Pacemaker and anaesthetic

Hi there,

Just wondered if anyone who is 100 per cent paced with chronotropic incompetence ( heart rate that doesn't rise on its own) has had an anaesthetic without any complications.

I get a bit concerned when I have been in hospital for tests which are normally carried out under general anaesthetic I get told that they will not give me a general and a local must be done instead.
The explanation that has been given to me is that the doctors would not know if I am being compromised by the anaesthetic as this would normally show up as a fast heart rate and as mine is totally paced they would be unable to tell. I would love to hear from others who have had procedures especially those who are totally dependent on their pacemakers.

Regards

Ann

5 Comments

What?

by golden_snitch - 2010-03-24 05:03:05

Hi Ann,

I'm have chronotopic incompetence and am paced almost 100% in the atriums as my sinus node has been completely ablated. I'm on anti-arrhythmic drugs, too, so my underlying escape rhythm is pretty slow. I have never ever heard that explanation from any doctor, and I have had several surgeries since I had the pacer implanted. Sounds strange. I really don't think this should be an argument for not doing a general anaesthetic. Is it always the same doctor or have you heard that argument from different doctors?

Best wishes
Inga

General anesthesia

by winelover - 2010-03-24 05:03:35

Hi Ann,
I am 100% dependent on my pm and had total hip replacement done last year under general anesthesia without any problem at all. It was never discussed with me if there could be a problem. My cardiologist and the orthopedic surgeon is at the same smaller hospital so maybe they discussed it.

Surgery

by Blueaustralia - 2010-03-24 06:03:14

I have had several surgeries in the last 6 years and I am paced 100%. Some time ago I was told I had an incompetent valve in the artery in my leg. It was correctable by surgery but the specialist blatantly said he would not touch me because I had a pacemaker. I haven't got to the bottom of that yet because other things in my life took over. However the sp did say I was welcome to go back to him anytime. I do intend to seek a second opinion. Maybe he was softening his stance. I am beginning to wonder if it is the surgeons who just make the choices because they are against operating on pm recipients.

Cheers from downunder

Billie

knowledge

by Tracey_E - 2010-03-24 08:03:19

Don't assume every dr is knowledgeable about pm's! Once you get outside the cardiologists and ep's, they know an appallingly small amount about them. Many of them had a short class on it years ago in med school and nothing since, and being outside their field they do not keep on top of it. This is why I've always been so adamant about understanding my condition and pm so well, so I can explain it to other specialists. When in doubt, tell the specialist to call your cardio/ep to ask if it's ok.

The way I understand it... they can do anesthesia on us, it just has to be done while the pm is monitored and in test mode so someone with a pm computer has to be there. This usually means surgi-centers are out of the question, hospitals only for us. I don't know why you would have had problems in the hospital, unless it's a hospital that does not have the ability to monitor a pm. Not all do.

Doesn't make sense

by ElectricFrank - 2010-03-25 02:03:37

In the modern OR there are multiple ways to monitor the progress anesthesia and HR isn't necessary. I guess the question is How do they do the cardiac surgeries where the heart is stopped and the patient put on an external pump?

Find another doctor. I wouldn't trust the one who is either incompetent or deliberately misleading you.

Having said all that are the tests all that unpleasant that you need general anesthesia? It's funny because my usual conflict is my asking to be awake. I am told the hazards of not having the general anesthesia. There is a good reason for their decisions. It is called physician convenience.

frank

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Member Quotes

It may be the first time we've felt a normal heart rhythm in a long time, so of course it seems too fast and too strong.