Electrophysiologist If I had known

I did not even know there was a distinction. I had my pm put in a week ago. Had a problem with spasms at the hospital. St Judes guy says it is the pacemaker turn voltage down. I feel no better than before. I have like a 7th sense when things are not right. Everybody disappears and I am released from hospital. That was Wednesday last week.

Called on Monday and told them I wanted pacemaker interrogated. They did not call me Back . I called on Tuesday and said nobody had called me. Wednesday morning I receive a call and missed it. I call right back and told secretary she said she would leave a message. Well 5 hours go by and I call again this time I am pissed. Nurse calls back in 5 minutes. Told here what I wanted she sets appointment for today at 3:00. Get a call at 5 now this has turned into a visit from my doctor also today which could not be done.

I go to appointment and tell him he needs to turn it up and turn some of the functions on or why even have a pacemaker. I also told him I downloaded manual and had read and researched it. Auto capture was not on and heart rate was static at 60 voltage had been turned down from 2 volts to 1. So he cranks it up and set it to allow my heart rate to go up depending what I am doing. Etc.

No w I can hear doctor asking him down the hallway what he thought. I heard some mumbling but that was it. I am moved to another room . Blood pressure is 178/80 bad ekg machine is brought in. I am hooked up and we do an ekg. Doctor comes in and tell me a lead to the heart is not working and is loose. I asked how did that happen . He started with did you wear your sling I told him of course I did what didn't he do. He said that is really bad for him, I look at him and say really and it is not for me? He says well he supposed so but I get to have it fixed. Well he says 1 out of 10 of leads fail. Apparently this lead did and now he wants to schedule me for a screw in type.

Ok, I am spooked. He wants a redo Monday. I am thinking if it was so bad for him........... It is my life I check his credentials. He runs a Cardiology Suit with about 8 other doctors. They are cardiologist and electrophysiologist and he is not. I have a name of Cardiologist that was recommended by a Cardiology operating nurse and he has all the proper board certifications and is a electrophysiologist board certified in 2004. Should I tell my doctor who is just to busy sorry I need a second opinion or just pray?

I choose whom I employ based on ratings. There are none on Doctors. We have no idea how many surgery's they have done or redo's. Being from Texas they could carve your heart out and let you die and the max it would cost them is 150k. Thanks Republicans against lawsuit abuse.

I really want this over. I have never been in a hospital in my adult life. They scare me even more now. How can he tell if a lead is loose without a x ray? I can see it on my ekg that the two leads are not communicating. Maybe he did not tighten a lead properly?????

Somebody give me some insight as my nightmares have come true even with the best research.

9 Comments

You are right.

by Gotrhythm - 2014-07-11 01:07:20

You're angry and you should be. If I'm reading you correctly, the anger is not primarily about the lead, although that's bad, but about the fact that your problem has not been attended to in any reasonably expeditious manner.

Based on my experience re: EP, I would say you need one. I messed around for 2 years with my cardiologist giving her the benefit of the doubt, until I caught one of her staff in a lie covering for her. THEN I demanded the referral I should have gotten long before.

The fact was my pacemaker problem was beyond her level of expertise. She didn't have a clue. Instead of admitting that, she decided I was a crock, and as often as possible shuffled me to the back of the deck. Like you, my tipoff should have been the non-returned phone calls.

I'm not bashing all cardiologists. I'm sure some of them do have expertise with pacemakers. I'm just saying that EPs for sure have the education, and a lot more experience with PMs.

I hope you find the help you need, soon, and that soon, you get to enjoy the very real improved quality of life a PM can offer.

Electrophysiologist all the way.

by LizzieB - 2014-07-11 02:07:14

I wouldn't want anyone who wasn't a specialist in electrophysiology putting in my pacemaker. If I'm reading everything above correctly, it sounds like he's just a cardiologist? They're just so much more familiar with the electrical workings of your heart, and I imagine they do a lot more pacemakers than a run of the mill cardiologist. If I were you I would find an electrophysiologist, shop around, find one you like. If you don't feel like your doctor is smart enough to be your doctor then you can't trust them. If he's putting in leads wrong, I wouldn't go back to him. It's a red flag for sure. I also had a cardiologist who botched a surgery by not doing the proper tests before hand, and I certainly never went back to him. If he's too busy to really pay attention to you, if he's not invested, and interested, and attentive you need to find someone else. He won't take it personally, as you've said he's too busy. Find yourself a good specialist in electrophysiology and go from there. If a doctor doesn't have time for you, you aren't in safe hands. Mine called me this afternoon from his cell just to check up, and I got a full conversation like I would in the doctors office without having to drive, make an appointment, or ask. You need a doctor with time for you, who cares, and is comfortable with pacemakers. If you can't find any good resources online I would go to one of the waiting rooms in the hospital where they're doing stress tests, echo's, and that sort of thing. Just ask if anyone has an electrophysiologist that they really like. You could also ask your primary care doctor, or any other specialists you might have if they have recommendations for one. Or, if you have tests done, you can always strike up a conversation with the tech and find out who their favorite doctors are, and how they feel about yours. I always get my best doctor gossip during stress test prep. Also, a little praying never hurt. I'm sorry you're having such a rough time, I'll definitely be keeping you in my prayers.

Dislodged lead

by golden_snitch - 2014-07-11 03:07:55

Hi!

Behaviour is the one thing - and I understand that your cardio acts really strange -, BUT a dislodged lead can happen to anyone, even the most experienced cardios and EPs. It is not his fault, and not yours, either, it just happens. If you read the consent you signed carefully, it was listed as a possible complication. I guess, I'll never understand how people can sign that stuff, and then when something that was listed happens, they blame it on the doctor. A pacemaker surgery is not completely risk/complication free. And a dislodged lead happens more often than you would think.

