ICD (implantable cardioverter-defibrillator)
Discussion
Hi I haven't got any experience that can help you but my late Father had 2 of these.
Forgive any layman terms as this is all 2nd hand & over 10 years ago.
He had cardio fibrillation & had several heart attacks over a period of 20 years. I think he had a triple bypass as well.
He was a strong stubborn man! As I'm sure you know, your 1st heart attack is normally the only one you get...
He did get down at one point to just over 10% heart function. Sub 10% is normally fatal.
He had them fitted at Papworth which has BRILLIANT staff in the crappest set of buildings.
He had the 2nd fitted when the 1st batteries were due for replacement.
iirc they used to have basically 3 settings which were monitor & record an irregular heart pattern, give a slight pulse to aid cardio function, & the full monty shock which you don't really want.
My father was on the receiving end of all 3 settings. He didn't like the full monty at all. The device could also be programmed to give a 10 second warning that it was about to shock you. He didn't ask for that option...
My father did get a slight infection from the wires both times - they couldn't re-use the wires - but nothing major. The infection travels very easily along the wires.
If you need them fitted, you need them fitted. The operations were relatively ok. He didn't stay in Papworth long either time.
However the defibrillators saved my Fathers bacon on several occasions & my opinion would be that it gave him probably an extra 15 years of life.
That is the thing you need to think about. You need it fitted because without it, your family may be facing life without you.
Forgive any layman terms as this is all 2nd hand & over 10 years ago.
He had cardio fibrillation & had several heart attacks over a period of 20 years. I think he had a triple bypass as well.
He was a strong stubborn man! As I'm sure you know, your 1st heart attack is normally the only one you get...
He did get down at one point to just over 10% heart function. Sub 10% is normally fatal.
He had them fitted at Papworth which has BRILLIANT staff in the crappest set of buildings.
He had the 2nd fitted when the 1st batteries were due for replacement.
iirc they used to have basically 3 settings which were monitor & record an irregular heart pattern, give a slight pulse to aid cardio function, & the full monty shock which you don't really want.
My father was on the receiving end of all 3 settings. He didn't like the full monty at all. The device could also be programmed to give a 10 second warning that it was about to shock you. He didn't ask for that option...
My father did get a slight infection from the wires both times - they couldn't re-use the wires - but nothing major. The infection travels very easily along the wires.
If you need them fitted, you need them fitted. The operations were relatively ok. He didn't stay in Papworth long either time.
However the defibrillators saved my Fathers bacon on several occasions & my opinion would be that it gave him probably an extra 15 years of life.
That is the thing you need to think about. You need it fitted because without it, your family may be facing life without you.
Edited by dirty doug on Monday 18th April 07:30
No problem.
It is very easy to be on the outside & say have it done as I'm not the one going under the knife.
However, forgive the slightly joking description that my Father used, but seeing as you are probably already a paid up member of the 'zip club' you have very little to fear from this further operation & a great deal to gain.
Your heart will be aided EXACTLY when you need it the most. My father had an episode when he was fishing late at night on the far side of a lake that few people went to. Without this device, he would have been the bait...
He probably had the full monty shock about 3 times before his death.
Yes he described it as the nastiest experience of his life ever. Seeing as he was shot at, at fairly close range during his national service, crap shot luckily, & survived an air crash in a light aircraft as well, that kind of tells us it's not nice in any way.
Sometimes in life, you have to do what you know is right even if 99.9% of your brain is screaming the opposite.
It's a personal decision of course, but I would say your cardiologist is making the correct call for you.
It is very easy to be on the outside & say have it done as I'm not the one going under the knife.
However, forgive the slightly joking description that my Father used, but seeing as you are probably already a paid up member of the 'zip club' you have very little to fear from this further operation & a great deal to gain.
Your heart will be aided EXACTLY when you need it the most. My father had an episode when he was fishing late at night on the far side of a lake that few people went to. Without this device, he would have been the bait...
