It's well-known that cats are meant to have nine lives - but one patient has gone a step further and had 10 after technically dying nine times.
Over the course of 19 years, one high-risk patient has experienced 10 therapies that have helped save their life.
Hypertrophic cardiomyopathy (HCM) was once considered the most common cause of sudden death in young people.
However, over the course of the last 10 to 20 years, there has been a significant decrease in deaths because of the number of implantable cardioverter-defibrillators (ICDs) in vulnerable patients.
One person to benefit from this has shown the strength of the treatment, science.com reports, and has gone on to mesmerise scientists.
The patient in question is a 62-year-old retired schoolteacher and music enthusiast from Minnesota, US, and a patient at Tufts Medical Center.
In July 2003, at the age of 44, she was initially identified with obstructive HCM, but this was only after the diagnosis was confirmed in her son.
Before this, her two brothers had died suddenly of HCM a decade apart, at the age of 20 and 34 respectively.
Due to her high-risk status, she presented as the ideal candidate for a certain kind of treatment, known as primary prevention implantable cardioverter-defibrillator therapies terminating ventricular fibrillation.
The scientific report - aptly named 'Cats Have Nine Lives but This Hypertrophic Cardiomyopathy Patient Has Had Ten (So Far)' - says the patient "appeared to be an ideal candidate for primary prevention of sudden death based on the single powerful risk marker of HCM-related sudden death in 2 first-degree relatives".
After this, six other relatives of the patient were identified with HCM, including her dad, who died of end-stage at the age of 84, a son (39), daughter (41), grandson (eight) and niece (44), all of whom are currently survivors with ICDs which have not intervened.
In August 2003, an ICD was implanted in the patient in August 2003 and, over the following 19 years, her clinical course changed dramatically.
She has since experienced 10 appropriate ICD therapies at various intervals, each terminating rapid VF - otherwise known as ventricular tachycardia/fibrillation.
The first happened only 17 months after her implant and, the patient didn't perceive a shock in any of the 10 therapies, although five were associated with syncope, five events occurred during sleep and five while engaged in sedentary activities.
None of the device shocks were part of an ICD storm, and there have been just two generator changes, taken five and 14 years following the implant.
While she was previously asymptomatic, after her fifth ICD therapy at the age of 52, the patient developed progressive exertional dyspnea secondary to resting LV outflow obstruction, and four months later underwent septal myectomy, a type of open-heart procedure where the surgeon removes part of the thickened, overgrown septum between the ventricles.
This surgery permanently removed her heart failure symptoms to date and, miraculously, the patient is now in her sixties and continues to be asymptomatic.
On her remarkable situation, the report says: "This unique case presentation underscores the power and durability of the ICD for preserving life in patients with HCM.
"Indeed, in our patient, the ICD demonstrated consistent reliability over almost 2 decades. This history is particularly impressive given the unusual and unpredictable arrhythmogenic substrate characteristic of HCM and the absence of inappropriate device shocks or ICD-related complications throughout the implant period."
It goes on to add that although multiple ICD interventions have been reported in up to a third of high-risk patients with HCM, the vast majority usually experience only one to three appropriate therapies over time.
