Pacemaker not far away ?

I found this site a few days ago and have been reading a lot of the posts. Recently I have been having mild chest pain and had an abnormal nuclear stress test last week. I'm scheduled for a heart cath this coming week. The cardiologists said I probably will need to get a pacemaker before long. My resting rate is 45 to 49 bpm. It's been slow like this all my life without any symptoms or problems. All of this is terrifying to me! I don't know what to expect. I'm scared. I'm single and live alone to make matters even worse. I guess I'll have to hire a taxi to bring me home from the hospital because they told me I couldn't drive after the cath was done. I don't have anyone to talk to or discuss this with, so I hope this site will be a blessing for me. I sure could use some encouragement about now. Thanks for listening.

9 Comments

You're among friends here!

by Gonnie - 2008-11-22 11:11:39

This is a great place to come! You'll find folks who can address your fears, answer your questions and offer you much reassurance. I think we can all relate to the fear of the unknown you're probably facing right about now so don't be afraid to ask away! I got my pm/icd last July so I'm still learning too. Just wanted to welcome you!

Camaroman

by dloseke - 2008-11-23 01:11:15

Hi, I just recently had another heart Cath and they put it in through my wrist which is so much easier than the one that went in the groin. It was done in the morning and I went home in the afternoon. They found nothing this time but the first time it was a stent which really relived the pain.
I did not know what they were doing as I was out shortly after entering the room. You will be fine. Just try and relax and let the doctors do their thing. If the hospital has a good heart reputation you will be fine.
I do think that the doctors will do a lot of unnessary tests after you have had any sign of heart trouble. They do want to generate money and also cover their liabilities with tests. Take care.
Don

Risk

by ElectricFrank - 2008-11-23 01:11:25

I tend to disagree with Smitty on this one. Here is a current statement in one of the medical sites.

"The risk of a major complication during diagnostic cardiac catheterization is less than 1-2%."

A 1% risk means that for every 100 procedures there will be 1 major complication. Suppose there was a 1 in 100 risk of a poison in your next meal at a restaurant? Would you accept this as very low.

This doesn't negate the beneficial effect of the procedure WHEN IT IS NEEDED, but with this becoming a profit center for the heart specialty hospitals it tends to be more common than it should be.

The nuclear stress test is known for its high false positives. Chest pain can be caused by many non-cardiac problems. Heavy activities using the arms can cause the pectoral muscles and or ribs to be sore. I made the mistake once at a routine checkup to answer yes to the docs question about chest pain. Before I could even finish telling him that I had used a jack hammer in the yard he was out the door and back with a ECG machine. I literally had to yell STOP in his face, and then watched the $ signs fall from his eyes! (G)

So bottom line is have you checked out all the alternatives before going ahead. How abnormal was your stress test? Maybe consider a second opinion? What is your fear level and how much is it influencing your decision (if you even made it) to have the cath.

I understand this is difficult and I hesitate making it more difficult by raising all these issues. I would feel worse if I didn't and later found out you had experienced a heart attack or stroke due to an unnecessary cath.

best of luck,

frank

Pacemaker not far away ?

by SMITTY - 2008-11-23 02:11:51

Frank, before you or anyone else thinks I am a strong advocate for caths, or any invasive procedure I want to make it clear I am not. I was simply trying to tell Camaroman what to expect as he/she seemed to be more than a little disturbed over the prospect of having a cath.

However, I will pass on a little advice I got from a cardiologist once when I was protesting having another cath. While this cardiologist did not perform caths he had recommended that I have one which would have been about my 3rd one at the time. My wife, an employee of this doctor, was sitting there when I protested. Dr. Jay Welch very quietly said "Bob the decision is yours but you might want to think about this. You can have the cath and we can find out if you have more blockage (I had already undergone a quadruple bypass a few years before) that is causing your chest pain and the abnormal results on your stress test; or we can wait and see if you have a M.I. (heart attack) and I'll have some blood tests run to check an enzyme level to see if you have had heart muscle damage. The level of the enzymes will give us an estimate of how much damage you may have; or you can just wait and we can get the complete picture from the autopsy reports."

I never said a word in reply as my wife spoke up and said, "Jay, when do you want him to have the cath?" I had it the next morning and got two arteries ballooned, this was in the mid 80s, before stents I guess. At least I don't recall hearing of them that far back.

So, like I was told, the decision is yours, but if you refuse, the consequences may not be to you or your family's liking.

Smitty

Asking questions......

by Bionic Beat - 2008-11-23 05:11:13

Asking questions can/might alleviate some of your fears.

It sounds as if you've not been told too much about why/options/etc.

Make a list of your concerns, questions etc and take it with you to get answers from the doctor.......take all the time YOU need to understand what's going on with your heart and why they are looking at a pacemaker.

