Havent seen a cardiologist in 15 years

I had a syncopy issue which caused me to pass out on rare occasions when my vegas nerve was overstimulated.  Since I had great insurance I said yes to having a PM installed.  That was 2004 and almost as soon as I went back to work I got laid off.  I went back to the cardiologist so many times to have them turn it down - it would activate and drive me bonkers just getting up to get a drink.  Finally they told me it was at its lowest setting.

I moved across the country and got on with life.  I became accustomed to it and then never bothered finding a new cardiologist.  I cant believe its been so long but i've never since had any passing out issues - maybe the PM is doing its job or maybe I grew out of the problem - I'm 58 now and wondering if the battery could start to leak at some point and cause serious problems.  Any ideas?

I know - GO FIND A CARDIOLOGIST!!  And I will, but now Im just looking for info.



by AgentX86 - 2020-01-27 23:24:09

First of all, you need an electrophysiologist, not a cardiologist.  Cardiologists are plumbers.  You need an electrician. 

Your pacemaker is almost certainly kaput but it's not going to leak.  You still should get it checked out ASAP.

Old Pacemaker

by Good Dog - 2020-01-28 09:13:23

Yes, the previous response is correct. You really must get checked-out for your own safety. However, keep in mind that many cardiologists are also electrophysiologists. My doc is listed as a cardiologist and you have to search for the fact that he has a specialty in electrophysiology. 

Battery leak

by Selwyn - 2020-01-28 12:14:45

Never! Case within a case. 

Had mine 12 years to date. The record is over 26 years.

I rest my case.

Cardiologist v Electrophysiologist

by IAN MC - 2020-01-28 12:29:31

I do wonder about the accuracy of their statements  when people say you must see an EP and not a cardiologist  or " cardiologists are plumbers ". This really is an over-simplification.

My understanding has always been that Electro physiology is a branch of cardiology .  An EP is a cardiologist.  Cardiologists are not all plumbers. My EP is a type of cardiologist . Cardiologists specialise in different branches of cardiology but they are all " cardiologists "

My EP calls himself a " Cardiologist " and he is not a plumber.

Just to confuse matters there are " interventional cardiologists " who carry out some surgical procedures e.g. stents and yes, sometimes pacemaker implants !  When it comes to ablations though , further EP training is essential . This is just my understanding ...........

Could one of our 2 regular medical contributors please give a view on this. Maybe terminology varies between countries.   Thanks



I suspect that the USA habit of abbreviation is a factor here

by crustyg - 2020-01-28 14:03:27

Looking at some of the local hospitals around me, all of the docs who specialise in cardiac rhythm management appear as Cardiologist with a sub-speciality in Electrophysiology, but I don't think that means that they insert stents into coronary arteries as well.

You know how in the USA they never use two words when one will do (in back, instead of in the back), or even more letters than necessary (math, not maths).  And since the above super-specialisation seems to be pretty complete, it makes sense to me that EP docs specialise in rhythm management and cardiologists are interventional, plumbing types.  I daresay that some of the older generation of docs might take umbrage at my sweeping generalisation, but I for one would *never* let a part-timer try and place a CRT wire into my coronary sinus (or remove a well bedded-in cardiac lead).  I would be wary of any heart doc who claims to cover all of this - you really want someone who does a *lot* of these procedures, of whatever type.  And in the USA this is an EP doc.

There are heart docs who specialise in structural problems especially in the young, and they may not do a lot of stenting, and they call themselves cardiologists - but they are still focussed on structural and not electrical management (except perhaps congenital CHB in youngsters).


Electrophysiologist vs cardiologist

by AgentX86 - 2020-01-28 14:04:07

Yes, an EP is a cardiologist with two years more residency in electrophysiology. It's a sub-specialty. However, cardiologists are not equipped to handle arrhythmias and fewelectrophysiologists have the experience to deal with blockages, stents, and other "plumbing" issues. My cardiologist is an interventional cardiologist (who originally found my blockages via a catheter) but referred me to an electrophysiologist as soon as the basic AF treatments failed. When they failed, or more precisely were causing more problems than they were solving, she referred me to the top electrophysiologist in the area. He may be a cardiologist and knows his way around a catheter but wouldn't even consider doing a stent. You choose the specialist with not only the book learning but the experience for the job at hand. Cardiologists only have so much when it comes to electrical problems in the heart.

