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Wildcat Signals. Ike's heart had so many, or such extensive, infarcts that the original sinus-node impulse could not follow its normal path. Moreover, infarcted areas sometimes develop wildcat electrical impulses of their own, which jam the sinus-node signals. Two deadly consequences may result. The first is ventricular fibrillation, in which the muscles of the main pumping chambers twitch rapidly and uselessly, producing no stroke or beat. The second is what cardiologists call "irritability," in which the heart's electrical system behaves erratically, apparently in response to those wildcat impulses. lice was struck by both.
Hoping to reduce the risk of either reaction, the Walter Reed doctors first tried a British drug, bretylium tosylate, which blocks the action on the heart of noradrenaline, a stimulating hormone in the adrenaline group. This did not work, so they switched to lidocaine (U.S. trade name: Xylocaine), related to procaine and similarly used as a local anesthetic. The Food and Drug Administration has not yet approved lidocaine for general use in heart cases, but the Walter Reed team could use it on an investigational basis. They dripped the solution into one of Eisenhower's arm veins to reduce the heart muscle's reactivity to erratic signals.
That was not enough. In 26 hours, after his seventh occlusion, Ike suffered four periods of ventricular fibrillation and lost consciousness. If these episodes had persisted for four minutes or more, the patient would have suffered brain damage. But the Army team was ready with a defibrillator, a device for giving an instantaneous shock to the heart through electrodes placed against the chest wall, and the beat was restored within two or three minutes.
Pace That Failed. Next, the cardiologists tried to control the faulty electrical system with an artificial pacemaker. Since this w'as not intended to be permanent, it was not implanted in the patient's belly muscle. The doctors used a table model. They threaded an electrode-tipped catheter through Ike's right jugular vein, then through the superior vena cava all the way to a point inside the right ventricle (see chart). Impulses from the catheter were supposed to blanket the node's action and take over its function. They did, for a while. Then the doctors removed the catheter and unhooked the device "because of its demonstrated ineffectiveness after the initial few hours." Evidently the pacemaker current could not safely be made strong enough to overcome the abnormal electrical impulses.
Episodes of ventricular irregularity recurred, some of only a few seconds' duration. Throughout this prolonged, heroic treatment, Ike was not only conscious most of the time, but cheerful. The doctors emphasized that he was not in pain, and rested comfortably. In fact, they said, Ike felt well enough to joke with them about all that electronic equipment to which he was hooked up.