibrillator and hope that if he had any problems, someone would be around to operate it and help him.

Another option, the one he is using, is a cross between the two. Edwards is wearing a defibrillator vest that consists of electrodes placed on the body and connected to a monitor and alarm worn on a belt-pack around the waist. The vest, worn round-the-clock, has a hand-held alarm that alerts Edwards when an abnormal rhythm is noted and allows him to push a button to stop from being shocked.

But if he were to pass out, his hands would fall off the controls and the device would deliver a shock that would jolt his heart back to a normal rhythm if the readings indicated the shock was needed.

"The advantage for him is he is ambulatory, out of the hospital," said Dr. Shaival J. Kapadia, a cardiologist overseeing Edwards' care. "If we didn't have this, we would send him home anyway and hope for the best."

LifeVest, made by Pittsburgh-based ZOLL Lifecor Corporation, was approved by the federal Food and Drug Administration in December 2001. Company officials say about 300 patients have since been prescribed the vest, wearing it an average of 2½ months.

"In about 63 percent of our patients, it's a bridge to getting an implantable defibrillator," said company spokesperson.

Physicians at Virginia Commonwealth University earlier this year prescribed the wearable defibrillator for a Northern Virginia woman.

The woman had had an implantable defibrillator but developed an infection and had to have it removed and replaced. While doctors made sure the infection was cleared up, they prescribed LifeVest.

"We didn't want to keep her in the hospital for a month," said Dr. Richard K. Shepard of VCU.

"The other thing LifeVest is good for is patients waiting on a heart transplant."

LifeVest is also useful for patients prescribed heart-rhythm medicine for the first time, Shepard said. For the first few days on the medicine, there is a risk that some patients will get worse. Doctors usually admit them to the hospital to monitor them.

LifeVest costs about $3,000 a month, which is not a lot when compared with several days or weeks in the hospital. The vest is rented and, according to the company, most insurance companies cover it as durable medical equipment. Edwards said his insurance company is not covering it.

"I just want to get better, then I will worry about the bills," he said.

The vest is comfortable, Edwards said. He takes it off only to shower.

"Without it, I would still be in the hospital," he said. "This allows me to do a little bit more, to move around. I have taken a little trip up to Maryland, knowing that if something did happen to where I needed to be shocked, it will do it."

He expects to find out this week or next when doctors can put in a permanent device. A long-distance truck driver and smoker since his teenage years, Edwards said the experience is causing him to evaluate some of his health habits.

"I am too young to go out of here," he said.

"In a good way, it's given me a second chance at life, made me realize some things I have to change - eating, my smoking."

Contact Tammie Smith at (804) 649-6572 or tlsmith@timesdispatch.com

Copyright 2003, Richmond Times-Dispatch. Used with permission.