Making the right decision

Hi, My husband is getting a heart catherization next week. Depending on the results, the Dr. will decide whether he will get a defib/pacemaker. He has already had 2 bypass surgeries & has a pacemaker. His heart is only working at 20%. I'm worried that the stress of the test & putting in a new pacemaker might be too much. Wondering if going through this is a good decision? Thanks for any replies.

7 Comments

Defib decision

by ElectricFrank - 2012-12-07 01:12:14

With his history of heart problems either way is risky. Just be sure it is being done by a cardiologist or E.P. who has lots of experience, and in a hospital with a good record.

One consideration is that the cath and defib represent a one time risk in a medical facility. The lack of a defib if needed would be a continuing risk in an unknown environment.

best wishes to both of you,

frank

Making right decision

by Ladybug42 - 2012-12-07 01:12:15

Thanks for the comments. My husband is 70yrs.old. He seems to be doing alright., except shortness of breath. I questioned the Echo tests, but, he had 2 & both came up the same EF 20%). If the cath. shows another blockage, that will be another thing to consider. They don't want to do a third bypass surgery. I appreciate the replies. I've been having problems coping with this. It's a help to know others are in the same place in life.

different problems

by Tracey_E - 2012-12-07 03:12:55

How efficiently the heart beats is different from blockages. EF is a measurement of how strongly the heart beats, how much blood is ejected out with each beat. Blockages are what's encountered when the blood leaves the heart. Blockages or no, if the heart isn't pumping out the blood, he's not going to have as much energy. Assuming he's pacing, the pm keeps his beat from getting too low but it can't make the heart beat harder. The CRT can synchronize the left and right ventricles, forcing them to beat together which means an improved EF which means more energy, less SOB, etc.

A defib means his chances of surviving a heart attack or sudden cardiac death increase dramatically.

Please correct me if I'm wrong but I'm hearing that your husband is doing pretty well aside from 2 bypasses which means he's not particularly high risk for a minor surgery, and he's not that old so he can have a lot of good years ahead of him. Sometimes it's hard to see the forest for the trees- a minor surgery now can mean a better quality of life as well as peace of mind. If the dr recommends upgrading his device, I'd look at it as an insurance policy, you can sleep better at night knowing his odds of surviving another cardiac event are a lot higher. If it was my dad, I'd be pushing him to do it as long as another blockage wasn't complicating things.

Fingers crossed they don't find another blockage, or if they do they can fix it with a stent or balloon.

risk

by Tracey_E - 2012-12-07 10:12:39

As Frank said, having an icd cuts way down on the risk, and the surgery risk is minimal. Have they discussed a CRT-D? It's a defib with 3-lead pm that synchronizes the ventricles and can increase EF. If he's going to have the surgery anyway, he may be a candidate for this.

And it's not the dr's decision, it's ultimately up to you and your husband if the potential for increase in quality of life and safety is worth it. All the dr can do it give you an idea how it can help and make his recommendation. Don't let them pressure you. Good luck to you both.

Information helpful

by Ladybug42 - 2012-12-07 11:12:28

Thanks TraceyE. You explained it better than the Dr. He does get tired, but once he rests- gets better. He suffered from sleep apnea for years & has finally gotten that diagnosed and treated. I think that has helped .I am feeling more optimistic now that I have heard from you & others. So appreciate it! We'll go next week to get the heart cath. Depending on the results---go from there. I will read these messages to him. I think it will help him to hear about others with a similiar problem. If & when I have a medical issue---it will be great to know someone out there cares. Take care all of you. I'll let you know how it turns out.

Update

by Ladybug42 - 2012-12-16 01:12:22

My husband had the heart cath. According to the Dr., his by-pass from last year had collapsed. A nuclear stress test told them there was dead heart muscle. They decided there was nothing else to be done,except for the defib-pacemaker. Just found out, a test in May showed he had a problem .Seems like they waited too long. I wonder if the defib.-pacemaker is the answer, if they can't fix the by-pass. It is scheduled to be installed next week. Appreciate some opinions.

Update on installing ICD

by Ladybug42 - 2012-12-22 10:12:04

My husband had his new defib-pacemaker installed. He had a few complications & it took longer than expected. His shoulder & arm are sore, but so far, everything is going OK.

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