First EP visit

Kind of an open question

by AgentX86 - 2018-09-13 23:33:28

I assume you're being referred to this EP by your cardiologist.  What is the reason (specifically) that he gave you?  The only way anyone can even attempt to answer such a question is to have some clue about your condition or at least symptoms.

First EP visit

by Limejuicer - 2018-09-14 13:09:32

Thanks for replying and apologies for the open question. I am new to this and don’t know what I don’t know. For example, it never occurred to me that seat belts could be an issue.  Here are some specific questions:

1. In regard to managing PVCs, is one manufacturer better than another?
2. Are 10-year batteries just around the corner?
3. Does a right shoulder pacemaker pocket require longer wire leads and therefore shorten the lifespan of the battery?
4. Is it possible to recharge batteries through the skin?
5. I live in Boston, Mass. Anyone recommend an EP for a second opinion?
6. If I opt for a pacemaker, is it a lifelong decision?
7. Like the seat belt, are there other issues that affect ones daily life, or placement to be aware of?

PVCs

by DAVID H - 2018-09-14 19:26:17

Hi, Limer............ Lots to learn from this site.  I can address one thing: PVCs.  If you normally have a BP of, say, 120/80 with pulse of 75 ..........PVC's will usually indicate this: 120/80 pulse 45. Your pulse will actually still be 75, but every other "pulse" will likely be a weak PVC. Drugs are the first choice for control.

Questions

by AgentX86 - 2018-09-15 23:00:43

You need to ask your EP this stuff but I don't think a pacemaker is going to fix PVCs, if that's your only problem.

2. Ten year batteries are here, depending on how you're paced.  I'm 100% paced in two ventricle leads and the pacemaker tech told me yesterday that I have 8.7 years left (.7 years behind me). If it were a normal pacemaker, with <100% pacing, it would last well over 10 years.

3. No.  Longer leads shouldn't need more energy anyway.

4. No.  These are primary batteries (like the bunny batteries).  They cannot be recharged, even if you could get at them.  Rechargable batteries have a lot less capacity and are a lot less reliable.

5. I'm not in Boston, so can't help.  You might find the list of Medicare EPs.  Medicare keeps a list of doctors and the number of various procedures each performs each year.  Find someone who does a lot of what you need done.  Pacemaker implants aren't highly complicated procedures so "the best" isn't an absolute necessity.  If you have other problems, like an unusually difficult case of AFib, then you need the best but for just an implant, it's less important.

6. Probably.  Hearts rarely get better.  The reason you would get one today will probably be with you for the rest of your life.  Of course, there is always a chance that a miracle will happen and some genius figures out how to turn on stem cells, or some such, and regenerate the heart tissue you need, but don't count on it.

7. Sure.  You might have issues with bras, too.  At least that's what they tell me.  ;-)

You'll probably spend some time with a technician tuning up your pacemaker to improve your life.  Small tweaks can make a big difference, either way.  Sometimes you have to try a new setting for a while to see if it works for you.  Invest this time.  It's worth it.

You'll probably have an issue for a few months finding a comfortable position to sleep in.

Oh, and don't whack your pacemaker.  It'll hurt.  ;-)

If you had problems with cardiac rehab, I think you sould seriously consider the pacemaker.  The most common reason for pacemakers has nothign to do with living longer, rather living better.  A pacemaker will probably help.  That's the first and most important question I'd be asking your EP' "how is this going to make my life better".  "What are the odds of it making my life better?"

What you didn't ask--but should

by Gotrhythm - 2018-09-16 16:20:47

AgentX has done a great job of answering the questions you asked. But I'd like to address some of the questions you didn't ask--but should.

It appears that no recommendation of a pacemaker has actually been made yet. There are many, many heart rhythm problems. Some lead to needing a pacemaker. Some don't. So the first question to ask is (1) what exactly did the monitor test show? (2) What is the diagnosis?

A pacemaker doesn't actually do anything to cure the underlying condition. It just allows us to live with the underlying condition. (3) How would a pacemaker help me? What would the pacemaker do?

(4) Could medication control my condition? Will I need medication in addition to the pacemaker to control this condition?

(5) There are one-lead pacemakers, two-lead, and three-lead. You need to understand which kind is recommended and why. And that leads us to

(6) which really isn't a question for your doctors, but more a need to educate yourself about the heart's electrical system. There are many reliable-source Youtube videos for lay people that will help you get up to speed. Also, pacemakers depend upon all sorts of fancy algorrhythms, but are actually very simple devices. Again, Youtube is a great resourch.

It's great you are thinking ahead and preparing your questions. You will get a lot more respect from medical people, and possibly better treatment.

One final point. A pacemaker cannot be expected to help PVCs, and just having PVCs would not be a reason to get a pacemaker.

My First EP Visit

by Limejuicer - 2018-09-16 19:47:41

Thanks to all who responded. What a supportive community you are.

A good, short, book as a starting place

by AgentX86 - 2018-09-16 20:05:43

<https://www.amazon.com/What-Pacemaker-Cardiologists-Patients-Providers/dp/1481916602?keywords=what+is+a+pacemaker&qid=1537139015&sr=8-1&ref=mp_s_a_1_1>