He probably had the full monty shock about 3 times before his death.
Yes he described it as the nastiest experience of his life ever. Seeing as he was shot at, at fairly close range during his national service, crap shot luckily, & survived an air crash in a light aircraft as well, that kind of tells us it's not nice in any way.
Sometimes in life, you have to do what you know is right even if 99.9% of your brain is screaming the opposite.
It's a personal decision of course, but I would say your cardiologist is making the correct call for you.
My father was due to have one of these fitted just before he died. He'd been in to have it fitted once, but they struggled during the operation due to excessive bleeding (he was on warfarin due to having an artificial valve fitted many years before). A week before the operation he collapsed and died from cardiac arrest and we can't help but think that the ICD would have saved his life.
He'd done a lot of research into it, and was excited about getting the device fitted. The "full monty" as described above sounds scary, but if it saves your life then it's got to be worth it.
Good luck!
He'd done a lot of research into it, and was excited about getting the device fitted. The "full monty" as described above sounds scary, but if it saves your life then it's got to be worth it.
Good luck!
I don't believe a cardiologist would ever suggest one if they thought you were likely to live very long without one... it's not a 'you might want to think about a hearing aid' deal, it's a 'consider travelling with a friend and your own AED as an alternative' deal.
As with all heart stuff you can drive once stable enough, the sensible looking Cardiac Risk in the Young page about ICD says 6 months post op, and the British Heart Foundation have a page all about driving too, a quick Google yielded that one.
Read a thing once that said it firing was a lot like being kicked square in the chest by a stallion, and an infinitely preferable option to carking it then and there, which is generally the alternative.
Airports - you'll have metal in you, you get to go through the special line and get wanded not scanned, it might slow you down or speed you up going through security occasionally but not by much. You might find you need a fit to fly letter, but then you may need one already!
Best of luck. Keep on tickin'.
As with all heart stuff you can drive once stable enough, the sensible looking Cardiac Risk in the Young page about ICD says 6 months post op, and the British Heart Foundation have a page all about driving too, a quick Google yielded that one.
Read a thing once that said it firing was a lot like being kicked square in the chest by a stallion, and an infinitely preferable option to carking it then and there, which is generally the alternative.
Airports - you'll have metal in you, you get to go through the special line and get wanded not scanned, it might slow you down or speed you up going through security occasionally but not by much. You might find you need a fit to fly letter, but then you may need one already!
Best of luck. Keep on tickin'.
Smokehead said:
55palfers said:
I'll let you know how it all goes.
Thanks chaps.
Keep us posted. My doc mentioned getting one for me, but I'm a bit leery of it. All the best.Thanks chaps.
Seems op takes about 3 hours. They keep you awake but sedated and a jab of local anaesthetic.
Firstly, good luck with this. It sounds like you have a switched on Cardiologist who's identified you as running with a higher risk than most of benefiting from one of these little gadgets. I work for the world's biggest supplier of ICDs and Pacemakers in a clinical support role so spend most of my time in Hospitals supporting both implants and clinics for implantable device patients.
Most of your questions are answered pretty well in this document, produced by the device team at Southampton General Hospital:
http://www.uhs.nhs.uk/Media/Controlleddocuments/Pa...
It's likely your local centre will have something similar too. A lot of the answers will depend on your reasons for requiring the device. Driving restrictions are one of these (the DVLA have info online but I suspect based on what you've said you'll be OK to drive again 1 month after implant as long as all is settled), as is the likelihood of you receiving a shock. Three hours is about the longest time you'd expect the implant procedure to take, you may get a device with either one, two or three leads. What's best for will depend on your clinical history and current status i.e. do you have symptoms of heart failure despite being on optimised medications plus what do your ECG and Cardiac Ultrasound results look like. NICE has specific guideline as to what type of device would benefit you most and your Cardiologist will be well up to speed with this:
https://www.nice.org.uk/guidance/ta314/ifp/chapter...
Feel free to PM me if you have specific questions.
