Electrophysiologist or Cardiologist

Does it matter whether a cardiologist or electrophysiologist does the surgery? The doctor I saw is a certified cardiologist, but not an electrophysiologist. He said he was grandfathered into doing pacemakers and has done 9,000 of them. Should I go with only someone who is certified as electrophysiologist?

7 Comments

RE: It depends on....

by Cecil Demill - 2011-07-18 01:07:22

Hi Dawn, thanks for your reply. What are the advantages of submuscular? I asked my cardiologist about getting that and he said, "that's for girls." I was worried about how it looks under the skin. I also play sports and wonder about protecting the PM from impacts.

It depends on your situation

by DawnM - 2011-07-18 01:07:38

I personally am glad I have an electrophysiologist, but cardiologists perform this procedure routinely. I'm an RN and worked on a cardiac floor for a few years. I have worked with some very well known cardiologists in my town, whom I have cared for their patients post implant in the hospital, and have seen good results. However, my personal experience was different, so I'm a little partial to EP's. It all depends on the complexity of your cardiac issues, but I think most important is the doctor's experience, as I wouldn't have a new EP, with little experience, have inserted my PM. My EP has performed thousands of these procedures. If you're having your PM implanted submuscular (which I highly recommend), make sure your doctor has plenty of experience implanting this way.

Just for girls?

by DawnM - 2011-07-18 03:07:46

Cecil,
I agree with Tracey. Submuscular isn't just for girls. I've seen some PM's implanted just under the skin, where they are very noticeable. If you are concerned at all with the esthetics of the PM (male or female), I highly recommend implanting under the muscle. The healing may be a bit longer, but well worth it. I'm 8 weeks post implant, and my PM isn't noticeable at all under clothing (even snug clothing) and my incision is very small, not even detectable under a swimsuit strap. Implanting under the skin is easier and faster, but if you find an experienced doctor willing to implant under the muscle, I don't think you'd be disappointed.
Dawn

depends

by Tracey_E - 2011-07-18 08:07:22

You don't necessarily have to have an ep but you might want one. My first 3 were done by a cardiac surgeon. My last one was done by an ep. My cardiologist does not do surgery so he's always referred me out when it's time to replace. I wanted the ep this last time because I needed a new lead and I wanted it done by someone who does pm's all day long, not the occasional one.

Submuscular is not just for girls! Submammary is just for girls lol. Subpectoral is for anyone who wants to be active and not have the pm in the way. Healing time is a bit longer but in the end it usually turns out to be more comfortable. If your dr gives you any hassle about doing it this way, to me that would be a red flag to go get another opinion.

Contact sports?

by Pacemakerman - 2011-07-19 01:07:21

I'm not sure what sport you are speaking of but I would exercise caution on that. Contact sports that run a risk of impact to the pacer site should be avoided. It is possible to fracture a lead and fixing that is a major procedure. Sub muscular or not, the leads are the week link in the system. Make sure you doc knows that you plan on engaging in such activities.

Muscle Damage?

by DawnM - 2011-07-19 11:07:13

I have been seeing the EP who implanted my PM for the past 3 years and I have complete trust in him. He was the one who recommended the submuscular implant, knowing how concerned I was with the esthetics of a PM. He did tell me that healing would take a bit longer, but no negative effects of implanting under the muscle. At 6 weeks post PM, I was cleared to resume all normal activities, including exercising with weights. The one caution he gave me was to avoid exercises to the pectoral muscles, such as the bench press or push ups, as this would put too much stress on the leads. I still have occasional tenderness around the incision site, but no unusual muscle soreness (even after what I would consider a pretty intense arm work out with free weights). Good luck with whatever you decide.

Muscle Damage

by Cecil Demill - 2011-07-19 12:07:05

The cardiologist said that implantation under the muscle can cause muscle damage. He said that just under the skin won't be noticeable. Is he just saying that because it's easier for him to implant it just under the skin?

I'll be doing some contact sports so I do want the extra padding, but also lift weights so I'm worried what it could do to the muscle.

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