Pacemaker CPR?

I have asked several professionals the following questions but have never been told a direct answer.

If I fall and am not breathing will the performance of CPR injure me worse if I have a pacemaker? I know CPR is performed lower than the heart and implant area but how will CPR start the heart if a pacer is inserted? Will CPR affect the pacer and patient?

If the pacemaker stops will CPR actually start the heart back up long enough to get to the hospital to change the pacer battery or replace the pacemaker? I'm using the example of attendants/security rushing you through the metal detector before allowing you time to explain you have a pacer, should something happen. 

Can the IED (?)  be used on a patient with a pacemaker or does my daughter just call 911 and hope they make it on time? How is this related?

 

 


10 Comments

CPR

by Grateful Heart - 2018-10-01 16:04:42

Pacemaker or no pacemaker....CPR would be performed if your heart stopped.  An AED would be used if available.  They would check and worry about the pacemaker later...life saving measures would take first place.  CPR class.

Going through a metal detector will not stop your heart.  If you find yourself in that situation, just keep walking through and away from the detector...don't linger near it.  I found myself standing on a line under a doorway with a metal detector.  I didn't realize it was there until I felt a vibration in my chest and then I walked quickly away and had to explain to the police officer why I jumped out of place.  I then got escorted to the front of the line.  :)

Try not to worry.  

Grateful Heart

CPR

by Tracey_E - 2018-10-01 16:04:50

If you need CPR or AED, it's the same on us as anyone else. They covered this when I did my last first aid class, just make sure the AED pads aren't directly over the device. CPR compressoins get the heart pumping, trying to circulate the blood until the heart beats on its own again. The pacer sends the signal to beat, the heart responds by contracting so if we need CPR that means the heart isn't responding to the signal. The pacer will continue to send the signal until it's turned off. 

If you need CPR, that means your heart has stopped and you are dead, there is nothing to lose. 

At the very worst, metal detectors will put it in test mode until you get away from it. But usually they don't do anything. I used to avoid them but since I got my newest pacer they said it's fine to walk through.

We have a lot of warning and two low battery modes, each of which lasts 3 months, so the pacer is not going to simply run out of battery and stop. 

what if's

by ROBO Pop - 2018-10-01 17:11:56

I don't know who the professionals you spoke to were, or what they were professional at but they're pretty dumb. My manual that every manufacturer provides with aeach device answers these questipons.

Unless you are pacemaker dependent, if for any reason your pacemaker did stop your heart will beat on it's own. Having one does not affect CPR.

Walking through a scanner (airport, courthouse, shopping) will not affect your device. They are not strong enough to activate the switch which would allow changes in operation. 

As for whether an AED would damage your pacemaker why would you care if it saved your life? But no, it won't damage your device. 

 

 

Class Last Saturday

by John W in SC - 2018-10-01 19:08:14

I took a CPR/AED class this past Saturday.  These topics were covered in the class as well as in the AHA student handbook, as was what to do if we discover a medical patch or other implanted device.

Bottom line is, CPR as usual.  For an AED don't put the pads over a device, and remove any medical patches if they are in the way. (Some have foil in them.)  If necessary (for example pacer on the right), reverse the positions of the pads.  Its even possoble to put the pads on the front and back, as is done with small people.

People worry about breaking a rib or other damage from giving chest compressions.  The chance is slight, but even if it happens it beats the heart stopping!

I suspect anyone who has taken this training will get similar information.  Its nice for me to know as a potential patient, but its more important for the person helping me to know it.

John W in SC 

CPR Response/PM Adjustments

by GoGranny - 2018-10-01 19:17:01

Thank you both, Grateful Heart and Robo Pop for the response.

First, IED (AED); thanks also for the correction. My daughter corrected me on this. :)

Second, thanks for the reassurance with the metal detectors. I have avoided them since my surgery (My daughter speaks up before I get near one)  Recently, I was at a ball game and waited almost 2 hours for a wheelchair. Being 91 degrees outside I needed to sit down and they said I could go inside the gate where there was some shade. While waiting for an attendentant to let me in a side gate the security rushed me through the detector side.

The next 3 days I was exhausted (like I was before my surgery of the PM) so my daughter immediately made an appointment.  I was always between 40% and 50% pacing since my 2014 surgery. Surprisingly and scaring me, after having gone through the detector and testing the same week my results had me pacing up to 99% percent. For years I had been the same. My last testing was at 50% this year in April 2018 so to have it jump that much concerned me.

