Need one or not?

Hello! I am looking for similar cases. My husband is 32. He currently has a biventricular pacemaker and a mechanical valve in the aeortic position. His cardiologist here in Pittsburgh says he needs a defibrillator because he has had several non sustaining episodes of ventricular tachycardia and by having the defibrillator if he would have one that put him into v-fib then it would shock him. The Cleveland Clinic is saying he does qualify for a defibrillator because his ejection fraction is above 40% and he only had one symptomatic episode of VT. He can be managed with the use of metoprolol which he is already taking and everytime his dosage is increased his blood pressure drops too low since it is already low. Any useful information would be appreciated. Thank you!

6 Comments

yes

by Tracey_E - 2010-01-08 06:01:41

If he's at risk of going into vfib then an icd is an excellent idea. Vfib can kill you in the time it takes to figure out what it is and get to an external defibrillator.

Have they considered switching from metoprolol to something else? I did not do well at all on metoprolol. I was switched to atenolol three weeks ago and am doing much better. My bp seems is steady and I'm not getting all the other awful side effects. His case is different than mine,but it can't hurt to ask.

Sorry!!!

by donb - 2010-01-08 07:01:55

I am really sorry to hear the full story of your husbands heart condition. I'm in real shock after reading your post above as I didn't have all the info on your other posting. I just read the above posting to my stepson and he said any opinion always has to come in three's. Maybe he's not too far from right.

I almost lost my best friend this past year, quad bypass along with aortic valve replacement and he's doing real good, age 70. Hopefully you can get all the info from people on this site along with the help of the best in the medical field. donb

ICD is Probably a Good Idea

by pacemaker writer - 2010-01-09 01:01:24

Is Cleveland Clinic saying he does or does not qualify for a defibrillator? If he does qualify, I would urge you to seriously consider this.
Non-sustained ventricular tachycardia (NSVT) does not necessarily always degenerate into ventricular fibrillation, but since your cardiologist in Pittsburgh thinks it could, I think an ICD is a great idea.
NSVT can be a kind of deceptive condition in that the actual episodes are not that bad but sometimes they can "set the stage" for worse rhythm problems in the future.

Thanks!

by lisamblack - 2010-01-09 09:01:00

Thanks for all the comments! To answer a few questions: Cleveland Clinic is saying he does not qualify for a defibrillator since his ejection fraction is above 40%. His cardiologist in Pittsburgh is saying he should get a defibrillator because he could get an episode of vfib since he had vtachs. They have not considered any other medications. They have his blood pressure on the low side so his heart doesn't have to functionas hard so any increases in dosages makes him lightheaded and dizzy.

OK I see ...

by pacemaker writer - 2010-01-10 07:01:13

Cleveland Clinic is going by the official guidelines which are consensus documents about who should get an ICD. Even that document has lots of gray areas (there are people who should get an ICD, people who should not, and then those who "might benefit.")

This is a tough question especially since he has had one episode of VT! I wish I could help you but this is one of those questions you and your docs have to wrangle out.

Good luck with this. I still think an ICD is not a bad idea particularly since it will just monitor the heart most of the time (no side effects) ... but it does involve a surgery and it isn't inexpensive.

cleveland clinic?

by cc49 - 2010-02-14 02:02:27

hi, was wondering how & who decides who gets a icd? i am new to all these and i just received and icd on jan12th 2010

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