You don't need an x-ray to tell that a lead has become dislodged. There are certain pacemaker parameters that allow you to make this diagnosis. A dislodged lead often fails to capture = it does not stimulate effectively. You see that it paces, but the impulse doesn't make the atria or ventricles contract. That's because there is no contact between the tip of the lead and the heart muscle.

I really dislike this "cardio bashing". There is a posting, if you scroll further down the recent messages, that is about cardios vs. EPs. Most comments, including mine, take the opinion that one should not discredit cardios doing pacemaker implants. They usually have the proper training to do the implants. You cannot become an EP, without having become a cardio first. And pacemaker implants are part of the training when you specialize in cardiology.

Hope you feel better after the lead has been put back in place.

Best wishes

Inga

2 pacemaker operations in 10 day

by jpotts - 2014-07-11 05:07:50

I value all opinions. I could be cardio bashing but I never liked mine even though it is not a prerequisite. I just wanted the most capable person doing the work. I failed myself by not turning over more stones. I was too busy with other commitments. It could have turned out the same even if I had used a more qualified Electrophysiologist Cardio Doctor. My problem was everyone said they would be back and nobody came back. I was left with a half set pacemaker not doctor around. I called nurses station and asked where they were she did not know. I called again and asked where doctor was and she said that she would call him and poof I was discharged. I wanted to jump on the bed and yell this thing is broken will somebody please show up and do their job. It would have been much less painful to go back up and replace the lead that day for me but they were not thinking of me...................

Yes if possible I will change to an Electrophysiologist , hopefully this one will be available, listen to my concerns. No I do not read the fine print absolving them of all sins. What is the use they have you over a barrel. My attorney always says you really do not want to read that.

So yes I am the 1% or less that it happened to. Mad, yes and venting should I trust him ever again I guess the saying goes s_ _ _ _ me once shame on you s_ _ _ _ me twice shame on me. Did they know something was wrong, yes. I did. I took me 3 days to get back in. I guess the disclaimer on their voice system if this is an emergency dial 911 covers it all. Maybe this time I will get it right. I have learned a lot.


Thanks for all the well wishes.




Jim

I am lucky

by Lurch - 2014-07-11 09:07:31

My Primary Care Physician (my new one after I fired my old one) is very involved, listens and will research if he doesn't have the answer right away. He recommended my Cardiologist who recommended my EP. I trust his recommendations.

That wasn't the case with my old Primary Care Doctor. He just seemed to go through the motions, seeing me every six months and having blood work done. This after me having an MI 16 years ago. Well, it was my fault for not taking action sooner, but I finally fired him and got another doctor.

My new doctor was shocked that I hadn't seen a Cardiologist in over 10 years and sent me immediately (insurance requires referral). He did the standard tests and found an EF of less than 30%. After more tests and workups I ended up with my ICD

If you are uncomfortable with your medical team and/or don't trust them, fire them and found a team you do trust! I finally realized it is up to me to hire the team I trust!

Good luck and hope it all works out for you.

Had to have my PM redone

by Sue66 - 2014-07-12 03:07:35

I am home 2 weeks from getting my PM, and I went in on a Monday to get it done. My Cardiologist called in the top guy to do it, and Tues when they checked it the one lead came loose. He said this can happen, and he had to put it in another way. I went back into Surgery on Tues afternoon, and its been working fine ever since.
I am having some other issues that they want to check out on me, but the nurses had told me that this can happen and its not unusual to have to go back in again.
If you have the right doctor doing your procedure, you will be fine.

EP all the way

by Marie12 - 2014-07-12 04:07:55

I was in an excellent Cardiac Unit for 13 days and was cared for by five different cardiologist. Not a one of them would implant the ICD until the EP came back from vacation. Two told me they could do it but preferred to wait for the specialist. They felt as long as I was monitored at the hospital, it could wait. Glad I did. The EP was amazing. Confident, relaxed and you could definitely tell he knew what he was doing.

A little research always helps

by jpotts - 2014-07-12 05:07:21

Ok, there seems to be a difference in research data on pacemaker implant problems verses types of certifications. I tried to find a more current version but none was found. Ep vs cardios overall 3.5 vs 4 % so there is a 12.5% difference overall here in the US.

http://www.math.com/students/calculators/source/3percent.htm



General link for
Board Certified Electrophysiologists vs not certified complications

https://www.google.com/webhp?sourceid=chrome-instant&rlz=1C1SAVU_enUS540US540&ion=1&espv=2&ie=UTF-8#q=Board+Certified+Electrophysiologists+vs+not+certified+complications

graphs and charts and percentages verses certified

http://www.medscape.com/viewarticle/701705

I had to do it all over I would use a ep but if everyone used one then they would need more. LOL . Looks like I am stuck with Cardio on Monday again unless I want to wait 3+ weeks for an appointment. Maybe I can force them to do an x ray and tell me if it is loose floating around in the atrium. Options, if it is attached It can wait if not it can cause damage.

Great I am glad it work well

by jpotts - 2014-07-13 05:07:47

I was ignorant and did not know about EP's. I was thinking old school that they were only Cardiologist. As electronics and electrical devise evolve so did the need for EP. They have taken the time and effort to become board certified as a specialist in surgery dealing with pacemakers and the hearts electrical system. It requires at least 2 more additional specialty years of education and passing a comprehensive test.

In a perfect world Cardiologist could do it but what happens if there is a complex problem? So if you want it done right always seek out the best person for the job. Had I not joined this board I would be pretty much ignorant of distinctions. I hope all will share their knowledge with friends, associates and this forum. With knowledge we are not sheep to be herded but can make informed decisions for ourselves.

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