Biotronik Edora dr-t
- by Monmon
- 2019-12-22 11:53:41
- General Posting
- 1044 views
- 12 comments
I was recently admitted in the Emergency of NCH here in Naples, FL. for high fibrillation (my Edora does not care about that !). They are know to have a very good cardiology service but at my great surprise, they dont have the necessary material to read my Edora. So the doctor let me go... Is this happening in other places ? Thank you. Ray.
12 Comments
Biotronik Edora dr-t
by Monmon - 2019-12-23 13:05:36
Thank you so much for your answer, AgentX86.
Yes, it was AFib but as I'm new in that field (1 year), I didn't know that it is not dangerous when the heart beats less that 100p/min. I apparently panicked without reason and went in ER on the advice of a nurse. Next time, I'll stay home quietly. About the Biotronik Edora, I contacted the company and wait for their explanation: them too were surprised and told me that they were very present in USA. To be continued...
Biotronik Edora dr-t
by Monmon - 2019-12-23 15:39:44
In Canada (Hôpital de Hull in Gatineau, QC) in Nov. 2018.
High heart rates
by AgentX86 - 2019-12-23 20:49:37
Yes, heart rates under 100bpm are benign. The risk of higher heart rates is cardiomyopathy but this is a long-term problem. A few hours isn't going to hurt anything. Some people keep a beta blocker and perhaps an antiarrhythmic drugs with them. If they start into Afib, they taket the pill(s) to try to convert back or at least to control the heart rate. This known as "pill in the pocket" (duh).
The big risk is blood clots (and the strokes these can cause). An anticoagulant is about all you can do to eliminate clots. There really isn't much an ER can do, other than convert you back to NSR. This isn't an emergency to an ER probably isn't the best place to go (and unnecessarily expensive).
I'd discuss this with your EP. Your situation may not be the norm and he may have a different plan for you. In any case, you should have a plan so an Afib episode doesn't panic you. That won't help. BTW, I wish my EP had discussed this with me earlier. I've gone to the ER a few times myself but they didn't do much except charge a *lot* of money.
Good to read your comment
by Monmon - 2019-12-23 22:02:24
I would wish my EP give me as much info as you did. Thanks again. I had a DCCV 3 years ago. That was spectacular: my heart came back to normal instantly. Unfortunatly it only lasted a few months. Now at 81, I'm taking Xarelto 20mg daily + sotalol 80mg twice a day. When my heart beats normally (3/4 of time), I'm in a great shape, playing tennis or pickleball daily. Very expensive indeed in USA (no insurance): the 4 hours I spent at ER costed me already closed to $2,500 and I expect other bills. BTW Merry Christmas!
Merry Christmas!!
by AgentX86 - 2019-12-24 11:27:45
Yes, ERs are expensive. They should only be used for emergencies, when you're going to die without immediate intervention. A better place for such things is an "immediate care" clinic. They'll be about 1/10 the cost and they can quicly tell if it's truly an emergency and get you there quicly with *lights flashine". Mostly what you see in ERs around here is druggies looking for a quick fix. Downtow, there are three within a two miles. It's known as "pill hill" for a reason.
Insurance... I may be missing something here but that $2500 will go a long way to a Medicare suppliment plan that would cover almost all of your expenses (the donut hole will still be painful).
Insurance
by Monmon - 2019-12-24 12:08:59
I really appreciate this info, AgentX86 (sounds like James Bond).
As a Canadian citizen, I'm totally covered in my country but not here. So it will be totally out of my pocket. (Original bill was $5,500 ! They got me a 60% discount if I pay soon). I take it as my 2019 special Christmas -gift... who prevents me to make gifts to my family members ;-) It is what it is: why complain?
Merry Christmas to all PM holders. Sursum corda!
Snow Bird
by AgentX86 - 2019-12-24 20:06:08
Got it. Sorry for that. Note that the 60% off is about what the insurance companies reimburse them under their contracts. The whole system is screwed up but it's mostly because government keeps meddling.
