Teach me new tricks!

Hiya! So I’ve been in the pacer game for a few minutes and feel like I understand enough about how it all works.

Today we found out my dad is most likely going to need a defibrillator. In January he has his second open heart along with a mechanical mitral valve replacement. He was still having issues that mimicked a lot of mine and I mentioned I thought they should put him on a 30 day halter monitor. They did. It caught him in V-Tach at 300bpm.

Today they got him in with his cardio. He mentioned the defib and said it’s probably due to him having multiple surgeries and scar tissue. I have shown a bout of v-tach as well as a-fib over the last few months and said something. So now his doctor is talking about testing genetic markers between us. (My dad is 60, I am 32) i. We see his EP tomorrow to see what else they want to do and how soon. I suspect he will end up with emergency surgery for a defib, but I don’t know much about them but the basics. For those of you who have them would you answer a few questions? You guys will know better than the doctors because you live it. I know this first hand. 

How bad are the shocks? Do they take you all day or a few days to recover from them? Has anyone ever been shocked while driving? 

Do you follow up with your EP or does it require a hospital visit? He no longer has subclavian arteries due to the open hearts and how they had to run things so how the hell would they run the leads? (I know good question for the ep tomorrow) 

Has anyone ever had their device go nuts when it wasn’t suppose to? 

Any and all information would be greatly appreciated. We’ve been through the ringer lately and just want to get the man situated. 

Thanks in advance! 

3 Comments

My limited experience

by Jimmy Dinfla - 2018-04-24 12:31:44

Never had a shock.  Have had several abnormal readings and felt strange a few times at home. Mine has three types of shocks:  a pacing shock if the heart rate is too low, low voltage anti-tachycardia pacing shocks, and the high voltage strongest shock.  These are adjustable.

Follow up is done via a remote (home monitor) and six month follow-ups at the cardiologist's office.  They have an arrhythmia clinic and interrogate the device.  I see the implanting cardiologist once per year.  I also see my primary cardiologist once per year. Not the hospital. 

I have not had any problem with my ICD in the ten months that I have had it.

If an ICD is required, get one that is MRI compliant (device and leads) and has a home (remote) monitoring capability.

Wishing your father the best!

defibrillator

by The real Patch - 2018-04-24 13:49:13

You already know a lot having a pacemaker yourself. Most defibrillators (except subcutaneous which can only provide full voltage therapy and I think are pretty much useless) have all the same functions of your pacer plus. A defibrillator can provide two types of therapy for fast heart rates.

Tachycardia is in and of itself not particularly dangerous but runs the risk of causing the heart to go into fibrillation. Fibrillation is a situation where the heart is "beating" so fast it actally just quivers and does not have enough force to push blood out. Unconsciousness occurs within seconds resulting in Sudden Cardiac Arrest (SCA) which is fatal in 75 - 80% of the time without immediate intervention.

Anti-Tachycardia Pacing (ATP) is used for ventricular tachycardia (fast heart). How it works is to over drive the ventricle, or simply make it go even faster, and then stops, allowing the heart to beat on it's own and hopefully go back to a normal sinus rhythm. As a side note I've had ATP therapy frequently and it never works for me. Most people don't even know when ATP happens, and at most all he would feel is a rapid heart beat. It can be programmed to make several attempts to resolve V-Tach. It can then be programmed to either stop trying to resolve the arrhythmia or provide full therapy.

Defibrillation, the shock you hear about I fondly refer to as a Jesus Jolt because when it happens you shout Jesus and it's over. In my opinion, and I've enjoyed more than my share of Jesus Jolts, it's not really painful, just startles you. It's the duration of a heart beat and over. Much like a muscle spasm (or charlie horse) the heart aches for a short period and then the ache subsides, no big deal. You may or not be conscious when you receive therapy dependent on how your device is programmed and what is going on. Under some conditions there may be no advance warning before loss of conciousness. And no I don't see an EP or Cardiologist after therapy. That's what the defibrillator is designed to do so what could they possibly do? If you have 2 or more therapies within a 24 hour period then you do need to check in with the doctor to see if a setting or medication change is needed.

I have survived therapy while driving but don't recommend it. I was lucky but it could be a fatal situation. 

They can attach the leads on the outer surface of the heart

The days of defibrillators run wild are pretty much over now they understand them better and inappropriate shocks are rare

I hope I've addressed all of your questions. Good luck

Update:

by Vmurph - 2018-04-26 11:15:56

Quick Update: 

They are implanting an ICD in my dad on Tuesday. He said they use the subclavian vein and not the artery so that will be good. Hopefully all will go well and not have any complications as the man has had enough of them. 

They’ve ordered me to go see a geneticists to get tested for long QT syndrome. If I test positive I wonder if they will want to replace my pacer with a ICD or a CRT-D? Has anyone ever been switched from one to the other before? I know a pacer is just a pacer but a Defib is a two trick pony. 

Anyway, Thats the scoop. I appreciate all of your input. It was all very informative and quite helpful! So, thank you. 

You know you're wired when...

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Member Quotes

I had a pacemaker when I was 11. I never once thought I wasn't a 'normal kid' nor was I ever treated differently because of it. I could do everything all my friends were doing; I just happened to have a battery attached to my heart to help it work.