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annals of emergency medicine

A case study reports that a man with two hearts – one his own, one a donor heart- was resuscitated via a defibrillator when both organs developed irregular heart rhythms.

The case study was published online recently in the journal Annals of Emergency Medicine and explains how the life-saving measures used in 2010 saved a 71-year-old who received the donor heart in 2003. The patient had also received a pacemaker in 2001. The heart was implanted in a heterotopic procedure, which means the patient keeps his heart and receives a donor heart.

The new heart is connected to the original organ to create a double heart, which offers some advantages: it offers the old heart a chance to recover, and if the donor heart is rejected and fails, it can be removed. The procedure, which dates back to the 1970s, is typically done when the original heart is too weak to work by itself or the donor heart is a different size than the patient’s original heart. It’s done less frequently nowadays, due to new surgical techniques and better immunosuppressive drugs.

The man came to the emergency room with shortness of breath, low blood pressure and a rapid heart beat. He was treated with medications but his blood pressure dropped even further and he was sent to the intensive care unit.

The abnormal heart rhythm in the original heart eventually started affecting the donor heart, and the patient became unconscious, stopped breathing, and had no pulse. At that point defibrillators were used and the patient recovered. The patient was transferred to a cardiac unit, his pacemaker was upgraded and he was eventually discharged. The report noted that the man is doing well, with no further irregular heart beats.

The authors noted that the case points out the importance of immediate treatment.