Pacemakers and Defibrillators

Parent Cafe
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<p>I haven’t bothered to look online as I wanted some first or second hand information here first. I find that CC is more knowledgeable that searching on Google :)</p>

<p>My 81 year old father is going to have a pacemaker and defibrillator implanted soon. He is at the doctor now with my mom to talk about the surgery, but I am interested in what some of you make suggest as far as what to expect, symptoms to keep an eye out for, etc… He really didn’t want the defibrillator as he knew someone that had one and would yell out in pain when it was activated. The doctor did tell my dad last week that some people feel like they are getting shocked when it fires, so I am guessing not everyone feels it go off the same. We also don’t know if it might fire every so often or several times a day. I am sure many questions will be answered at the appointment today assuming my parents ask the right questions and their doctor gives them all the details.</p>

<p>I of course worry about my father having yet another surgery. He has lived much longer than anyone expected as his heart is is horrible shape. He has vascular issues as well as Diabetes and early onset Parkinson. Whenever he has surgery it bothers him that he ends up being on insulin for a while; currently he is on oral meds.</p>

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<p>Physician here. My 80+ yr old father got a pacemaker a few months ago. The surgery aspect is no big deal, maybe not even in the OR, under local… For safety’s sake will need to be NPO beforehand but being on oral diabetes meds and not taking them one day won’t hurt. He’ll get all kinds of rules for the first week/months so things can heal and not dislodge anything before being vigorous. </p>

<p>Definitely worth it for being able to do daily activites without triggering problems (no personal knowledge of the life with the defllibrator). Don’t worry- he’ll be in the hands of the physicians who can best handle any heart problems, and in the right facility/area for it. They (staff) are used to elderly patients and know what to tell them and do the follow up. There are teaching materials geared to the mindset of his age group.</p>

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<p>Having a pacemaker inserted is rather a minor, in hospital procedure, though the ICD (defibrillator) can be a bit longer of a procedure. It usually is not done with full anesthesia, rather a local and what is called conscious sedation-drugs to keep you sleepy, and not aware of what they are doing, but not fully unconscious. </p>

<p>The ICD fires when it senses a too fast, incompatible with life rhythm, to shock a heart back into normal rhythm, and yes, it is a most unpleasant experience that has been likened to being kicked by a mule in the chest. The point, is that it can save your life. However, may people with ICDs never feel a shock, but it is there should that lifesaving jolt be needed. The point is to hopefully be able to control the rhythm with drugs and several shocks a day would tend to warrant an ER visit, if not hospitalization to change medications and fine tune things. </p>

<p>People tend to get ICDs when like your dad, their heart is in bad shape, and there is a tendency toward fatal arrhythmias. You should also know that there is a pacemaker in the ICD, which will pace if needed, and may help them fine tune his medications.</p>

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<p>Snowball - first of all, as I am guessing you know, one device will be implanted that has both a pacemaker and defibrillator. </p>

<p>DH has had one for about 18 months, it was implanted after he went into VT due to damage that occurred at the time of his heart attack 15 years ago. The surgery is fairly simple, a little longer than when a pacemaker is implanted because they need to induce the arrhythmia to make sure the device kicks in when needed. </p>

<p>Since DH has had the device implanted, it has gone off three times, but in all cases, he knew it was warranted. He knew his heart was not functioning properly, and in one case got off his bike, and on the ground as he prayed the ICD would work. He would agree that it feels like a horse kicked you, or someone punched you, but there is no lingering sensation as there would be in those case. After the first time, he actually said he was less anxious, because he knew what to expect.</p>

<p>What is more troublesome, is that sometimes the device responds “inappropriately” and the shock is unwarranted. When that happens, I think that is what causes someone to become extremely anxious. There is no warning and suddenly they are shocked. Fortunately for my DH, that hasn’t happened. </p>

<p>There are times when the device works, but someone doesn’t feel anything. This is when the device senses the person’s heart is out of rhythm and I think the pacer part works to get the heart back on track - if that works and that is all that is needed, then the person is unaware that anything happened. IF the defib part is needed, I suspect everyone feels it!!! </p>

<p>The one medication that is often used with heart patients is amiodarone (sp?) and it is one that is not well tolerated by older patients. It is apparently one of the best meds for heart arrhythmia but if it is prescribed for your dad, watch for extreme nausea and just feeling really crappy. </p>

<p>I am certainly not a physician, but with four seniors with pacemakers and a DH who has been followed by a cardiologist for 15 years, I know more than I would like to know about defibs & pacemakers! Feel free to PM me.</p>