If you're not pleased with the answers, time allowing, you might want another opinion......but only if it's not a pressing matter.

(I say that because it takes a long time to get an appointment with the very busy cardiologists/EP guys in Canada)

I know that my fears about medical issues is usually resolved by finding out EXACTLY what's going to happen and why.

The doctor owes you a complete and thorough explanation and please don't be shy about telling them that you're frightened. They can address that at the same appointment.....sometimes there IS a reason to be concerned but not frightened.....but sometimes it's not as bad as we imagine.

My pacemaker implant was easier than I had imagined...same with my AV Node ablation.

Good luck, best wishes with your next appointment/ phone call.


Bionic Beat

hi

by alice G - 2008-11-23 05:11:31

i know its the most scariest thing in the world when you have no back up . i live alone too i do have good friends and family but you cant explain or expect them to understand if they have never gone through it and iam very independant and hate to rely on people but there does come a time when you have to .my advice to you such as it is is never stop asking questions even if you think there silly . i found out the hard way that to the hospital this is a everyday thing but to someone who is needing things done it is a life changing decision and no matter how many times you ask or how silly it is ask,and keep asking until you are sure please get all your options go on the internet read as much as you can so you can go to them and have some idea of what they are talking about . good luck and you will never find finer friends and chat buddies as on here someone is always here and they will support you on your low days and share your good days with you too i have never laughed so much and had such good advice as here

Smitty

by ElectricFrank - 2008-11-23 11:11:19

Smitty,
With your history of heart problems that you have posted I would tend to thing that a cath would be a very good idea. That is the kind of situations they are intended for.
The point I was trying to make is that they are not something to be taken lightly. They carry their own risk so it isn't an open and shut case.

To add to your statement"
"So, like I was told, the decision is yours, but if you refuse, the consequences may not be to you or your family's liking. " the doctor should also add that if you agree the consequences may also be something not you or your family's liking. How would you have felt if the cath had resulted in a stroke, but showed clear arteries?

All I want is an honest assessment of the risks of either decision without the fear element thrown it. In my case 10 years ago I was told the same thing with the added prediction that I had a 50% chance of having a heart attack within the next year. I looked the doctor straight in the eye and told him I did not want the procedure and that I understood his concern.
If I had experienced a heart attack (and lived through it) I would still accept that it was responsibility.

frank

Cath & PM

by SMITTY - 2008-11-23 12:11:30

Hello,

A cath will tell if your heart has any blocked arteries that may require a stent, or worse bypass surgery. Of course, the bypass surgery you don't want as that will put you out of commission for several days, but the cath and a stent, if needed, is no big deal, except for someone in your situation. Either one will slow you down for a couple of days, but I've had 16 or 17 (I've lost court) caths since '82. My last one was in April of '08 and it is amazing how much things have improved in the last 25 years. I was kept in the hospital overnight and they wouldn't let me drive home, but truthfully, I felt fine. I did favor the cath insertion site for a couple of days, not because it hurt but because I did not want to take an chance on causing it to start bleeding.

I don't know if it has been implied that they may be able to determine how badly you need a pacemaker from the cath, or not, but I will be most surprised if it sheds any light on that subject. You say you have a heart rate in the upper 40s with no symptoms that usually go with a low heart rate. Based on that I say make them give you some very good reasons why you should have a pacemaker right now. I got one for the same reason because I didn't know any better and while I did need one some 5 or 6 years later, I often wished I had not gotten the thing when I did. I've had mine 8 years now, and have really needed one 2 of those years, but then I'll soon be 80 yrs, old and I'm learning there are lots ways my tired old body could use some help.

But to try to give you some comfort, a cath is no more than just a pain in the butt. The procedure itself is not as bad as having a tooth pulled. It does take a little longer than pulling a tooth (mine have usually been 30 to 45 min in duration) and if they slip in a stent while they have the cath in place, you will not notice it at all. I guess the worst part is the anxiety of the procedure because you know they have placed a foreign object in your heart for a few minutes. If you are lucky you will be able to watch what they are doing on the monitor, but if you are like me you will not know what is going on. The absolute worst part of the entire thing is having to keep your leg as still as possible for a few hours after they remove the cath from the femoral artery. On my first one I had to lie flat of my back for 24 hours with a 10 lbs. bag of sand on the area where they inserted the cath. On the last one I had to lie still for 4 hours and they used some type pressurized device to keep pressure on the insertion spot.

So relax and leave the driving to them and things will be fine before you know it.

I wish you the best and please let us know how things go.

Smitty

Good way to put it

by ElectricFrank - 2008-11-24 11:11:09

Cabg_Patch, I like the way you put it. You are saying about the same thing I was trying to get across, but in a nicer way. We need to respect what we know as well as what the doctor says.

Smitty and I have earned our "Old Fart Status". Let us have our fun.

best,

frank

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