Not James Bond. More "Get Smart" meets Intel. ;-) Long story.
Sursum corda ...by the pacemaker? ;-) (Orthodox?)
Merry Christmas to all!
Snowbird Pacemaker Issues?
by Marybird - 2019-12-26 22:23:54
Monmon, sounds as though you are a Canadian snowbirding in Naples and went to the NCH ER in afib/tachycardia. You have a Biotronic Edora pacer, which you were informed at this hospital ER they don't have the equipment to interrogate or get any information from, so they couldn't help you with that and dicharged you. Sound right?
As I understand it your Canadian insurance will not pay for medical care in the US, and even travel insurance (which I understand some Canadian snowbirds get to cover the "emergency" medical care they may get here) will not pay for pre-existing conditions, so you are likely to be charged as a self-pay patient for ER visits here. Though as you found out, they will likely give you a substantial discount for paying the bill yourself.
I'd assume you had your pacemaker implanted at home in Canada and are followed by a cardiology practice/cardiac device clinic for your pacemaker activity and afib there. My suggestion would be to contact them to get instructions in the event you have problems while you are in Florida. Perhaps they can give you the name and address of a facility here in southwest Florida that does have access to interrogation equipment for your Biotronic Edora. I'm a little surprised that NCH did not, but perhaps up the road some at the Lee Memorial Health hospitals you might have better luck if you need something. In any case you could be prepared.
Good luck, Mary
Traveling with a Biotronik device- travel guide
by IPGENG12 - 2019-12-27 14:26:48
Hi, I was thinking about your experience with going into the ER at the hospital in Naples, Florida and them not being able to interrogate your device.
Biotronik has a website where you can find clinics/hospitals worldwide which do Biotronik implants: https://www.biotronik.com/en-us/patients/travel-guide
I've used this to pre-plan visits in Asia and Europe just in case there is some trouble. I checked the region around Naples, FL and the hospital you went to (NCH) is listed there, so I'm thinking there was some disconnect with the ER not being able to get the programmer delivered from the Electrophysiology department. There is also a heart rhythm Doctor's group a few blocks from the NCH which does Biotronik implants.
Sorry to hear about the insurance hassles. The system here in the US leaves a lot to be desired. I had a left ventricular lead extraction and repositioning done on my system 2 yrs ago where the initial hospital bill was 185 K$, that was then negotiated down to 21K$ by my insurance company. Just insane!
Have a great New Year!
A snowbird with a PM but without wings
by Monmon - 2019-12-29 10:14:45
Thank you Mary and IPGENG12 for your comments and explanations. I checked on the website you mentionned and, yes, you are right :they should have what it needs to interrogate my PM. I'm still waiting for the Biotronik response. In the mean time, bills continue to arrive. The last one ($2,071.00) from a strange location called PLANTATION BILLING CENTER for Physician Services rendered at NCH: Emergency Dept visit: $1,889.00 + Electrocardiogram Report: $91.00 (twice = $182.00). I don't know when this serie will stop...I saw this doctor for 2 minutes.
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Kinda surprising
by AgentX86 - 2019-12-23 11:36:29
It's surprising in one way and not so much in another. It's surprising that they can't read any PM that comes into the ER, though it's understandable that they wouldn't have anyone on staff that was trained in Biotronik pacemakers if all the hospital did was Medtronic, for example. Since it's an ER, they may not have been able to get a Biotronik representative on site in the time that you were in the ER, as well. They should have been able to direct you to someone who could help, though.
You don't say what sort of fibrillation you were experiencing or much of your history (Afib, I assume). If it was Afib, there's nothing important that your PM could tell them about it. The obect is to get the heart rate down under 100bpm. As long as you're on anticoagulants, there isn't anything else that they can do, other than do a DCCV. They're unlikely to do that without more information. That's best left to your cardiologist or electrophysiologist.