It was just too strange- not only my energy level was down but the results led me to believe it was the metal detector. I questioned the tech and the doctor and they said I was fine. Truth is I'm more tired than before (I haven't had any changes in exercise,diet, or other.)

The staff at the surgery told me I have an older pacer so I wasn't sure if older ones are supposed to stay away from magnets. Both doctors told me to stay away from detectors.

I am going back to the doctor I had before, I think, because she was able to "adjust" (?) it for me. This new tech didn't even know what I was asking about when I asked if it could be adjusted. She said " It can't be adjusted" You just need it more now. Now that I read these forums there are people talking about the adjustments. Surely a tech should know about this. Any opinions on this?

Again thanks so much for your quick responses. I value what you say.  

CPR response 2

by GoGranny - 2018-10-01 19:29:43

Thank you Tracey and John.

My daughter took an AED class but long before I had a pacer. She made me take CPR with her.  She says " Thanks for reminding her about the positions of the AED pads. She forgot some of her training"

All your information was helpful. My pacer is on my left side. Some people have them on the right, correct?

.

Robo Pop

by AgentX86 - 2018-10-01 22:35:38

"Walking through a scanner (airport, courthouse, shopping) will not affect your device. They are not strong enough to activate the switch which would allow changes in operation. "

The first sentence above isn't true, even though the second may be. There are two completely separate issues of pacemaker interference.  One is activating the magnetic MRI "default" switch. This requires a strong constant (non-varying) magnetic field. The other is confusing the pacemaker with external signals (that may look like the millivolt signals coming from the heart).  A scanner isn't going to trip a mechanical reed switch but it certainly can interfere with the operation of a pacemaker. It's recommended that those with pacemakers not go through magnetic scanners, more so for those dependent on their pacemakers becuase they don't have a plan-B.

metal detector

by dwelch - 2018-10-01 22:49:33

Well before 9/11 I was not worried about metal detectors and would go through them from time to time.  If/when you set off the detector you tell them.  It wont hurt you, cant see how it could have that strong of a field to flip the relay.  Nor should the pacer be confused as it doesnt speak pacemaker protocol, nor should it be in that frequency.

 

Now post 9/11 the TSA is not amused by us going through willy nilly.  It may just slow them down if you mess around.  I did buy a TSA hide and seek t-shirt at one point, but never used it.  Not sure if I still have it...

 

You either need to hug a transformer or a generator to be within a field of concern and that will (simply) confuse the device and you can move out of the field.  Or need a magnet on/close to the device.  The magnets that came with the phone testers are almost hockey puck sized.  This will put the device in a battery test mode, your rate determines the battery status.  I believe this is in the 60BPM at least.  it wont turn off the device. 

As far as CPR goes, I think thats covered, if you need it its a last ditch effort, so there isnt much worse they can do.

 

You're very confused about pacemaker interference

by AgentX86 - 2018-10-01 23:29:42

Again, there are two, completely separate, issues with two completely different mechanisims.  One is the MRI reed switch (or "relay", as you call it).  It requires a fairly strong *DC* magnetic field to activate this switch.  This comes from things like permanent magnets or DC magnetic fields (some welders).  Tripping this sensor isn't normally a problem because it will just put the pacemaker into its "default" mode.  You might feel it but it's unlikely to do any harm.

The bigger issue is electro-magnetic interference from AC electrical sources.  Recent pacemakers have been fairly well hardened against electrical fields (so the transmitter in cell phones isn't likely to cause any harm) but there is nothing that can be done for magnetic fields. It takes a lot of specialized metal (called Mu Metal) to shield magnetic fields.  They will penetrate the sheilds on the leads and induce a current in them.  The big problems are from large motors, transformers, and welders, where there is a very high alternating magnetic field.  Magnetometers are in this class of interference sources, too.  As I said, this magnetic field induces a current in the pacemaker's leads and can confuse the pacemaker.  This isn't something to ignore.  It is real. Ignore your EP at your peril.

Unipolar Lead

by Grateful Heart - 2018-10-01 23:35:05

I have a CRT-D.  One of my leads is unipolar.  

A unipolar lead returns the pulse to the generator via tissue and body fluids making it much more sensitive than bipolar leads.

Grateful Heart

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