Most of your questions are answered pretty well in this document, produced by the device team at Southampton General Hospital:
http://www.uhs.nhs.uk/Media/Controlleddocuments/Pa...
It's likely your local centre will have something similar too. A lot of the answers will depend on your reasons for requiring the device. Driving restrictions are one of these (the DVLA have info online but I suspect based on what you've said you'll be OK to drive again 1 month after implant as long as all is settled), as is the likelihood of you receiving a shock. Three hours is about the longest time you'd expect the implant procedure to take, you may get a device with either one, two or three leads. What's best for will depend on your clinical history and current status i.e. do you have symptoms of heart failure despite being on optimised medications plus what do your ECG and Cardiac Ultrasound results look like. NICE has specific guideline as to what type of device would benefit you most and your Cardiologist will be well up to speed with this:
https://www.nice.org.uk/guidance/ta314/ifp/chapter...
Feel free to PM me if you have specific questions.
Edited by Deliveredenergy on Wednesday 20th April 10:24
Edited by Deliveredenergy on Wednesday 20th April 10:26
UPDATE.
Went for my pre-op yesterday at the Birmingham's splendid Queen Elizabeth hospital.
Was seen spot on the appointed time too.
Had the usual height, weight, BP, bloods, etc. with nurse, then session with specialist implantation nurse.
Went through very detailed reasons for needing the device, showed me some devices (bigger and heavier than I expected), explained what it feels like if it fires, what to do post firing and importance of attending for regular check-ups.
Explained what the op involves, post op recovery and do's and don'ts, no driving for a month! Made sure he knew I wanted the maximum amount of sedation!
No longer allowed to put my phone in a shirt pocket. Looks like I'll need one of those dodgy belt holsters or something. Please God, just not a man-bag!
He answered all my questions and to some extent put my mind at ease.
Will be having op on 14 June @ 07:30.
Went for my pre-op yesterday at the Birmingham's splendid Queen Elizabeth hospital.
Was seen spot on the appointed time too.
Had the usual height, weight, BP, bloods, etc. with nurse, then session with specialist implantation nurse.
Went through very detailed reasons for needing the device, showed me some devices (bigger and heavier than I expected), explained what it feels like if it fires, what to do post firing and importance of attending for regular check-ups.
Explained what the op involves, post op recovery and do's and don'ts, no driving for a month! Made sure he knew I wanted the maximum amount of sedation!
No longer allowed to put my phone in a shirt pocket. Looks like I'll need one of those dodgy belt holsters or something. Please God, just not a man-bag!
He answered all my questions and to some extent put my mind at ease.
Will be having op on 14 June @ 07:30.
Hi there LT
Well, I'm still here and have got used to the device.
It's a big old thing but it's part of me now and I hardly ever notice it. Just need to tuck the seat belt under my arm when a passenger as the belt comes right over the device. Don't want to risk anything getting damaged in the event of a bump and the belt tightening on it.
Op went well, had heavy sedation so I knew nothing about it until the Dr woke me up. Had 12 hours recovery in bed and a few tests then went home.
I get a 6 monthly check where they download the data in the device.
Thankfully, it hasn't fired yet!
Good luck.
Well, I'm still here and have got used to the device.
It's a big old thing but it's part of me now and I hardly ever notice it. Just need to tuck the seat belt under my arm when a passenger as the belt comes right over the device. Don't want to risk anything getting damaged in the event of a bump and the belt tightening on it.
Op went well, had heavy sedation so I knew nothing about it until the Dr woke me up. Had 12 hours recovery in bed and a few tests then went home.
I get a 6 monthly check where they download the data in the device.
Thankfully, it hasn't fired yet!
Good luck.
FlyingMeeces said:
gadgetmac said:
I had an ICD with Pacemaker implanted this week.
If you have any questions fire away.
I see what you did there. If you have any questions fire away.
How are you feeling?
Sitting there whilst they use a laptop and bluetooth (or whatever) to increase and decrease your heart rate is a bit surreal.