Strange you slipped through the net

by Gemita - 2020-01-28 16:38:39

Hello Bruceomaha,

yes do get that PM checked.  Can't understand how you could have been ignored all these years.  Surely someone other than yourself should have been responsible for following up on their PM recipients.  PM company, clinic, consultant ??  It really sounds so unprofessional, but I guess you too had a certain amount of responsibility!

On the subject of cardiologist/EP, my EP runs a clinic on Mondays for arrhythmia patients and on Tuesdays for patients with structural heart disease.  He is both a consultant cardiologist and a consultant EP and many of his colleagues also run clinics in both specialities too.  My EP clearly has expertise in both areas I have no doubt.  I can only assume from the number of NHS patients waiting to be seen by a cardiologist/EP, consultants are in short supply in relation to patients needing treatment and consultants certainly do not always have the luxury of specialising in one area alone.  Hopefully that doesnt make them any less of a consultant?  Indeed my consultant is frequently happy to carry out nursing duties also when he has to

from original poster

by BruceOmaha - 2020-01-28 16:54:23

Thanks everyone for your comments.  I will keep the electrophysiologist point in mind when I start navigating the insurance / primary care physician / consultant referral maze of red tape.  I guess the main thing I was checking for was if I would see a hair-on-fire exhortation to run, not walk, to the nearest emergency room.  Doesn't sound like that's the case, and that's what I thought but smarter people than me have done far more stupid things.

As far as slipping through the cracks goes, it rather surprised me as well.  I mean, I accept responsibility for my own health care of course, but I am a little disappointed that nobody bothered to check up on me.  I bet they would have if I was making payments.  To be fair, on one hand I did move halfway across the country almost immediately after surgery.  But on the other hand, I did see a cardio once immediately after moving here, and I did log in to check out a recall notice (my serial number was not listed).  Seems that if anyone was looking for me they would have flagged the serial number for follow up if an inquiry was made.  I mean, I did register with my email.

In any case, thanks again for your thoughts on this.  I appreciate you.

Maybe it's still working?

by BruceOmaha - 2020-01-28 16:58:35

Since they turned the sensitivity down to as low as possible, perhaps I will set a record for the longest lasting Kappa KDR701 PM

I know, that along with a couple dollars will get me a cup of coffee.

What are cardiologists?

by Selwyn - 2020-01-29 13:06:03

I can only speak for the UK.

After general medical training ( 7-8  years if you include medical school), there is specialist training in cardiology ( usually another 6 years).

Of those cardiologists some will go onto specialise within the field ( often still having an interest in general cardiology. 

So we have:

General cardiologists

Paediatric cardiologists

Congenital heart disease cardiologists

Electrophysiology cardiology

Interventional cardiologists 

Ultrasonography cardiologists. 

and probably a few more that I have never come across. I am waiting to see someone specialising in genetic cardiology. 

So, my general cardiologist ( pacemaker insertion and arrhythmia noted) referred me to an electrophysiology ( Ablation and pacemaker) cardiologist, who referred me to an interventional cardiologist ( stent). .My electrophysiologist referred me to an ultrasonography cardiologist ( further diagnosis), and a genetic cardiologist.

From primary care ( general practice), I was referred to secondary care ( the local teaching hospital) to see a general cardiologist, and thence to tertiary care ( a specialist hospital dealing with heart and lungs). 

As medicine has progressed in its knowledge base there has been a huge expansion into specialisation within my lifetime.  In the UK tertiary centres are regional centres, here in Liverpool the Liverpool Heart and Chest Hospital draws patients from all over the North West of England. A general practitioner cannot refer directly to a tertiary centre.

Within medicine in the UK, where income is not dependent on patients seen,  it is quite common for one consultant to consult another consultant within the same speciality. Each to his own.  This can sometimes result in fragmentary care- the general practitioner ( usually the family's doctor)  holds it all together for the patient in a holistic manner. People are registered with a general practitioner who has a 'list' of patients and the opportunity to know you and your family as a person, sometines over 30 years. 

As Clint Eastwood says, " A man ( lady) must know their limitations".

Confucius Quote: "To know that we know what we know, and that we do not know what we do not know, that is truely to know".

Therein lies the skill of a good doctor, and even perhaps those that contribute to this club!


Same here

by Lady Lee - 2020-01-30 18:08:51

I had a pm for 17 years it ran on reserve mode.  I never had it checked but went to see general medical and he said my pulse was in the 50s and he urged me to go to ER I did and was admitted and pm was changed. I suggest you get it checked! (pm does not leak)

You know you're wired when...

Bad hair days can be blamed on your device shorting out.

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