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CHENEY gets implant to protect heart in procedure called a success

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WASHINGTON (AP) _ Doctors implanted a dual-purpose pacemaker in Vice President Dick Cheney's chest Saturday to control potentially dangerous irregular heartbeats and said he should be fully able to carry on in his job.

``The vice president's prognosis is terrific,'' said Dr. Jonathan Reiner, his cardiologist. ``He felt great when it was over.''

Cheney left the hospital seven hours after he cheerfully walked in. Mildly sedated during the morning procedure, he was eating shrimp salad for lunch.

It was the third time since the November election that Cheney had been hospitalized for treatment of his heart disease. Despite the optimism expressed by his medical team, questions are sure to persist about his health and ability to shepherd the full range of domestic and national security policy that now crosses his desk.

Doctors said he can go back to work Monday. No ill effects were foreseen from the procedure except for temporary soreness around the implant.

``Everything went exceedingly well, exactly as planned,'' said Dr. Alan Wasserman, chairman of the medicine department at George Washington University Hospital.

President Bush said he saw no need to lighten duties on a vice president in whom he has invested unusual influence and trust. ``No, I don't think he ought to slow down,'' Bush said at Camp David., Md. ``I think he ought to work at a pace that he is comfortable with.''

Bush said, ``I know Dick Cheney well, and if I were to say, `You've got to slow down, Mr. Vice President,' he's going to say, `Forget it,' because he's got a job to do.'' The two talked by phone after Cheney's surgery.

The vice president has had four heart attacks over 25 years and the procedure he went through Saturday was for heart problems more serious than those faced by most recipients of pacemakers.

The device, about the size of a pager, is more sophisticated than an ordinary pacemaker because it has two actions _ speeding up a slow heart and slowing down a racing heartbeat. If it detects an abnormally rapid heartbeat, it sends an electrical surge to a defibrillator coil and jolts the heart back into a normal rhythm.

If this happens, Reiner said, Cheney will probably feel a pop in his chest. ``It's really much less dramatic than in the movies,'' he said. ``His hair is not going to stand on end.''

Cheney, 60, waved upon entering the hospital Saturday morning, saying he expected an easy time of it. ``But you never know until it's over.''

Doctors examined his heart in a 35-minute exploration that confirmed the need for the device, called an implantable cardioverter defibrillator, or ICD.

Then he went through hourlong surgery, under light sedation and essentially ``snoozing,'' the medical team said. ``He didn't appear to be particularly nervous going into the procedure,'' Reiner said. ``He was happier to do this than to get some planned dental work.''

Reiner said Cheney's heart has suffered moderate damage from his heart attacks over the years. The latest was a minor one in November, after which doctors implanted a tiny scaffold known as a stent to open an almost completely blocked artery.

In March, Cheney had an angioplasty to clear a clogged artery.

Asked about Cheney's life expectancy, Reiner said it is impossible to put a number on that, but he would judge it to be ``excellent.''

Such pacemakers can have a few odd effects for the average recipient, perhaps most notably an ability to set off metal detectors on occasion. That is not expected to be much of a problem for Cheney as long as he is vice president and traveling in his own security bubble.

Doctors said the possibility exists of interference with a cell phone, so patients are advised to use the phones on the ear opposite the implant. Cheney's device was implanted under his left collarbone.

It was detection of an abnormally fast heartbeat that prompted doctors to recommend the implant. The vice president had worn a heart monitor for 34 hours about two weeks ago and four brief episodes fast heartbeats were detected.

Heart disease is the No. 1 killer, claiming the lives of more than 900,000 Americans a year and accounting for 40 percent of deaths. Treatment advances have contributed to a 20 percent decline in death rates over the past decade.

Before the procedure, Cheney called it ``my great good fortune that the technology has gotten so good that it's kept pace with my disease.''

Cheney said before the surgery that he would step down if he could not do the job properly, but felt confident his work would not be impaired.

For Bush, Cheney has been an indispensable adviser, easily overshadowing most vice presidents in the amount of influence he has exerted.

Bush put Cheney in charge of the abbreviated transition to power, of the White House's relations with Congress and of the development of a national energy policy, even while tapping his counsel on a broad array of domestic and national security matters.

Cheney's already heavy workload expanded further last month when Bush named him to lead an administration working group on terrorism. A report is expected in October.

Even so, Cheney plans to spend at least two weeks in August at his Jackson Hole, Wyo., home, where he likes to fish.
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