back from the doc

  • by dibs
  • 2007-11-14 07:11:04
  • ICDs

Saw the rep from Medtronic and yes we have the infamous 6949 lead. We found ALOT today.
First John has Cardio Myopathy due to the 2 arteries 90% blocked, then the heart attack. They had hoped that his heart would improve with a medicine regemin but it didnt. His heart is quite compromised due to the damage done because of the heart attack. He is paced @ 100% with a Bi-V because of this.

He passed out last night -- first time in three months. But when the EP interrogated and we spoke with the doc, it had nothing to do with his heart. They moved some settings up and some settings down [impedement?] to assure John that the 6949 would not fowl up..........
well as best they could -- we were told that it was better to take a wait and see rather than to open him up and change it
Rep said that after 30 months time 97.2% of the leads were fine but that left 2.8% that fractured. And although that was not statistically significant, it certainly WOULD be to a patient who had a fractured lead !!

I am sure you all have hear the talk from the Medtronic rep by now or will soon. All the patients at the heart institute here in Shreveport LA were given the 6949 lead in the last two years.

One thing I didnt understand- John is paced at 100% but not dependent on the pace maker -- that doesnt make sense.
They said his heart rate is his own and not done by the pace maker. -- I dont get this !
They set the alarm on the ICD and you can barely hear it !!!!

We were told to move some of his meds in the hopes that we can get rid of the dizziness. They think its the meds or like you all said - low BP. IF this doesnt work they want to put him on a tilt table. FUN !!!!

They set him so that his BPM would have to go past 207 for 24 heartbeats before the Defib fires up or at least thinks about it
I feel much much better knowing more. I only hope that John learns to relax more. Of course, I am not the one with a tin box in my chest. So this is all very easy for me to say.

Please let me know if I am not understanding any of this !!!!!!

We are feeling better -- Well I am but John is still frightened. He will get better in time but it may take him longer because he is a WORRIER !!!!!
Physically John is good but Mentally I cant help him. I have tried to get him to look on the positive side but he can only worry. So at this point, I can only give him time and patience.



by kyle0816 - 2007-11-14 02:11:40

I actually went in for the same thing with for the lead recall. They set the ICD to check for a lower impedance level in the leads. Basically what this means is this.. If the lead starts to break at all the amount of electricity going through it will not be the same so when they change the settings to check for lower impedance they are basically making it so the ICD knows BEFORE the lead(s) totally break that there is a problem. You would then hear the alarm whenever it's set to go off. When the Dr. showed me what the alarm would sound like it was pretty loud to me, mine is also placed under my muscle so I think that would make it even harder to hear.
As for being paced 100% of the time and his heart rate being his own not by the pacer that doesn't make sense like you said. I'd call the Dr. back and ask them about that.
Do you know which model ICD John has? I know with mine the ICD will first try to pace the heart our of the dangerous rhythm using small shocks which you don't even feel. Only when that tactic failed (which apparently works 3 out of 4 times) it would give a shock. Maybe that would help him feel a bit more relaxed knowing he wouldn't necessarily get shocked if there was a dangerous rhythm. Again, it depends on the model you have though, I think the EnTrust and Virtuoso models both have that feature. Hope this helps!

type of device

by dibs - 2007-11-14 08:11:01

he has a concerto


by kyle0816 - 2007-11-14 09:11:09

I looked up the Concerto model on Medtronic's website. It looks like it has the feature I was talking about...

Offering an array of Medtronic-exclusive features to help improve the care of heart failure patients, the Concerto AT CRT-D device includes:
• ATP During Charging™: Automatically uses pacing pulses to painlessly stop fast, dangerous heartbeats, while concurrently preparing to deliver a shock if needed, with no delay. Anti-tachycardia pacing (ATP) has been clinically proven to eliminate three out of four shocks with painless pacing therapy.

And thanks for explaining the 100% pacing question PreviousDays.

100% paced - but not dependent DOES make sense with the Biventricular device.

by PreciousDays - 2007-11-14 09:11:40

How the Biventricular pacer "paces at 100%" without him being dependent on it works like this

Each time his heart beats, the pacer picks up on the beat, and tells the ventricles "it's time" causing them to compress (hopefully in a synchronized manner). Thus he is 100% paced. - if you look at his ekg - you will see a little "wiggle" at the edge of each beat - that's the pacer kicking in.

HOWEVER - the pacer doesn't set the speed his heart beats at - it allow his heart to do that - which is why he still likely has a fairly rapid heartbeat. (Mine runs about 90 - that's on meds, resting.) - if the heartbeat gets too fast 207 - for 24 beats in his case - then and only then - will the defibrillator kick in.

I wish you both the best in learning to cope with his device.



by travelingreids - 2007-12-01 10:12:06

Comment for dibs, has John's outlook improved in reference to being frightened and worried all the time? We are experiencing this with my dad who had a lead fracture in June 07 and was replaced. We then got the news in Oct about the recall - the one they replaced it with was the 6949. Not sure what he had that fractured. Dad is not taking any med for depression at the moment - he takes so many other meds, not sure we can add any more? My mom feels your pain.


by aparker - 2008-05-26 10:05:25

Hello. My EP is also located in Shreveport, Louisiana; however, I was not implanted with one of the defective leads. I wish you the best of luck.


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