Ejection fraction going down with icd

I have had my icd since 2010 when my ejection fraction was at 13%, after the icd my ef went up to 39%.

Last September my ef had gone down to 31%, and after a rough winter, feeling so weak and tired my ef has gone done to 21%. I went to have my icd checked last week and they said they might as well remove the 2 leads and just leave the defibrillator because it isn't helping me anymore. 

What does that mean?

 

4 Comments

says who?

by Tracey_E - 2017-08-28 10:29:47

Is that comment from a technician/nurse or your doctor? Sounds kind of off the cuff and uninformed to me. Do you have ICD or CRT-D? How much do you pace? Checking the device has nothing to do with judging EF, that's done by echo. A regular pacemaker + ICD will only make the heart go faster, not beat more efficiently. If that's what you have and you are pacing, then you need those extra wires. If you have a CRT, then that is a second ventricular wire which forces the ventricles to stay in sync and can increase function. Sometimes it helps, sometimes it doesn't, but it could be that you'd be worse off without it which means taking it out is not a good choice. If you don't have CRT-D, then perhaps discuss it with your doctor, sometimes it'll help EF. Make a list of questions and have a chat with your doctor. 

ICD

by Ladybug1955 - 2017-08-28 10:44:01

This is what I was told at the arrhythmia clinic. I am being paced 100% , I originally was diagnosed with cardiomyopothy grade 4 end stage in 2010. Once they put in the icd things did improve from 13% to 39%. 

pacing

by Tracey_E - 2017-08-28 12:30:49

If you are pacing 100%, taking those leads out would not make a whole lot of sense. The question for your doctor is are you pacing with two or three leads. If it is two, ask about adding a third, tho given the jump you got when it was implanted it sounds like maybe you got a CRT (3 lead). Two leads only makes the heart beat faster, a 3rd can make it more efficient. 

Ejection Fraction

by The real Patch - 2017-08-28 13:42:52

This is a complex issue and difficult to address in a simple reply online, far too many variables and you haven't really given enough information. TraceyE is right on though, whoever told you that they might as well disconnect the two leads is not well versed in heart issues.

A defibrillator cannot help improve the Ejection Fraction, it only provides therapy for an erractic rhythm called fibrillation. Except the new subcutaneous defibrillators, all of the models include a fully functional pacemaker buit in.

Pacing the heart as close to 100% as possible can in some cases help improve the ejection fraction. There are also situations where the EF number may not improve but pacing is helping slow the heart's decline...switch that puppy off and things deteriorate rapidly.

TraceyE is talking about a specialized device that paces both ventricles in sync so that the beats forcing the blood out of the heart are more forceful. Again, no guarantees but in a situation like yours, it could be helping slow the breakdown.

just FYI I have a CRT-D and am paced 100% in both ventricles yet my EF is still declining, just not as fast as my heirs would like.

 

Get another opinion if they decide to shut down your device.

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