I had one fitted five years ago at 42.
It has saved my life five times now, twice only last April. I'm on some fairly toxic medication to calm my heart and stop it trying to kill me at a whim which is a bit of a quandry. My heart tries to kill me suddenly whilst the medication I take to stop it doing that is killing me slowly. Oh well.
I'm off for latest six monthly checkup on Monday, which I hate. Reason being they have to test the lead inegrity by increasing your heartrate via the ICD. This is just about bearable from the upper lead but is total and utter weirdness when they do it via the lower lead as your heart beats from the bottom up instead of top down.
As for being zapped, it really doesn't hurt that much. What is an issue is the aftermath and realisation a few seconds later of what happened and what would have happened if you didn't have the device. It causes me massive anxiety and takes at least a month for me to settle back into any kind of normality.
For one of my shock events the hospital ran through the telemetry of it on screen. Quite simply within two heartbeats the ICD went from trying to pace me out of a dodgy rhythm to forgetting all about that and charging itself to delviver a full fat 41 joule shock some nine seconds later. For those nine seconds I was in VF (Ventricula Fibrillation) and effectively dead. Suffice to say that didn't ease any of the anxiety.
I'll be interested to see find out how much battery is left on mine this coming Monday also. At implant the battery was showing 10.5 years and last April showing 7 years remaining despite zapping me five times.
And for a clarification of terms;
A heart attack is when your heart muscle is starved of Oxygen and apparently hurts like hell.
A cardiac arrest is when your heart simply stops doing its job. You normally go into VT (Ventricula Tachycardia) then VF (as above) and are very soon on the floor sparko and dead unless you are zapped. It is totally painless, very quick and is most certainly the way to go as and when the time comes.
A heart attack and a cardiac are completely different but a heart attack can go on, sometimes quickly, to cause a cardac arrest.
The best way to distinguish between the two is;
Heart attack = dodgy plumbing
Cardiac arrest = dodgy electrics
I can't believe I've previously missed this thread!
It has saved my life five times now, twice only last April. I'm on some fairly toxic medication to calm my heart and stop it trying to kill me at a whim which is a bit of a quandry. My heart tries to kill me suddenly whilst the medication I take to stop it doing that is killing me slowly. Oh well.
I'm off for latest six monthly checkup on Monday, which I hate. Reason being they have to test the lead inegrity by increasing your heartrate via the ICD. This is just about bearable from the upper lead but is total and utter weirdness when they do it via the lower lead as your heart beats from the bottom up instead of top down.
As for being zapped, it really doesn't hurt that much. What is an issue is the aftermath and realisation a few seconds later of what happened and what would have happened if you didn't have the device. It causes me massive anxiety and takes at least a month for me to settle back into any kind of normality.
For one of my shock events the hospital ran through the telemetry of it on screen. Quite simply within two heartbeats the ICD went from trying to pace me out of a dodgy rhythm to forgetting all about that and charging itself to delviver a full fat 41 joule shock some nine seconds later. For those nine seconds I was in VF (Ventricula Fibrillation) and effectively dead. Suffice to say that didn't ease any of the anxiety.
I'll be interested to see find out how much battery is left on mine this coming Monday also. At implant the battery was showing 10.5 years and last April showing 7 years remaining despite zapping me five times.
And for a clarification of terms;
A heart attack is when your heart muscle is starved of Oxygen and apparently hurts like hell.
A cardiac arrest is when your heart simply stops doing its job. You normally go into VT (Ventricula Tachycardia) then VF (as above) and are very soon on the floor sparko and dead unless you are zapped. It is totally painless, very quick and is most certainly the way to go as and when the time comes.
A heart attack and a cardiac are completely different but a heart attack can go on, sometimes quickly, to cause a cardac arrest.
The best way to distinguish between the two is;
Heart attack = dodgy plumbing
Cardiac arrest = dodgy electrics
I can't believe I've previously missed this thread!
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