Medtronic's TV ad goes straight for the heart.
The ad opens with an older but still blond woman kissing her graying husband; then she hugs a young woman, her daughter, it seems. A second later, she's smooching a fat-cheeked baby. The images seem to flow out of a silvery object pictured in the background.
"If you've had a heart attack or heart failure," the ad's narrator says, "inside this little device you just might find 10,000 more kisses, snow, 200 more football wins. This is an implantable cardiac defibrillator, a device that is always there for you, close to your heart, with the power to restart it in case of sudden cardiac arrest."
The narrator cautions that only a doctor knows if a defibrillator is for you and warns there are surgical and other risks. And in some instances the devices don't work as expected.
The ad is part of a $100 million Medtronic advertising and education campaign to raise awareness of sudden cardiac arrest -- and the Medtronic devices that treat the problem.
Sudden cardiac arrest occurs when the heart stops due to a problem with the organ's electrical system. Medtronic has a big stake in that problem. The company is the world's leading maker of implantable cardiac defibrillators. ICDs can restart hearts by giving them a jolt of electricity.
Defibrillators have been around since the 1980s. But Medtronic says hundreds of thousands of people who could benefit from ICDs do not have them.
Despite the potential for growth, ICD sales have been slumping. For years, sales grew by 15 percent to 20 percent a year. But last year, the number of devices sold fell about 3 percent. In Medtronic's most recent quarter, revenues from ICDs fell 2 percent overall -- 10 percent in the U.S.
Medtronic blames slack sales in part on bad publicity that defibrillators have received. In recent years, Medtronic and other manufacturers issued a series of recalls and safety alerts.
“I think you'll see lot more edgy campaigns as time goes on.”Biomedical marketing expert Tim Calkins
"Some of the bad publicity that surrounded these devices over the last year has affected people's desire to have them implanted, both from a physician's standpoint and also from a patient's standpoint," says Dr. David Steinhaus, medical director of cardiac rhythm disease management at Medtronic.
Steinhaus says defibrillators are not risk-free.
"There's risk from implantation. There's risk of infection," Steinhaus says. "The devices are not perfect. They're man-made, probably never will be perfect, no matter how hard we try."
But Steinhaus says defibrillators cut the death rate for people suffering sudden cardiac arrest from 95 percent to 2 percent.
Despite the adverse publicity, the medical community's confidence in implantable defibrillators remains high.
"The devices are more likely to help you than to harm you," says Dr. William Maisel, a Boston cardiologist and FDA consultant.
Maisel was the lead author of two reports last year on defibrillator reliability. As of 2004, Maisel says the devices were performing about as well as they ever have, with an overall malfunction rate of 1 percent to 2 percent.
"In fact, the chance of your defibrillator saving your life is 100 times greater than it not working when you need it," says Maisel.
Maisel says his confidence in debrillators was not shaken by widely publicized recalls in 2005. He notes that tens of thousands of devices may be recalled even if just a handful actually malfunction.
But Maisel says manufacturers need to do a better job of communicating with doctors and patients when the devices do have problems.
Dr. Robert Hauser, a cardiologist at the Minneapolis Heart Institute, agrees communication is important. In 2005, Hauser helped push Guidant into telling thousands of patients about an electrical defect in a Guidant defibrillator.
Hauser believes Medtronic is doing a lot of good with its campaign, raising awareness of a condition that kills nearly 1,000 people a day in the United States.
"Sudden cardiac arrest is not a well-understood condition," says Hauser. "Yet it affects a lot of people. And from a public awareness standpoint, I think the ad will help."
But some doctors are not pleased with Medtronic's direct-to-the consumer TV ad. "It's overly simplistic," says Lyle Swenson, a St. Paul cardiologist.
Swenson says a short TV ad is not a very good tool for educating people about defibrillators.
"It is a lifesaving therapy," says Swenson, "but it's not all a bed of roses. There's a short hospitalization. There is a certain low complication rate. There is a certain amount of monitoring that has to be done."
But more ads are likely.
Northwestern University biomedical marketing expert Tim Calkins says medical device makers are getting over their fear of offending doctors by advertising to consumers.
In 2005, medical device manufacturers spent only about $116 million on advertising.
But Calkins expects device manufacturers will advertise much more frequently and aggressively, following the lead of drug companies. Pharmaceutical firms spent $4.1 billion advertising their products in 2005.
"It makes enormous sense for a company like Medtronic to be proactive and try to aggressively shape its brand," says Calkins. "I think you'll see lot more edgy campaigns as time goes on."
During a year-long campaign, Medtronic will spend about $35 million on print, Web and TV advertising. To reach its target audience of people 50 years or older, Medtronic will run the ads on the History Channel, CNN, the Golf Channel and morning news programs.