Getting a defibrillator

I have just been told I need to have a defibriallor implanted. I am 55 years old with long history of heart issues. At age 40 I had a heart attach and a quadruple bypass. Later as the bypass began to close I was given stents. My ejection fraction is down to 27%. That's why my cardioligest is suggesting the defib. I feel great. I walk 5 miles a day and lift moderate weights. I don't have any breathing problems or serious fatigue issues. I'm on Plavix, Lipitor, Altace, Coreg, and Imspra. Can my ejection fraction improve? Will I lead a normal life? I'm really pretty scared and may not need to be. In general, what are some suggestions or others experience? Thanks in advance for any comments

[caregiver222]

I would not be too scared of the defibrillator. It is simply a device that senses the electrical activity of the heart. Clearly your physician believes you might end up with a condition called ventricular fibrillation. In this case, the heart loses the ability to beat in a coordinated matter and quivers like a shaking bowl of jello. Fortunately, such a rhythym is easily converted to a normal rhythym by timely application of electro-countershock. That's the purpose of the defibrillor. If a defibrillator is not available, death is inevitable.

The propensity to go into fibrillation is something debated for hours and days. In general, the venticles can become irritable, and the threshold at which they can develop this condition is raised.

There are also random accidental electrical conditions that seem to occur quite naturally (R on T phenomena, for example) that, together with an iritable ventrical, can produce this condition.

Modern implantable defibrillators are a wonder. The technology has matured.

I don't know if your ejection fraction will improve. Ask your cardiologist if he would recommend magnesium glycinate supplements.

I would not be scared of having an implantable defibrillator, however. The procedure has low mortality and is relatively safe.

I would trust my physician.

[stevewya]

Thank you for your response. I do trust my physician and will follow his treatment. I am considering contacting the Cleveland Clinic though to get a more detailed examination and learn of other treatment options (if any) in addition to the defibrillator. Is it possible to live another 5 years with an ejection fraction this low (mine is 27%)? Thanks again

[kevk]

I have had four defibrillator`s for over seventeen years.  In my opinion it is the best thing in the world if you have a high chance of developing a serious arrhythmia.  I have been shocked a couple times and owe my life to my ICD.
The newer ICD`s have pacers also and in some cases they can pace you heart and improve your EF.  There are a lot of different kinds of ICD/Pacers your doctor can tell you which one is best for you. I also want to add I have friends who have lived longer than five years with EF`s lower than 27%. I think CCF is one of the best places to go, Good luck !

[stevewya]

Thanks for the comment. Seventeen years! That's great. Reading some of the stuff on the internet can be pretty scary. It seems like most studies predict about a 5 year mortality rate for those having an EF of less than 30. I guess I can just do what the dr. tells me (although I am going to try and go to Cleveland) and hope for the best. Thanks again.

[caregiver222]

You pose some interesting questions.

The problem traditionally has been that when cardiac muscle becomes necrotic (dies) due to lack of oxygen it was believed there was no way to cause it to re-grow.

One would think that ordinary growth hormone would do the trick, but it doesn't work.

Surprisingly, the specific growth hormone that stimulates building cardiac muscle has apparently been discovered, and there are tests in Germany trying to see if dead heart muscle can be regrown. They were inserting catheters into blood vessels and applying this polypeptide directly to the heart muscle.

There are similar experiments going on in Singapore, the world center for stem cell research.

So the future holds some interesting possibilities.

[Jo846]

My EF was 12%.  Had a stem cell procedure - 123 million stem cells were put into my heart muscle.  These cells came from my own stem cells - not embryonic.   One month later my EF was 25%.  I am due for another EF Test at the end of February.  Will let you know what the numbers are!

[stevewya]

Thanks for your reply's last week. I had an appointment today at the Cleveland Clinic. An amazing facility. I met with the Dr. for almost 2 hours. He explained everything in very understandable terms. The bottom line for me is that he doesn't want me to have a defibrillator YET. He doesn't believe medication, diet, and exercise has had enough time to see how my EF responds. He has increased my Coreg to 40 MG per day, and will take me to 80Mg in 2 weeks. He believes I can handle up to 160MG's daily by May. At that point he will revisit my condition and see how my EF is doing. I'm committed to working very hard to make it work. Strict diet and exercise for the next 3 months, lots of prayers, and new doses of medication. Maybe it will all work out. Thanks again to everyone for their input.

[kevk]

Hey that sounds good ! Wish you the best of luck.