Pregnancy/giving birth with an ICD/pacemaker

Hi! Soooo...my husband and I were trying for a baby before my unexpected cardiac arrest in December 2018. It has been 5 months (today) since my SCA (4.5 months since my ICD/pacemaker implant). My diagnosis was: Arrhythmogenic Mitral Valve Prolapse. I know this is a personal question, but do you think it's too soon to start trying for a baby again? I'm pretty stable emotionally, I think my ideal beta blocker dosage has been figured out (I'm on 5mg of bisoprolol - which is supposed to be pretty safe during pregnancy), and I haven't experienced any shocks since January.

Also, just thinking ahead about things... I've read that they will need to put a magnet over my ICD when I give birth (whether it's a natural birth or c-section). Does anyone know anything about this? Anything else I should know?

Thanks!!


6 Comments

Pregnancy

by AgentX86 - 2019-05-13 15:55:06

I'm too old (as if that's the only reason ;-) and haven't given this much thought but this is a perfect question for both your EP and OB/GYN. Both really need to get on the program to have the best outcome. That said, accidents do happen.

The old magnet on the PM trick just sets the pacemaker to "open loop" mode with default settings, so when things get exciting,  your ICD doesn't start thinking for itself.

pregnancy

by ROBO Pop - 2019-05-13 20:02:53

Two guys giving you advice on pregnancy...when will men stay out of womens reproductive rights?

Look if your husband and doctors are okay with you getting pregnant, who am I to object?

5mg of Bisoprolol is nothing. Should have no effect. Your biggest risk is the valve, did the repair or replace it? If not I would consider getting that changed first. When your Mitral goes south all kinds of entertaining issues arise which may contraindicate giving birth.

We have a lot of lady members including the infamous Hall Monitor, TraceyE who've given birth. Hopefully a knowlegable one will step in here and help.

Good luck whatever you decide

Thanks guys!

by lildanishgirl - 2019-05-13 20:32:06

Thanks guys!

I have "mild" Mitral Valve Prolapse. My EP says it could be years before I'd need to start worrying about repairing it/replacing it (knock on wood!)

I did speak quickly with an EP who specializes in pregnancies. She said that the bisoprolol I'm taking shouldn't be a problem. I guess I'm the most worried about pregnancy being hard on my heart and triggering my ICD/pacemaker.

devices while pregnant

by Tracey_E - 2019-05-14 10:40:25

Love how the boys jumped in on this one :o)

I have a pacer, not an icd, but I had two perfectly normal pregnancies and deliveries. First thing to do is have the EP talk to your OB. OB's tend to flip out because they can go a career and not have a patient like us. Mine was a lot more chill after his call with my EP who told him treat me like all his other healthy pregnant patients.

The biggest question has already been answered, your meds are stable and ok while pregnant. Ask them if the added stress of a pregnancy will be hard on the valve. Ask them about exertion. I was given permission to work out, which I did right up until I delivered, so in my case they weren't worried about stressing the heart. Pregnancy is more of a small stress all the time rather than a big stress all at once, if that makes sense. It's hard on the heart, yes, but it's because it's working harder for 9 months. That's not likely to trigger the icd. 

They would do the magnet thing for surgery but probably not for a vaginal birth. If you are pacing, you'll need your heart rate to keep up. If you should end up needing the ICD to fire, you want it to fire, that's what it's there for. You'll want to discuss this with both EP and OB, whether they'd want to change the settings temporarily. For me, my EP told the OB no restrictions as far as he was concerned other than he wanted me on a heart monitor during labor and if my heart showed any signs of stress or it got too drawn out, then it would be a c-section. They even let me deliver in the birthing suites instead of the main hospital. Be prepared for lots of heads to pop in the door, they don't see many pacing spikes on the monitors on the labor and delivery floors!

I did my own research, had long conversations with my doctors as well as a friend who's an anesthesiologist, and chose not to do an epidural. They can slow labor and drop blood pressure. My bp is always low so I was concerned it might get too low, I was afraid of things getting too slow and ending up with a c-section, and also I have a history of reactions to medications. I couldn't think of a worse time to find a new one I'm allergic to so I chose to not take anything. I've talked to other paced women who did the opposite, they had the epidural because it's easier on the heart and the mother is less stressed. We are all different, so discuss the pros/cons with your team and decide what's right for you. 

We are a little bit higher maintenance than women without a heart history, but there are quite a few of us out here with devices who have had babies without complications. Good luck to you! If you have questions or ever just want to chat with someone who's been there, I'm always around. 

Thank you Tracey_E!

by lildanishgirl - 2019-05-15 14:04:27

Thank you very much, Tracey! Lots of great information. I'm going to book some appointments with my doctor pre-pregnancy so I know a bit more about what to expect and so we're all on the same page! I'll be sure to reach out to your privately if I have any further questions! Thanks again!

Come on Tracy...

by AgentX86 - 2019-05-15 21:06:13

...we were just the clowns entertaining the crowd until the star finally came out of her dressing room. ;-)

You know you're wired when...

Your life has spark.

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