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ICD versus standard pacemaker for my 3rd.
Just turned 80 with 2 heart attacks, 2 double bypasses 1983 and 2007. Am scheduled for a 3rd pacemaker (6/04, 9/09) since my EF has gone from .38 to .27. Drs are recommending the more complex ICD versus a simpler pacemaker and additional lead that would stimulate both sides of heart to get bi-ventricular pacing. The 6/04 installation was non trivial and I'm not anxious for complications coming from a more complex operation.
Does anyone know what likelihood of the defibrillator being activated i.e. being used? Versus likelihood of complications in the installation procedure?
If feels like the safe thing is to give everyone an ICD versus a pacemaker that will give me bi-ventricular pacing versus one-sided pacing I do now that supposedly caused EF to get lower.
3 Comments
ICD vs CRT-D
by Tracey_E - 2014-08-21 09:08:57
Adding a new lead is a bit more complicated than simply replacing the generator, but it's not a big deal and is not considered risky. As Lurch pointed out, most shocks save lives, so if it goes off, it's well worth any trouble it took to get it.
ICD's serve a different function than a bi-ventricular pm. A CRT-D is a bi-vent with an icd, sounds like that's what they want to give you. Right now, you have a two lead pm. It's job is to keep your rate up appropriately and to keep the ventricles in sync with the atria. It just makes the heart go faster.
The CRT adds the second ventricular lead so it forces the two chambers to beat in sync. This can make your heart beat more efficiently, bring up your EF.
ICD is there to shock you out of a dangerously fast rhythm. Given your history, it's not a surprise they want to add this along with the CRT. I don't have statistics but I believe CRT-D are much more common than just a CRT. It's just another layer of precaution, the super deluxe insurance policy.
Yes
by Grateful Heart - 2014-08-21 10:08:54
Like Tracey said, the CRT-D (bi-ventricular ICD) will cause your ventricles to beat in sync, most likely helping your EF since it has decreased.
As far as the defibrillator firing, I have had mine for 5 years with no incidents as far as shocks.
I feel like I have been saying that a lot here lately....so now I am getting nervous....LOL.
Judging from your EF changes, I think you would benefit from the CRT-D.
Grateful Heart
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by Lurch - 2014-08-21 08:08:13
On another forum I visit they did a poll; only 5% had received what they considered an "inappropriate shock." However, 22% had received an "appropriate shock." So that tells me that you are four times more likely to receive a life saving shock versus a mistake.
Those are pretty decent odds...
Granted it was not a scientific poll, but rather questions posed to folks who have an ICD and are members of that forum.
As far as I know (limited experience) the installation procedure is pretty much the same.
if it works once correctly, it is worth it!