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Ejection fraction and ICD implantation
I am 43 with a 20+ year history of A-fib and on my 4th pacemaker due to a very slow heart rate (documented pause of 9 seconds slow). More recently and no doubt related in some way, shape or form, I have cardiomyopathy with a recent ejection fraction of 25%. I have been very physically active throughout my life, eat good, have no blockage of any sort as proven by recent cath. I am symptomatic with more issues that I care to elaborate on. Wall thickening, enlarged chambers etc. With the highest dose of Coreg and Enalapril my cardiologist feels comfortable with I have had one echo that reads as high as 32%. Both of my cardiologists now want an ICD placement. Questions are: does the shock further damage the heart? What is prognosis with or without? At what point do I get on a donor list? (I am on the "watch list" meaning I have pre-registered and discussed the possibility but not really on the "list" yet. Can anyone else relate? What can you tell me for words of wisdom?
Hello Madlyn,
Thank you very much for your wonderful response. Your experience with your husband reminds me a lot of the relationship I have with my wonderful wife. I go in to see the electrophysiologist on Friday so I am guessing I will leave there with a surgery date. You did shed some light and perspective for certain on my questions. Appears your husband has the same type of symptoms that I experience (SOB, dizzy, passing out etc.)
Good luck you you, good luck to us :).
Take care,
Mike
Thank you very much for your wonderful response. Your experience with your husband reminds me a lot of the relationship I have with my wonderful wife. I go in to see the electrophysiologist on Friday so I am guessing I will leave there with a surgery date. You did shed some light and perspective for certain on my questions. Appears your husband has the same type of symptoms that I experience (SOB, dizzy, passing out etc.)
Good luck you you, good luck to us :).
Take care,
Mike
Read your question and will respond based on the knowledge I have acquired as a nurse (RN) for the past 34 years. Most recently I worked as a hospice nurse. I had 2 patients with ICD's. Doctors wanted them to have disconnected. Both were quick to respond "NO". Said they would die if "heart acted up"
In January, My husband was told he had 30% EF. His heart rate was mostly between 30-50. Mostly in 30's. That's what allowed me to take him to ER. He was dizzy and would fall if I was not there to catch him. This is what the cardiologist explained to us. He said when thallium stress done, heart rate would go to 130-140's. He said the ICD would help correct this problem if his heart didn't correct itself. Explained it heart was allowed to continue beating at that rate it could and possibly kill him. He too has cardiomyopathy. If heart didn't convert on it's own, then and only then, would the shock be given. He explained it would feel like someone had kicked him in abdomen. He explained it was like insurance...if you need it, it's good to have it. If you never need it, you wonder why you took in first place. Said there was another way we could look at it. Would be great if needed and he had it, bad if he needed it and had chosen not to have it. So in a sense it would be like insurance. The pacer on his ICD was set at 65. At next visit they set it at 70. Long story short, he had ICD placed the end of Jan. '10.His heart rate is regular rate 65-70. At times I can sill feel heart skipping beats with large space between. It's then that pacer kicks in and he's back on the right track. His real problem is SOB. Refuses oxygen. I have news for him, after next MD visit, he WILL be on oxygen.
You asked if the shock from the ICD, would further damage the heart. I am not sure. I do know that if you should need the shock and no ICD, I think you know the answer. In my opinion, and I base this on what the doc told us, then I came up with this, and they agreed. The damage to the heart from A-Fib, would be far greater than the damage from the shock. Gosh, I am sorry for going on and on. Hope I haven't scared you. Would really encourage you to ask your cardiologist these questions. He would be the best to answer them. Like I said, I have given my opinion. Not sure about transplant. I would go with answer above for that question. Hope I have been able to shed some light, at least in the smallest of ways.
Blessings,
Madlyn
In January, My husband was told he had 30% EF. His heart rate was mostly between 30-50. Mostly in 30's. That's what allowed me to take him to ER. He was dizzy and would fall if I was not there to catch him. This is what the cardiologist explained to us. He said when thallium stress done, heart rate would go to 130-140's. He said the ICD would help correct this problem if his heart didn't correct itself. Explained it heart was allowed to continue beating at that rate it could and possibly kill him. He too has cardiomyopathy. If heart didn't convert on it's own, then and only then, would the shock be given. He explained it would feel like someone had kicked him in abdomen. He explained it was like insurance...if you need it, it's good to have it. If you never need it, you wonder why you took in first place. Said there was another way we could look at it. Would be great if needed and he had it, bad if he needed it and had chosen not to have it. So in a sense it would be like insurance. The pacer on his ICD was set at 65. At next visit they set it at 70. Long story short, he had ICD placed the end of Jan. '10.His heart rate is regular rate 65-70. At times I can sill feel heart skipping beats with large space between. It's then that pacer kicks in and he's back on the right track. His real problem is SOB. Refuses oxygen. I have news for him, after next MD visit, he WILL be on oxygen.
You asked if the shock from the ICD, would further damage the heart. I am not sure. I do know that if you should need the shock and no ICD, I think you know the answer. In my opinion, and I base this on what the doc told us, then I came up with this, and they agreed. The damage to the heart from A-Fib, would be far greater than the damage from the shock. Gosh, I am sorry for going on and on. Hope I haven't scared you. Would really encourage you to ask your cardiologist these questions. He would be the best to answer them. Like I said, I have given my opinion. Not sure about transplant. I would go with answer above for that question. Hope I have been able to shed some light, at least in the smallest of ways.
Blessings,
Madlyn
ICD will shock your heart when there is a serious arrhythmia to get the heart to beat normally. There should't be any damage to your heart with a shock. It is not possible to know the prognosis, but the odds would be better with an ICD than without. You can search the archives for information regarding heart transplant and who may be waiting, etc.
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